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EDITORIALS: Melissa A McDiarmid Depleted uranium and public health BMJ 2001; 322: 123-124 [Full text]

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Depleted Uranium use still suggest risks

Gino Spinelli   (19 January 2001)

Depleted uranium and radiation dose measurement

Richard F Mould   (19 January 2001)

DU: A short bibliography to understand the issue

Marco Saba   (21 January 2001)

hogg wash

Terry Walker   (21 January 2001)

Is it morally defensible?

Cory Mermer   (21 January 2001)

Embarrassing Standard of Reporting in UK Media

Barry Marshall   (22 January 2001)

Related worker studies on DU

Thurman B Wenzl   (23 January 2001)

Whose perspective is important in the DU debate?

Nick Emmel   (24 January 2001)

Late Twentieth Century Health

John Fryer   (26 January 2001)

Risks to uranium process workers

Robert Alvarez   (29 January 2001)

Untitled

H Al-Sardar   (4 February 2001)

DU: Epidemiology or Medicine?

John Michael Williams   (13 April 2001)

Depleted Uranium use still suggest risks 19 January 2001
Gino Spinelli, Professor of Microbiology University of Bari Send response to journal: Re: Depleted Uranium use still suggest risks	Sir The recent claim on your Journal by Professor McDiarmid suggest a poor scientific approach in discussing the problems connected to the use of Depleted Uranium as a weapon in several conflicts. I'll focus the attention on main aspects of this poor approach. The number of cases reported is too small to claim for excluding any effect of DU in generating cancer. In fact only 60 cases are considered between US Gulf war veterans, where there are many independent reports which claim for an actual Gulf war syndrome with thousands of cases reported and hundreds of dead. It is well known that independent reports are not easly accepted by official Journals and also not financied. This does not means that they are less scientifically signi- ficant and should be ignored by the scientific community. For this reason I'll not put any reference in this response in open polemic with official claims that there is no a Gulf war syndrome. Should be noted that about sixty years of studies on the effects of radiations have only one result which is clear and definitive: exposure to any radioactive material is cause of mutations in DNA sequence, chromosome break and many other phenomena connected to DNA mutagenesis. The DNA mutagenesis is the only cause of cancer both spontaneous and provoked by mutagenic substances. The small energy associated with Uranium 238 decay which is the main component of Depleted Uranium does not exclude any mutagenic effect especially if inhaled. It is important to distinguish between mine workers and people exposed to Depleted Uranium weapons. In fact Uranium 238 is pyrophoric and burns easily when exploded. This suggest that a oxide of Uranium is formed when this metal is used as a weapon component. Is there any study on the biological effects of such Uranium oxides? Several lines of evidence lead me to suggest that Depleted Uranium should be considered dangerus and potentially mutagenic especially when distributed in enormous amounts in a war scenario. Moreover there is a recent claim by the Italian Government that Depleted Uranium is not the only component of NATO weapons. In fact Minister of Italian Defence has claimed that Plutonium may also be present in small amount in DU weapons. Plutonium is formed spontaneously in Uranium mines as well as in nuclear reaction. Plutonium is much more radioactive and much more toxic. These claims have been scientifically and independently evaluated? In conclusion of this short note I would like to draw the attention on the fact that listing 11 references on a topic so vast and important with a conclusion that there are no evidence of cancer in using Depleted Uranium is antiscientific and superficial. Where the claim is that 50 years' study show non correlation with cancer, my claim is that 60 years' study on radiactivity effects on Human Health strongly prove that there is a correlation between the use of any radioactive material and cancer. Gino Spinelli Geneticist, Professor of Microbiology University of Bari
Depleted uranium and radiation dose measurement 19 January 2001
