Part I: Human Studies
Part 2: Depleted Uranium and other Toxic Exposures
Part 3: Historical Political Background of the Dispute over Depleted Uranium

INTRODUCTION:

The Toxicity of Depleted Uranium (DU) as used in war, has not been investigated with a medical toxicological methodology, as have other hazards found on the First Gulf War battlefield. This is because Uranium is considered to be a radioactive pollutant, and such pollutants are relegated to the physicists for analysis. Since World War II the branch of Radiation Toxicity has been handled differently, with its own peculiar mathematical approach to calculations of exposure, dose and probability of a cancer death. Most toxicologists consider this area to be outside of their expertise.

This has led to some confusion in understanding the Gulf War Syndrome (GWS). It is important to look at the history of how this division of toxicology happened and how it has influenced studies of the GWS.

The use of DU by the U.S. and U.K., two nuclear countries, was deliberate, and no protection for the military and civilians was undertaken. It could be called an experiment with human beings. In these two nuclear countries there has been a long history of both using the radioactive properties of uranium for military benefits, and a verbal policy of minimizing its danger so that workers will not be afraid to handle it, and citizens will put up with its mining and milling, transportation and waste disposal. These two countries have a vested interest in maintaining the status quo, and therefore are not in a position to do proper objective investigations. This is not a recent phenomenon, but has roots deep in the histories of these two countries. Much of the behavior has become rote and the problems are not seen in perspective It is clear that the benefit of the doubt about the toxicity of DU should go to the victims of this shocking human experiment.

HISTORY OF RADIATION PROTECTION

As has been discussed in the two earlier papers in this series, radiological analysis has proceeded under a physics model which we have called the ICRP (International Commission of Radiological Protection) model, while toxicological investigation of the use of other hazardous agents in the first Gulf War has followed a medical toxicological model. Normally these two disciplines are taught separately in our Universities, and those who are in the radiation physics course do not study medical toxicology, while those in medical toxicology do not study radiation

As early as 1921, 23 years after the discovery of radioactivity by Wilhelm Conrad Roentgen, medical radiologists came together to address the health problems associated with working with radioactive substances. [Ref 1.] By this time, a book on radiogenic cancer had been published, and several experiences of radiation burns, and even amputations, were well known. The famous physicist, Professor W.V. Mayneord, Head of the Physics Department at the Royal Cancer Hospital, London, UK, addressed a Conference, convened by the Institute of Biology and the Atomic Scientists Association, on Biological Hazards of Atomic Energy, at Oxford in October 1950.[Ref 2.] His paper was called: «The organization of Protective Measures Against Radiation Hazards», and he began the discussion with an historical record of broad concerns evidenced by the series of International Radiological Congresses, hosted by the British X-ray and Radium Protection Committee. This International Congress was formed in 1921, and included the Royal Society of Medicine, the British Association for the Advancement of Radiology and Physiotherapy, the Institute of Physics, the Radium Institute (London) and the National Physical Laboratory. «The personnel of the Committee was afterwards widened to include representatives from other bodies» [Ref 3.] One is taken back by the breadth of the early attempts to deal with radiation health problems! It was clearly a multi-disciplinary problem. Even the American Philosophical Society held a symposium to address and overcome the various problems posed by the expanded use of nuclear materials [Ref 4.]

This group of radiologists in London had taken the initiative and organized a series of meetings in London, in 1925, called International Radiological Congresses, which set up two Commissions, on Units and Protection, respectively. In 1928, at Stockholm, at the Second International Congress of Radiology, the British recommendations were accepted, and the radiological protection committees were accepted as subcommittees of this organization of Radiologists.

The physicists of the Manhattan Project, who had been meeting between 1945 and 1950, approached the Radiologists in 1951, seeking to belong to the radiation protection committees of the International Congress of Radiology. This merger was accepted and the group was renamed the International Commission on Radiological Protection (ICRP). Since that time, the membership of the Main Committee of ICRP, which makes all decisions on recommendations, has been about 51% physicists. Radiologists have been reduced to about 15%, and Medical Administrators from nuclear nations were added, making up about 25 %. The other 10% of the Main Committee is made up of medical physicists, geneticists, a pathologist and other sub-specialties (specifically excluding oncologists, epidemiologists, public and occupational health specialists).

