Epidemiologic Studies of Veterans Exposed to Depleted Uranium Feasibility and Design Issues (2008) / Chapter Skim
Currently Skimming:
4 Conclusions and Recommendations
4 Conclusions and Recommendations
Pages 41-48
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 41... ...
to assess fully whether DU exposure is associated with health outcomes. For example, the Depleted Uranium Follow-Up Program includes extensive assessment of DU dose and health outcomes, but it is limited by the small study population (fewer than 100 veterans)
|
From page 42... ...
The chapter concludes with recommendations aimed at improving future epidemiologic studies and identifying current active-duty military personnel and veterans with potential DU exposure. PROPOSED APPROACHES TO THE STUDY OF HEALTH OUTCOMES OF EXPOSURE TO DEPLETED URANIUM As summarized in Table 4-1, the committee examined four general approaches to study health outcomes related to DU exposure in military and veteran populations.
|
From page 43... ...
or before analogous for controls, including information from timepoint for controls, including existing questionnaires, interviews, work information from existing or assignments and tasks, urinalysis prospectively administered questionnaires, interviews, urinalysis; prospective collection of exposure information could be tailored and intensified beyond what is possible from historical questionnaire, interview data Outcome Use existing databases, such as military Existing health conditions would be assessment health records and registries, to identify ascertained from historical records, (used to people with relevant diseases prospective onset of conditions determine ascertained from similar sources; disease [case] , prospective ascertainment of health control status)
|
From page 44... ...
Outcome Documentation of occurrence of relevant In addition to assessment of outcome assessment adverse health outcomes via linkages with with existing data, study population death certificates or disease registries would be monitored for relevant adverse health outcomes via clinical surveillance or linkages with death certificates or disease registries Limitations Identifying study population likely to be Small study population unless new challenging given time elapsed since 1991 persons (beyond current military Gulf War rosters) are recruited Characterizing exposure may be Few health outcomes, low disease problematic rates Low disease rates Time and cost to conduct study may be considerable NOTE: DOD = US Department of Defense, DU = depleted uranium, VA = US Department of Veterans Affairs.
|
From page 45... ...
The committee recognizes that information from the 1991 Gulf War and from Operation Iraqi Freedom concerning the extent of exposure and identification of exposed people is suboptimal and that this limits the ability to conduct epidemiologic studies of health outcomes of DU exposure. Given the limitations of the studies described above, particularly the low statistical power and the lack of adequate exposure data, the committee concludes that it would be difficult to design a study to assess health outcomes of DU exposure in military and veteran populations comprehensively.
|
From page 46... ...
DOD should design and implement a data-collection system to assess potential exposure, obtain biologic and environmental samples, and define the cohort for long-term followup of health outcomes. RECOMMENDATIONS FOR IMPROVING FUTURE EPIDEMIOLOGIC STUDIES • DOD should use the most sensitive assays when collecting biomarker data and should investigate available in vivo assay techniques other than measuring urinary uranium to determine whether they offer advantages (for example, increased sensitivity)
|
From page 47... ...
Comprehensive clinical assessments of exposed people provide extensive data on health outcomes potentially related to DU exposure and might have value in stimulating further study. • DOD determine the feasibility of identifying military personnel who were at Camp Doha during the time of the fire in 1991 and of collecting biomarker data on them.
|
From page 48... ...
London, UK: The Royal Society Working Group on the Health Hazards of Depleted Uranium Munitions.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.