Richard F Mould, MSc (Nuclear Physics) PhD (Cancer statistics) formerly Director of Medical Physics, Westminster Hosp Retired [Home address] 41 Ewhurst Avenue, South Croydon, Surrey CR2 0DH Send response to journal: Re: Depleted uranium and radiation dose measurement	EDITOR-McDiarmid has raised the topic of depleted uranium (DU) in her BMJ editorial [1] and whilst agreeing that there is no justification for any claims of radiation induced lung cancer and leukaemia in Gulf War veterans she has made no mention of how individual radiation doses can actually be measured in any screening programme for Gulf war and Balkan veterans. This is important not only for the peace of mind of the veterans but also for medico-legal purposes. For due process of law in the Courts of the USA and the United Kingdom where at present some veterans are taking legal action for possible radiation induced illnesses, DU must first be 'ruled in' before being 'ruled out' if the doses are found to be too low level. Global dose estimates or results of mathematical modelling are too inaccurate to be used as dose values for an individual veteran. To date no practical method has been proposed for the measurement of the expected small doses received by veterans. I would suggest that electron paramagnetic resonance (EPR) dosimetry using tooth enamel would be appropriate. This technique has already been used for some of the 1986 Chernobyl accident clean-up workers and evacuees from the 30 km exclusion zone [2]. EPR dosimetry using tooth enamel has also been used for some of those exposed in the Techa river area and Mayak facility in the eastern Urals where Soviet nuclear warheads were produced for many years, resulting in widespread contamination. This was reported by a group at the Institute of Metals in Ekaterinburg [3]. This Ekaterinburg EPR dosimetry research and development has continued in Gaithersburg at the US National Institute of Standards and Technology (NIST) to where some of the Ekaterinburg scientists have relocated [4]. The NIST group can now measure EPR dose estimates down to a level of 20 milliSievert [2]. Moreover, NIST are organised such that they can if requested, undertake EPR tooth enamel dosimetry from any sources, including European veterans. This was confirmed to me by the NIST Chief of the Ionising Radiation Division [5]. Hence there is at least one centre which is able to be incorporated into any screening programme for veterans and as the technology becomes more widely available it can be expected that more facilities will be suitable for this form of low level radiation dosimetry. Richard F Mould radiation scientist & cancer statistician 41 Ewhurst Avenue, Sanderstead, South Croydon, Surrey CR2 0DH United Kingdom richardfmould@hotmail.com ------------------- 1. McDiarmid MA. Depleted uranium and public health. BMJ 2001;322:123-4. 2. Mould RF. Chernobyl record: the definitive history of the Chernobyl catastrophe. Bristol: Institute of Physics Publishing, 2000, pp. 158-64, Electron paramagnetic resondance dosimetry with tooth enamel. 3. Romanyukha AA, Ignatiev EA, Degteva MO, Kosheurov VP, Wieser A, et al. Radiation doses from the Ural region. Nature 1996;381:199-200. 4. Desrosiers MF, Romanyukha AA. Technical aspects of the electron paramagnetic resonance method for tooth enamel dosimetry. Biomarkers: medical and workplace applications. Washington DC: Joseph Henry Press 1998:53-64. 5. Coursey B. Personal communication at NIST. 1999. CONFIRMATION I confirm that I have no completing interests and for example that I am not employed as a consultant to NIST. I only correspond and exchange academic papers with NIST.
DU: A short bibliography to understand the issue 21 January 2001
Marco Saba, Researcher Ethical Environmental Observatory Send response to journal: Re: DU: A short bibliography to understand the issue	A short bibliography to better understand the DU-round Issue: Nuclear Regulatory Commission on DU hazards - ANNEX D-1 AMXBDC-X 229 - STANDING OPERATING PROCEDURE FOR HANDLING, USE AND STORAGE OF URANIUM AND THORIUM - 11 February 1966 Hanson, Wayne C. Ecological Considerations of Depleted Uranium Munitions, LA-5559. Los Alamos, NM: Los Alamos Scientific Laboratory, June 1974 Environmental Assessment - Depleted Uranium (DU) Armor Penetrating Munitions for the GAU-8 Automatic Cannon, Development and Operational Test and Evaluation, AF/SGPA, April 1975 Elder, J.C., M.I. Tillery, and H.J. Ettinger. Hazard Classification Test of GAU-8 Ammunition by Bonfire Cookoff with Limited Air Sampling, LA- 6210-MS, Informal Report. Los Alamos, NM: Los Alamos Scientific Laboratory of the University of California, February 1976 Prado, Captain Karl