>From this broad beginning, focused originally on the protection of radiologists and their patients from X-ray, the Main Committee of ICRP - 13 men - have reduced the complex health effects of exposure to ionizing radiation, to risk estimates for fatal cancer (sometimes expanded, to include non-fatal cancers and serious genetic disease in live-born offspring) and eliminated all other health effects as «not of concern».

As physicists, they have elaborated the complexity of the sources of radiation, the pathways to humans, and the various weighting formula for partial body exposures, internal and external radiation, exposures from alpha, beta and gamma radiation, etc. However, the biological endpoint has remained simple: cancer death, adopted because it was thought (by physicists) to be relatively simple and easy to count. Actually, the death rate from cancer is subject to several other variables: early detection, medical interventions, patient's health at time of diagnosis, competing causes of death, and whether the cancer had been diagnosed or not (many are found on autopsy), etc.

Several other biological endpoints were considered in 1950, including congenital malformation, miscarriages, obesity, autoimmune disease, and immune suppression. These other effects, although they may be experienced by those exposed, have fallen away out of sight of the medical profession, the media, governments, and physicists. Many now think that only cancer death is caused by ionizing radiation exposure.

The reasoning of the physicists was that cancer deaths were a severe, easily observable effect of radiation exposure. If this effect could be minimized, then all other «lesser» effects would also be lessened, and therefore not of concern. They protected themselves from mistakes by insisting that they make only recommendations, and nations are free to accept or reject them. Most nations have felt unable to challenge these recommendations because of their comparatively scarce scientific resources and personnel. In effect, the recommendations have been universally followed with the exception of the U.S..

HEALTH PHYSICS

The term «Health Physics» made its first appearance in 1942 and meant: «that field in which physical methods are used to determine the existence of hazards to the health of personnel». The Health Physics Society expanded and adopted its official meaning in 1959:

«Health Physics is a profession devoted to the protection of man [sic.] and his [sic.] environment from unwarranted radiation exposure. A health physicist is a person engaged in the study of the problems and practices of providing radiation protection. He [sic] is concerned with an understanding of the mechanisms of radiation damage, with the development and implementation of methods and procedures necessary to evaluate radiation hazards and with providing protection to man [sic.] and his [sic.] environment from unwarranted radiation exposure.» [Ref. 6.].

In 1951, Mayneord pointed out that:

«The problems now faced (in 1950) seemed infinitely more complex than those previously dealt with. For example, although there had been accidents in the handling of radioactive sources, generally the radium in use had been completely enclosed in platinum containers, and the gamma and beta radiations were all that had to be guarded against. Now, with open sources, and the necessity for cooling of chain reactions, the problem of contamination of the atmosphere either by gaseous or particulate matter became of prime importance. Again, where as previous radioactive wastes were unimportant, except in a very few locations, the radioactive wastes both from the atomic piles themselves and from the associated chemical extraction plants became problems of the first magnitude.» [Ref 7]

A health physicist was usually trained in mathematics, physics or engineering. He or she then took courses in measurement of radiation, and the radiation regulations, which a Health Physicist would be expected to keep. Rarely has the Health Physicist taken a basic course in biology or any biomedical sciences. This discipline, which began as measuring of radiation in the work place to protect workers, has developed into the sole arbiter of radiation health problems!

INTERNATIONAL COMMISSION ON RADIOLOGICAL PROTECTION (ICRP)

The ICRP gradually moved away from the International Association of Radiologists. Today it is an independent Non-Governmental Organization (NGO) which has declared itself to be the authoritative source of all radiation protection advice.

After the successful nuclear bomb detonation, Bravo, 1954, in the Marshall Islands, President Dwight Eisenhower went to the United Nations and declared the beginning of the Atomic Age. He promised that nuclear power would be tamed and used to produce electricity too cheap to meter. It would provide unlimited electrical power to the developing world, and prevent future wars. The real reason behind this promise was the need of the U.S. military for a civilian industry which used nuclear fission. Only a civilian industry could assure the military of the support industries which it would need: uranium mining and milling, transportation, University support with courses in nuclear physics and engineering, and toleration of the waste products. Without these it would be difficult to replace all of the military ordnance in the U.S. with nuclear bombs.

The response of the United Nations was to form two new agencies to deal with the nuclear technology: United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) in 1955 and the International Atomic Energy Agency (IAEA) in 1957.

