Gulf War and Health Volume 4: Health Effects of Serving in the Gulf War (2006) / Chapter Skim
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2 Exposures in the Persian Gulf
2 Exposures in the Persian Gulf
Pages 21-44
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From page 21... ...
EXPOSURE ASSESSMENT IN EPIDEMIOLOGIC STUDIES As described in more detail in later chapters, most of the Gulf War literature is based on veterans' reports of their own exposures. In addition, many studies report the prevalence of specific health outcomes or clusters of outcomes among Gulf War veterans; those studies might or might not compare prevalence with that of control groups.
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list of 7,691 people who were vaccinated at least once. The list was compiled from several sources and is the largest compilation of Gulf War veterans identified as receiving anthrax vaccination.
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(2004a) specifically asked Australian Gulf War veterans to refer to their own immunization booklets for information regarding the number and timing of immunizations relative to their Gulf War deployment.
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Exposure to Depleted Uranium The validity of self-reported exposure to DU can be evaluated on the basis of measurement of urinary uranium. Uranium activity decreases over time, but it has a very long radiologic half-life (4.5 x109 years for U-238)
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Those studies clearly indicate that a high frequency of Gulf War veterans report a large number of exposures but provide little information regarding the validity or magnitude of the exposures. Studies that compared self-reported exposure frequencies with exposure of control groups are more informative.
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Given that the simulation studies demonstrate the potential for high exposures to combustion products (some of which are similar to those in the oil-fire smoke plume) , exposures to tent-heater emissions could modify or potentially confound the assessment of associations between oil-well fire smoke exposure and respiratory outcomes.
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, and Bernard Rostker, of DOD, used models to estimate ground-level concentrations of sarin and cyclosarin as a function of distance and direction from the detonation sites and then to estimate the extent of potential exposure of US military personnel to the nerve agents (PAC 1996a)
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Table 2.1 and the chronology that follows describe the evolution of those approaches to estimate potential exposures. It must be noted, however, that in no cases were sarin and cyclosarin measured, although a Czechoslovak chemical-decontamination unit did detect sarin in areas of northern Saudi Arabia within the timeframe of the Khamisiyah demolition, which suggested that sarin was released into the air.
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Revision included updated meteorologic and dispersion models incorporating dilution, deposition, and degradation terms; revised emissions estimates from the CIA, and improved troop location information and specificity (Model 1 determined
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. · DOD's estimate of the troop number possibly exposed increased by about 2,000.
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EXPOSURES IN THE PERSIAN GULF 31 Day 1 1997 Model SOURCE: Rostker 2000. Day 1 2000 Model SOURCE: Rostker 2000.
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32 GULF WAR AND HEALTH Day 2 1997 Model SOURCE: Rostker 2000. Day 2 2000 Model SOURCE: Rostker 2000.
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EXPOSURES IN THE PERSIAN GULF 33 Day 3 1997 Model SOURCE: Rostker 2000. Day 3 2000 Model SOURCE: Rostker 2000.
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34 GULF WAR AND HEALTH Day 4 1997 Model SOURCE: Rostker 2000. Day 4 2000 Model SOURCE: Rostker 2000.
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Most important, the revised model included more-specific information regarding the location of individual military units at the time of the Khamisiyah explosion and added information on Air Force personnel that was not included in the original estimates. In the earlier (1997)
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Even if the final model can be accepted as an accurate determination of exposure, an important problem for epidemiologic studies has been introduced by the numerous notifications to veterans regarding potential exposure to agents released from Khamisiyah. Given that the sequential notifications went to different people, under any of the more recent modeling scenarios there will be people who were previously notified as being exposed but who will be considered unexposed on the basis of model results.
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Most of the oil fires were still burning when measurements began. Individual fires created distinct smoke plumes over short distances, but over longer distances the plumes merged into one "supercomposite" plume about 40 km wide south of Kuwait City.
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. The reference category of no exposure accounted for 16.8% of the 405,142 study subjects (75% of the active-duty deployed Gulf War veterans)
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(2004b) reported the results of urinary uranium measurements for a total of 446 Gulf War veterans, including 169 veterans with no known friendly-fire involvement but self-reporting of other potential DU exposures.
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. In summary, results of detailed surveillance indicate persistently increased urinary uranium in a very small number of subjects with embedded DU-containing shrapnel.
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2005. Mortality in US Army Gulf War Veterans Exposed to 1991 Khamisiyah Chemical Munitions Destruction.
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1999b. The postwar hospitalization experience of Gulf War Veterans possibly exposed to chemical munitions destruction at Khamisiyah, Iraq.
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2001b. Surveillance of depleted uranium exposed Gulf War veterans: Health effects observed in an enlarged "friendly fire" cohort.
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1998. Health status of Persian Gulf War veterans: Self-reported symptoms, environmental exposures and the effect of stress.
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