L. External Radiation Hazard Evaluation of GAU-8 API Munitions, TR 78-106. Brooks Air Force Base, TX: USAF Occupational and Environmental Health Laboratory, 1978 Bartlett, W.T., R.L. Gilchrist, G.W.R. Endres, and J.L. Baer. Radiation Characterization, and Exposure Rate Measurements From Cartridge, 105-mm, APFSDS-T, XM774, PNL-2947. Richland, WA: Battelle Pacific Northwest Laboratory, November 1979 Gilchrist, R.L., J.A. Glissmyer, and J. Mishima. Characterization of Airborne Uranium From Test Firings of XM774 Ammunition, PNL-2944. Richland, WA, Battelle Pacific Northwest Laboratory, November 1979 Davitt, Richard P. A Comparison of the Advantages and Disadvantages of Depleted Uranium and Tungsten Alloy As Penetrator Materials, Tank Ammo Section Report No. 107. Dover, NJ: US Army Armament Research and Development Command, June 1980 Ensminger, Daniel A. and S.A. Bucci. Procedures to Calculate Radiological and Toxicological Exposures From Airborne Release of Depleted Uranium, TR-3135-1. Reading, MA: The Analytic Sciences Corporation, October 1980 Elder, J.C. and M.C. Tinkle. Oxidation of Depleted Uranium Penetrators and Aerosol Dispersal at High Temperatures, LA-8610-MS. Los Alamos, NM: Los Alamos Scientific Laboratory of the University of California, December 1980 Chambers, Dennis R., Richard A. Markland, Michael K Clary, and Roy L. Bowman. Aerosolization Characteristics of Hard Impact Testing of Depleted Uranium Penetrators, Technical Report ARBRL-TR-02435. Aberdeen Proving Ground, MD: US Army Armament Research and Development Command, Ballistic Research Laboratory, October 1982 Hooker, C.D., D.E. Hadlock, J. Mishima, and R.L. Gilchrist. Hazard Classification Test of the Cartridge, 120 mm, APFSDS-T, XM829, PNL- 4459. Richland, WA: Battelle Pacific Northwest Laboratory, November 1983 Mishima, J., M.A. Parkhurst, R.L. Scherpels, and D.E. Hadlock. Potential Behavior of Depleted Uranium Penetrators under Shipping and Bulk Storage Accident Conditions, PNL-5415. Richland, WA: Battelle Pacific Northwest Laboratory, March 1985 Wilsey, Edward F. and Ernest W. Boore, Draft Report: Radiation Measurement of an M1A1 Tank Loaded with 120-MM M829 Ammunition. Aberdeen Proving Ground, MD: US Army Ballistic Research Laboratory, July 1985 Magness, C. Reed. Environmental Overview for Depleted Uranium, CRDC- TR-85030. Aberdeen Proving Ground, MD: Chemical Research & Development Center, October 1985 Scherpelz, R.I, J. Mishima, L.A. Sigalla, and D.E. Hadlock. Computer Codes for Calculating Doses Resulting From Accidents involving Munitions Containing Depleted Uranium, PNL-5723. Richland, WA: Battelle Pacific Northwest Laboratory, March 1986 Haggard, D.L., C.D. Hooker, M.A. Parkhurst, L.A. Sigalla, W.M. Herrington, J. Mishima, R.I. Scherpelz, and D.E. Hadlock. Hazard Classification Test of the 120-MM, APFSDS-T, M829 Cartridge: Metal Shipping Container, PNL-5928. Richland, WA: Battelle Pacific Northwest Laboratory, July 1986 Hooker, C.D. and D.E. Hadlock. Radiological Assessment Classification Test of the 120-MM, APFSDS-T, M829 Cartridge: Metal Shipping Container, PNL-5927. Richland, WA: Battelle Pacific Northwest Laboratory, July 1986 Life Cycle Environmental Assessment For the Cartridge, 120MM: APFSDS- T, XM829. Picatinny Arsenal, NJ: US Army Armament Research, Development and Engineering Center, Close Combat Armament Center, December 12, 1988 Parkhurst, M.A. and K.L. Sodat. Radiological Assessment of the 105- MM, APFSDS-T, XM900E1 Cartridge, PNL-6896. Richland, WA: Battelle Pacific Northwest Laboratory, May 1989 Wilsey, Edward F. and E.W. Bloore. M774 Cartridges Impacting Armor-Bustle Targets: Depleted Uranium Airborne and Fallout Material, BRL-MR-3760. Aberdeen Proving Ground, MD: Ballistic Research Laboratory, May 1989 Erikson, R.L., C.J. Hostetler, J.R. Divine, and K.R. Price. Environmental Behavior of Uranium Derived From Depleted Uranium Alloy Penetrators, PNL-5927. Richland, WA: Battelle Pacific Northwest Laboratory, June 1989 Fliszar, Richard W., Edward F. Wilsey, and Ernest W. Bloore. Radiological Contamination from Impacted Abrams Heavy Armor, Technical Report BRL-TR-3068. Aberdeen Proving Ground, MD: Ballistic Research Laboratory, December 1989 Hadlock, D.E. and M.A. Parkhurst. Radiological Assessment of the 25-MM, APFSDS-T XM919 Cartridge, PNL-7228. Richland, WA: Battelle Pacific Northwest Laboratory, March 1990 M.A. Parkhurst, J. Mishima, D.E. Hadlock, and S.J. Jette. Hazard Classification and Airborne Dispersion Characteristics of the 25-MM, APFSDS-T