When the IAEA (International Atomic Energy Agency) was asked by the United Nations to set radiation protection standards, the IAEA turned to ICRP, rather than the WHO. Today's problems date from a 1959 agreement between the two Agencies, [Ref 8], which has, in effect been interpreted that IAEA is the lead agency for researching or assessing radiation-related research and the WHO can take care of healing the victims of exposure. ICRP is now a self-constituted and self-perpetuating organization, advisory to nations and to the IAEA, with no professional accountability to anyone in the global community. It is a very powerful organization, with the ability to disregard scientists who challenge its premises and assumptions. The IAEA is also a powerful U.N. Agency, which reports directly to the U.N. Security Council, while all other Agencies (including the WHO) report to ECOSOC (the U.N. Economic and Social Council).

Hermann Muller, the 1946 Nobel Prize winner in Medicine, for demonstrating the mutagenic effects of ionizing radiation, stated in 1952:

«It is not well to have the mathematical computations run so far ahead of their biological and chemical bases as they have in this [nuclear radiation] case.... When this happens, comparatively simple basic issues too easily become submerged and distorted under masses of calculations. Especially are such calculations misleading when given in such a mathematically technical and elided form that most of the biologists reading them, and they must be intended primarily for biologists, tend to take the conclusions in faith.»[Ref. 9]

This is precisely what has happened to both the majority of biologists and the physicians. The whole complex field of radiobiology and medicine has been abandoned to the physicists, who produce complex formula, accurate and important in themselves, but serving to quiet the contribution of every other discipline to understanding and resolving the complex interdisciplinary questions most troubling to those who experience radiation damage.

DOMINANCE OF PHYSICS:

This dominance of radiobiology by physicists persists to this day. For example: Marie Woolfe, Chief Political Correspondent for The Independent, in the UK, reported that Michael Meacher, the former U.K. Environment minister, accused the British Government (7 September 2004) of covering up the risk to human health from nuclear power.

«Mr Meacher said government lawyers had tried to suppress a report by experts on a committee he set up three years ago to assess the cancer risk from radiation. The Committee Examining Radiation Risks from Internal Emitters [CERRIE] was to advise ministers on the effects of low-level radiation. He said two members of the committee had warned that the cancer risk of radiation could be 300 times higher than previously believed - findings he said the Government had tried to stop being published. [Ref 10]

This has happened over and over since 1950, and the disputed findings are inevitably decided by governments by appealing to ICRP recommendations. On the other hand, ICRP describes itself as only a recommending organization, claiming that nations must set their own standards. Thus no one is responsible for serious errors in judgment which affect many human lives and the health of large groups of people, like those exposed to DU.

«The minority report, co-written by Richard Bramhall, of the Low Level Radiation Campaign, also won the support of the committee's secretary, Dr Paul Dorfman, who has investigated leukaemia clusters around nuclear plants. Dr Dorfman said yesterday that the committee's decision to in effect block two of the expert views had severe implications for public trust.» [Ref 11]

The clarification of the health effects of DU used on the battlefield, has been confused and substantially hampered by the minimalist methodology of the physicists, who have assumed responsibility for ultimate decision-making on all human health problems related to radiological hazards. The Medical Profession knew a great deal about radiation exposure before the Manhattan project brought the physicists into the fore. Medical studies of Radiologist, relative to colleagues of other medical specialties had revealed that not only that radiologists die of leukemia and other cancers at a higher rate than did other medical specialists, but thy also died at higher rates of cardio-vascular diseases, and «all other causes». Medical studies had determined significantly increased health problems in the children of radiologists, especially diseases of the cardio-vascular system. Because these studies did not have accurate measurements of the radiation dose, they are ignored by physicists, bent on finding dose-response estimates.

This is only the tip of the iceberg of research which has been rejected by the physicists because it is lacking precise dose data. Even radiation research which recognized a different biological endpoint than cancer death, is rejected by physicists as irrelevant. There are other methods of validating suspicion of causality, for example, when the radiologist became more careful of radiation exposures in their work, the rate of occurrence of leukemia significantly decreased. [Ref 12]. It is admitted, of course, that having good dose estimates is ideal!

There are also serious scientific doubts being raised as to the accuracy of the dose models on which the analysis of the physicists depends. For example, internal exposure to non-homogeneously distributed alpha emitters may be much more serious then has been anticipated by the physicists assumption of homogeneity. [Ref. 13]). Clearly, ceramic nanometer particles of DU will not distribute themselves homogeneously in organs or tissues!