XM919 Cartridge, PNL-7232. Richland, WA: Battelle Pacific Northwest Laboratory, April 1990 Kinetic Energy Penetrator Long Term Strategy Study (Abridged), Final Report. Picatinny Arsenal, NJ: US Army Production Base Modernization Activity, July 24, 1990 Jette, S.J., J. Mishima, and D.E. Haddock. Aerosolization of M829A1 and XM900E1 Rounds Fired Against Hard Targets, PNL-7452. Richland, WA: Battelle Pacific Northwest Laboratory, August 1990 Munson, L.H., J. Mishima, M.A. Parkhurst, and M.H. Smith. Radiological Hazards Following a Tank Hit with Large - Caliber DU Munitions, Draft Letter Report. Richland, WA: Battelle Pacific Northwest Laboratory, October 9, 1990 Memorandum for SMCAR-CCH-V from SMCAR, Radiological Hazards in the Immediate Areas of a Tank Fire and/or Battle Damaged Tank Involving Depleted Uranium, Letter Report, Picatinny Arsenal, NJ, December 4, 1990 Mishima, J., D.E. Hadlock, and M.A. Parkhurst. Radiological Assessment of the 105-MM, APFSDS-T, XM900E1 Cartridge by Analogy to Previous Test Results, PNL-7764. Richland, WA: Battelle Pacific Northwest Laboratory, July 1991 Parkhurst, M.A. Radiological Assessment of M1 and M60A3 Tanks uploaded with M900 Cartridges. PNL-7767. Richland, WA: Battelle Pacific Northwest National Laboratory, July 1991 Life Cycle Environmental Assessment for the Cartridge, 105MM: APFSDS- T, XM900E1. Picatinny Arsenal, NJ: US Army Armament Research, Development and Engineering Center, Close Combat Armament Center, August 21, 1991 Life Cycle Environmental Assessment For the Cartridge, 120MM: APFSDS- T, XM829A2. Picatinny Arsenal, NJ: US Army Production Base Modernization Activity, February 2, 1994 Parkhurst, M.A. and R.I. Scherpelz. Dosimetry of Large Caliber Cartridges: Updated Dose Rate Calculations, PNL-8983. Richland, WA: Battelle Pacific Northwest Laboratory, Reissued, June 1994 Parkhurst, M.A., G.W.R. Endres, and L.H. Munson. Evaluation of Depleted Uranium Contamination in Gun Tubes, PNL-10352. Richland, WA: Battelle Pacific Northwest Laboratory, January 1995 Parkhurst, M.A., J.R. Johnson, J. Mishima, and J.L. Pierce. Evaluation of DU Aerosol Data: Its Adequacy for Inhalation Modeling, PNL-10903. Richland, WA: Battelle Pacific Northwest Laboratory, December 1995
hogg wash 21 January 2001
Terry Walker, gulf war veteran home Send response to journal: Re: hogg wash	dear sir/madam as a gulf war veteran, and have been tested pos for D.U in Canade i find it hard to belive in what as been said. in a memorandum from the DoD date 16 Aug 1993 on depleted uranium. during peace time, exposure must be kept as far below the NRC limits (specified in exposure to DU in table 11 of the Code of Federal Regulations, 10CFR20, Appendix B to part 20.1001 thru 20.2401, page 23409, Federal Register, May 21,1991.) as is reasonably achicvable. there are no comparable limits for wartime. whan soldiers inhale or ingest DU dust, they incur a potential increase in cancer risk. the magnitude of that increase can be quantified ( in terms of projected days of life lost) if the DU intake is known ( or can be estimated). so who is telling the truth? terry walker Gulf war veteran.
Is it morally defensible? 21 January 2001
Cory Mermer, Researcher/Writer Send response to journal: Re: Is it morally defensible?	While McDiarmid maintains that there is no conclusive scientific evidence of adverse effects of depleted uranium, this certainly does not mean that its safety is PROVEN. Without such proof, it is should not be morally acceptable to use depleted uranium in ANY military applications. By polluting the ecosystems of other nations, we are essentially committing war crimes against the women, children, and all civilians of these countries. I am no expert on this subject, but I would think that such actions would go against international law. If strengthing metals is an acceptable use for depleted uranium, why not use them domestically in items such as cars, cookware, and dental amalgams? Simply put, if a nation is not willing to fertilize its own soil, treat its own water, and pollute its own air with depleted uranium, then it should not be doing so to others.
Embarrassing Standard of Reporting in UK Media 22 January 2001
Barry Marshall, Professor of Microbiology University of Western Australia Send response to journal: Re: Embarrassing Standard of Reporting in UK Media	Dear Sir/Madam, It is refreshing to see a reasoned response to the depleted uranium stories I have been seeing in the media. As one of millions who recieve international news from Sky News and BBC World Service, I have been amazed at the way they seem to retransmit press releases without proper scientific review. As long as a perceived danger is present, stories are sent out with no fact checking, raising the biased opinions of people who know nothing to those of international scientific experts. When I see these stories I always recall the scene in Monty Python's "The Holy Grail" as the rabble tries a witch.. A filthy peasant (John Cleese) "She turned me into a newt!" silent pause for 3 seconds... "but I got better!". I guess things haven't changed much in England over the past 1000 years.
Related worker studies on DU 23 January 2001
Thurman B Wenzl, Research Industrial Hygienist NIOSH Send response to journal: Re: Related worker studies on DU	Readers may be interested to know of a few worker populations with exposures to airborne DU that are similar to those in Kosovo; at least one has been studied with published results available. Since uranium metal is pyrophoric, meaning that chips can easily ignite - some of the US Department of Energy workers have been exposed to oxides of DU in the machining of metal slugs (cylinders) at the Fernald facility in Ohio. (They were also exposed to external radiation and perhaps radon.) One of these published papers is: Ritz B. Radiation exposure and cancer mortality in uranium processing workers. Epidemiology 1999; 10:531-538. The data used by Ritz is also available through the Comprehensive Epidemiology Data Resource (CEDR) at http://cedr.lbl.gov/ This study and its predecessors don't 'prove' that the DU in Kosovo caused or did not cause leukemia, but they may be informative for any feasibility efforts that are underway. The usual disclaimers apply; these are only my own thoughts, and not those of my employer.
Whose perspective is important in the DU debate? 24 January 2001
Nick Emmel, Teaching and research fellow Nuffield Institute for Health, University of Leeds Send response to journal: Re: Whose perspective is important in the DU debate?	McDiarmid’s contribution to the depleted uranium (DU) debate (1) once again raises particular problems that arise from rather specific definitions of health. On the one hand, and exemplified below, is the 'medical experts' response to risk, through the careful weighing up of epidemiological evidence. On the other hand, there are the lay-perceptions of the soldiers, humanitarian workers, and their families, of the chronic health effects that have arisen from contact with DU shells, and possibly, other toxic substances while serving in the Gulf or the Balkans. It is notable that McDiarmid goes out of her way to belittle lay- perceptions, arguing that 'lack of familiarity' leads lay observers, and some experts, to seek inappropriate causality. The overwhelming message from this piece is that those who are raising questions about DU should show deference to the authority of epidemiological science. Certainly, when confronted with the barrage of evidence that is placed before us in this paper, it is most easy to demur to this authority. However, this particular debate, and others that have gone before such as the chronic health effects for residents of Camelford following the accidental contamination of their water supplies with aluminium sulphate (2), suggest that epidemiology may well not have the tools to really understand the relationships between causative agent and chronic disease processes and disability. What is most evident in this editorial is a strong message telling those who have a rather different perspective on their ill-health to be quiet. This DU debate raises important issues. First, we must question who controls the findings and conceptualisation of epidemiological research. This means we should question what we are told are facts, and ask questions about what criteria are being applied and by whom. This in turn leads to questions about whose perspective is most legitimate in any particular given situation. Inevitably, setting such a train of questions in motion raises issues relating to disagreements over cause and effect; and conflict based on different interests. While an editorial, such as this one, may seem to close the door on further debate, we must recognise that a biomedical and epidemiological view of health may not be the most appropriate one, and there may well be other explanations, experiences and perceptions that should inform the debate. (1) McDiarmid MA Depleted uranium and public health Fifty years' study of occupational exposure provides little evidence of cancer BMJ 322:123-124 2001. (2) Williams G and Popay J Researching the people's health: dilemmas and opportunities for social scientists. in Popay J and Williams G (eds.) Researching the people's health. Routledge. London. 1994.