FINELY POWDERED URANIUM:

The inherent problems of DU ammunition were anticipated and even predicted to be desirable for the military. Apparently radioactive powder was first proposed, in the U.S., to General Leslie Groves, Director of the Manhattan Project, by senior scientists in the project. In this memo, dated 30 October 1943, these scientists noted that radioactive material, including uranium, could be used to contaminate air, water and terrain The letter stated that inhalation of radioactive materials would result in bronchial irritation «coming on in a few hours to a few days».

«The material was to be ground into particles of microscopic size to form dust and smoke, and distributed by a ground-fired projectile, land vehicles or aerial bombs. In this form it would be inhaled by personnel. The amount necessary to cause death to a person inhaling the material is extremely small. It has been estimated that one millionth of a gram [one microgram] accumulating in the person's body would be fatal. There are no known methods of treatment for such a casualty. Two factors appear to increase the effectiveness of radioactive dust or smoke as a weapon. These are, it cannot be detected by the senses, and it can be distributed in a dust or smoke so finely powdered that it will permeate a standard gas mask filter in quantities large enough to be extremely dangerous.» [Ref 14]

The grinding into microscopic particles is no longer necessary, since a uranium fire produces many levels of non-soluble respirable particles, sometimes called a metal fume. Uranium powdered by air friction or impact with a hardened target is subject to spontaneous fires, increasing the amount of surface of the uranium and other metals sublimated by the high temperature in the fume.

UNSCEAR AND ICRP:

The United Nations created The United Nations Scientific Committee on the Effects of Ionizing Radiation, UNSCEAR, in 1955, to «assess and report levels and effects of exposure to ionizing radiation». According to the UNSCEAR website, «governments and organizations throughout the world rely on the Committee's estimates as the scientific basis for evaluating radiation risk, establishing radiation protection and safety standards, and regulating radiation exposure.» UNSCEAR was envisioned as an organization of physicists, who at that time were the only ones who could measure radiation (since it escapes our senses and requires specialized instruments for detection). Establishing radiation standards eventually (in the non-professional civic .society) became understood as decision making power on whether or not an exposure to radiation was legally permitted or an observed cancer or illness was radiation related. The reality was that standards were set on a risk-benefit trade off basis, not on health, and the primary benefit was production, testing and storage of nuclear bombs.

UNSCEAR became primarily a reporting agency, detailing the measurement of radioactive fallout, worker exposures and eventually emissions from nuclear power plants. I would assume that legislators saw this agency as providing independent monitoring of nuclear activities, as a check on predicted pollution and theoretical estimates of harm. Unfortunately, UNSCEAR incorporated into its midst the same scientists who were making the predictions, members of the Main Committee of the International Commission on Radiological Protection (ICRP),[Ref. 15] These same individuals were estimating which levels of low level radiation exposure caused «no unacceptable harm» to workers and the public from activities through which they gained a livelihood. As has been noted ICRP is not a U.N. Organization. Rather, it is a self-established and self-perpetuating non-governmental agency which has given itself the mandate to recommend radiation protection standards to nations.

ICRP has never claimed to be a public health agency. Rather, it makes the decisions as to how much risk of ill health in workers and the general public, should be acceptable for the benefits of radiation-related activities (on which member's incomes and national security depended). No other industry is allowed to monitor itself. We do not ask the tobacco companies to tell us about tobacco's harm, or the pesticide companies to tell us the effects of their products on children.

ROLE OF THE WORLD HEALTH ORGANIZATION:

In 1957, the World Health Organization, which had been established by the U.N. in 1948, became alarmed about the atmospheric nuclear testing and the proposed expansion of this nuclear technology for «peaceful uses». It called together eminent geneticists to consider the threat this exposure would pose to the human and ecological gene pool. Prof. Hermann Muller, the geneticist who received a Nobel Prize in Medicine for «the discovery of the production of mutations by means of X-ray irradiation» in 1946, was a participant at this conference. Although the United States had not sent him as its delegate, (only state appointed scientists normally attend these official committee meetings) he received a special invitation to attend, and he received a standing ovation at the conference for his work. He consistently opposed extension of nuclear technology into civilian uses because of the danger it posed to the gene pools of plants, animals, and humans. The conclusion of this expert group was that there was not enough information available in the scientific community to assure the integrity of future generations, should the burden of ionizing radiation exposure be increased. [Ref. 16]

The WHO Committee of experts called for extreme caution and further genetic investigations, especially in Kerala, India, where there is high natural background radiation, and people have lived in this environment for hundreds of years. WHO found the atomic bomb research at Hiroshima and Nagasaki of limited use for genetic studies because of the relatively short time period since exposure, and the violent wartime situation which caused severe post-exposure losses in that population. . The first serious study of the genetic effects of ionizing radiation in Kerala's environment was published by VT Padmanabham in 2004. [Ref 17], 47 years after the need had been identified as an urgent priority by the WHO!