Late Twentieth Century Health 26 January 2001
John Fryer, Retired Scientist Home Send response to journal: Re: Late Twentieth Century Health	It is good to debate the health effects good or bad of uranium. My knowledge is not as extensive as Melissa McDiarmid and we rely on her and others to warn us of any dangers from being exposed to uranium. Does she take responsibility for harm if it is proved to be dangerous to ingest uranium into our lungs? Does she take responsibility if farmers in the polluted areas suffer illness? She likens uranium to lead and arsenic - does she imply that like uranium, lead and arsenic are also harmless? The radiation from uranium is puny and weak, true - but surely this puniness and weakness mean that the effect is concentrated on the immediate cell or cells? The body is magnificent at recovery from mutations, but like chemical toxicity there are 50% and 1% levels where fatal results occur. At what level do we accept that uranium is 'harmless'? We live in a world where radioactive pollution has been occuring for 50 years - where do the controls live? Has lung cancer not increased in line with our expansion in the use of radioactive elements? Rather than look at masses of data and find no worries, shouldn't we look at individual cases and study them in some detail. Not only is this more cost effective, more thorough, but we may also see what her studies do not :- That harm accrues from the misuse of harmful materials. John Fryer
Risks to uranium process workers 29 January 2001
Robert Alvarez, Director, Nuclear Policy Project Institute for Policy Studies Send response to journal: Re: Risks to uranium process workers	In her review of the risks of depleted uranium to occupational groups, Dr. Mc Diarmid concludes that "Fifty years' study of occupational exposure provides little evidence of cancer." Curiously, McDiarmid does not mention a special and very prominent review of Department of Energy occupational epidemiological studies undertaken at the request of the President in July 1999. ( National Economic Council,Interagency Working Group No. 1, January, 2000). This review made a special effort to search out published and unpublished papers, which were not readily available in the literature. Over the years, several important papers sponsored by the DOE that reported significant risks associated with workplace exposures at U.S. nuclear weapons sites were not published and remained buried. The IOM study apparently could not perform the kind of literature review relative to occupational epidemiologic studies of uranium process workers that was done for the White House in early 2000. Had they done so, perhaps they may have come to different conclusions. A careful review of the interagency report would have revealed significant findings relative to uranium-exposed workers. For instance: Oak Ridge Y-12 weapons Plant, Tennessee. Total mortality was low as expected for this group, indicating a "healthy worker effect." The study also found elevated death rates for brain cancer, several lymphopoetic (immune system) cancers, as well as cancers of the prostate, kidney and pancreas. Excess death from breast cancer among women was found. The authors found excess lung cancer as their main finding and urged that this disease warrants continued surveillance An earlier study found similar risks, with a marginal dose-response trend for lung cancer only. (Dana P. Loomis and Susanne H. Wolfe, Mortality of Workers at a Nuclear Materials Production Plant at Oak Ridge, Tennessee, 1947-1990, American Journal of Medicine, 1996, 29:131-141,Harvey Checkoway, Neil Pierce, Douglas J. Crawford-Brown, and Donna Cragle, Radiation Doses and Cause-Specific Mortality Among Workers at a Nuclear Materials Fabrication Plant, American Journal of Epidemiology, 1998, 127:2:255-266.) The K-25 Gaseous Diffusion Plant, Tennessee. Excess risks of dying from all causes were found for white males when compared to general population rates. Other statistically significant increases among white males were for cancers of the respiratory system, bone cancer, mental disorders and all respiratory diseases including pneumonia. Generally the excess deaths from diseases among females were similar to males. Upon further analysis, increased risks of dying from kidney cancer and chronic nephritis (kidney disease) was found. The latter condition was more than 600 percent higher when deaths from the last decade of followup was observed.(Elizabeth A. Dupree, Susan M. Wells, Janice P. Watkins, Phillip W. Wallace, Nancy C. Davis, Mortality Among Workers Employed between 1945 and 1984 at a Uranium Gaseous Diffusion Facility, Draft Report, Oak Ridge Institute for Science and Education. ( no date)) Fernald Uranium Processing Plant, Ohio. Significant increased risks of dying from stomach cancer were found among salaried workers (261 percent higher than expected). For hourly workers statistically significant increased death risks were found for all cancers (21 percent higher) and lung cancer (26 percent higher). The authors concluded that there is evidence of a radiation-dose relationship for both nonmalignant respiratory diseases and lung cancer. (Donna L. Cragle, Janice P. Watkins, J. Nicholas Ingle, Kathryn Robertson-Demers, William G.. Tankersley, Charles M. West, Mortality Among a Cohort of White Male Workers at a Uranium Processing Plant: Fernald Feed Materials Production Center [FMPC], Radiation Research ( not sure if it is published)) Linde Air Products Co., NY. Statistically significant increased risks of dying from all causes (18 percent higher), laryngeal cancer (447 percent higher), all circulatory diseases (18 percent higher), arteriosclerotic heart disease (19 percent higher), all respiratory diseases (52 percent higher) and pneumonia (217 percent higher) were found among workers who processed uranium at this facility between 1943 and 1949. (Elizabeth A. DuPree, Donna Cragle, Richard, W. McLain, Douglas Crawford-Brown, M. Jane Teta, Mortality among workers at a uranium processing facility, the Linde Air Products Company Ceramics Plant, 1943- 49, Scandinavian Journal of Worker and Environmental Health, 1987, 13:100- 107.) Mallinkrodt Chemical Works, Missouri. Workers who processed uranium between 1942 and 1966 were found to have a significant increased death rate from all cancers (10 percent higher). Respiratory diseases, chronic nephritis/kidney disease (218 percent higher) and lymphatic cancers were significantly elevated. In particular, significant increased risks were found for cancers of the esophagus (40 percent higher), rectum (45 percent higher), pancreas (31 percent higher), larynx (36 percent higher) kidney (34 percent higher) and multiple myeloma/bone marrow (33 percent higher). Kidney cancer showed a significant positive dose-response association with external radiation. (E. DuPree Ellis, J.P. Watkins, J.N. Ingle, J.A. Phillips, External Radiation Exposure and Mortality Among a Cohort of Uranium Processing Workers, Oak Ridge Associated Universities, Oak Ridge TN, (unpublished report). It is remarkable that this White House review was not mentioned by McDiarmid since it recieved widespread attention as it prompted the Department of Energy to officially concede on January 29, 2000 that it's nuclear weapons workers were placed at risk of increased disease and death. This Presidential review also served as an underpinning for the recent creation of a major worker compensation entitlement program by the U.S. Congress -- which specifically grants a non-rebuttable presumption for 22 listed cancer to uranium process workers exposed to recycled uranium,(contaminated with isotopes such as plutonium-239, neptunium-237, and Tectnicium 99) which now apparently has been measured in depleted uranium found on the battlefields of the Balkans and the Persian Gulf. Robert Alvarez (Senior Policy Advisor, U.S. Secretary of Energy 1993-1999)
Untitled 4 February 2001
H Al-Sardar, specialist registrar James Paget Hosp Send response to journal: Re: this article	The Editor, BMJ. DR H AL-SARDAR Dept. of Cardiology Dear Sir James Paget Hospital Great Yarmouth NR31 6LA E-mail h.alsardar@ntlworld.com 23.1.01 THE ILL EFFECTS OF DEPLETED URANIUM I read the article (Depleted uranium and public health) by professor McDiarmid with interest. Unfortunately she didn’t mentioned facts about what Iraqis have suffered from exposure to very high level of depleted uranium. She has almost led people to believe that depleted uranium is as safe as exposing your self to a shower gel! There was no evidence because there was no clinical research into possible links. The observations from Iraqis showed clear evidence that there is almost certainly a connection between ill health and the exposure to depleted uranium. The effect on Gulf war veterans and Balkan peacekeepers might be little, as the exposure was not as high as the nations subjected to the explosion. The veterans and peacekeepers were not at the same distance as the Iraqis or Serbs were from the site of the explosions, nor the intensity of the dust containing the particles of the uranium was the same. Holding or getting close to the missiles containing depleted uranium is not dangerous, but it is worrisome is the explosion of these missiles. When they hit their targets they create a dust containing particles of insoluble uranium dioxide, which was the potential hazard. These particles once interned the body; scavenger cells will take them to the lymphatic system. The particles of the depleted uranium emit alpha particles. Each alpha particle is capable of causing a tremendous damage to the surrounding tissues. Obviously, the veterans were not in the close proximity to the sites of the exploded targets. It was the Iraqis and Serbs who were at the centre of the explosions. Some targets were hit several times, either because they were tactically important or were missed in the initial attempts, by tons of the missiles creating a huge clouds with great potential of contamination to the environment and most importantly the humans. The incidence of unexplained illnesses are markedly increased in Iraq. The number of cases of cancers and leukaemia’s particularly among the children has almost trebled since the Gulf war. The evidence from the research works in the post war period showed clearly, that the only agent to be blamed for the higher incidence of the cancers, is the depleted uranium. References: 1.McDiarmid AM, depleted uranium and public health. BMJ 20 Jan. 2001,322:123-4 2.Garfied R, Zaidi S, Lennock J.medical care in Iraq after six years of sanction. BMJ 1997,315:17475. 3.O’Kane M. Did we do this? Gardian 1998; 21 December. 4.Stott R, Holdstock D. WHO should undertake full inquiry into Gulf war illness. BMJ 22 May 1999; 318:1422. 5.Sikora K. Cancer services are suffering in Iraq.BMJ 16 Jan 1999; 318:203.
DU: Epidemiology or Medicine? 13 April 2001
John Michael Williams, President Markanix Co. Send response to journal: Re: DU: Epidemiology or Medicine?	I thought the editorial by Melissa A. McDiarmid was, as Alvarez points out, poorly reasoned and incomplete. More directly, should medical opinions firmly be held on the basis of census results, opinion polls, demographics, or other government concerns? The editorial was quite clear by standards of a bill introduced to a legislative body for further compromise and amendment. Do we really want a "Battle of the Statistics" to take over from physical examination or simple laboratory experimentation? The Oracle of Saint Compilus says uranium is not bad for us, just as surely as the heart is the seat of all feelings? The major factor in the danger from alpha emitters, such as uranium, is that the damage is localized near the substance in the body, and that therefore the physical location in the body must be weighted with the greatest importance. In particular, imagining all the DU to be dilutely distributed through the body or specific tissues thereof, leads to one analysis, while imagining that it might be in even tiny fragments of a microgram or more leads to others. All reports of the radiation danger agree that keeping a macroscopic fragment of DU near the skin (not even borne internally), will be harmful. There have been only about two laboratory studies in all "50 years" of the effects of DU on animals, and they were not able to study long term (~decades) effects. One recent result on rats is that uranium, as opposed to inert control metal, caused sarcoma when implanted as fragments in muscle. This is reported at MedScape (http://www.medscape.com/reuters/prof/2001/01/01.25/20010124scie002.html). It is a US Army-funded experiment. The larger the fragment, the greater the number of tumors. Read it. The author(s) are responsible persons, not patients who vanish into the night, leaving only someone elses count of themselves. What does this mean? To me, it means that uranium is at least as harmful as arsenic or tungsten. Being radioactive would make it more chemically toxic (because of radiation through passive oxide layers), and of itself a greater danger than could possibly be a nonradioactive metal of the same chemistry.