The potential conflict between those who wished to exploit the new nuclear technology for both profit and military supremacy, and the custodians of the public health, was superficially resolved by an Agreement of the World Health Administration (Res. WHA 12-40, 28 May 1959) stating that the IAEA and the WHO recognize that

«the IAEA has the primary responsibility for encouraging, assisting and coordinating research on, and development and practical applications of atomic energy for peaceful uses throughout the world without prejudice to the right of the WHO to concern itself with promoting, developing, assisting and coordinating international health work, including research, in all its aspects.»»

If the reader is confused, so is the writer. To understand this, one needs to know that the health effects of radiation were classified as secret under the U.S. Atomic Energy Act and the Official Secrets Act in the U.K, for national security. The «international health work» assigned to the WHO was taking care of the victims. While technically the IAEA and WHO are «equal» in the U.N. family, those agencies that report directly to the Security Council, as does IAEA, have more status than those who report to ECOSOC (the Economic and Social Council) as does the WHO.

POST-CHERNOBYL DEVELOPMENTS:

After the Chernobyl disaster, 1986, the ICRP developed a protocol for use after a radiation accident. [Ref 18] According to this new policy, the post-accident status quo is considered to be the «norm», and any proposal for clean up must determine that there is sufficient benefit to warrant the expenditure. The WHO document adheres to this ICRP policy, namely that unless the radiation exposure of the public exceeds 100 mSv per year, there is no presumed need to clean up a site. If the dose to the public per year will be greater than 10 mSv and less than 100 mSv, then a risk vs benefit judgment should be made. This is in contrast to the policy of ICRP for uncontaminated land, which proscribes that environmental activities, involving exposure of the public to ionizing radiation, limit doses to no more than 1 mSv per year [Ref 20]. It is obvious that human health has not changed. The only change is the cost.

It is known that documents prepared by health professionals and presented at a WHO conference in 1996 (the tenth anniversary of the Chernobyl disaster) on the observed health problems of the Chernobyl survivors, many of whom were trying to live on the contaminated land, have never been published. A former Director of WHO stated that IAEA had opposed their publication.

PUBLISHED STUDIES OF DU BASED ON ICRP METHODOLOGY:

Rand Report: One of the first reports, often quoted, is the Rand Report [Ref 21], sponsored by the Office of the U.S. Secretary of Defense in response to a mandate from the U.S. Congress. The preface of this document contains a disclaimer seldom quoted. Note that use of military manuals in this report was excluded.

«The reviews are intended principally to summarize literature on the known health effects of given exposures to these risk factors. Where available evidence permits, the reviews also summarize what is known about the range of actual exposures in the Gulf and assess the plausibility of the risk factor at-hand [in this case, DU] as a cause of illness. Statements related to the Gulf War experience should be regarded as suggestive rather than definitive, for much more research both on health effects and exposures remains to be completed before definitive statements are made.

«These reviews are limited to literature published or accepted for publication in peer-reviewed journals, government publications, and conference proceedings.»

Since the literature contains no studies of DU used on the battlefield, the authors relied on reports of uranium mining and milling exposures. Uranium dust is considered to be particles with course surface, of approximately five micron in diameter. Uranium dust normally does not travel into the deep lung or the alveoli. For this reason, the lung cancers which miners or millers experience are attributed to radon gas. As was discussed earlier, Gulf War exposures to DU include the one micron, or less, particle diameter range. These ultra-small particles are fully capable of entry into the deep lung and alveoli.

U.S. Institute of Medicine: The report of the Institute of Medicine, of the U.S. National Academy of Science [Ref. 22], recognizes the problems of DU and the absence of information on its toxicology and radiological properties. It urged:

«continuation and expansion of efforts to model potential exposures to DU in various military settings (e.g. inside and outside vehicles damaged by DU munitions, and other areas potentially contaminated by the dispersion of DU particles). Such efforts may result in a quantitative assessment of Gulf War veterans' exposure to DU. Further, the committee urges publication of the results in the peer-reviewed literature so that studies may receive broad review.»

Besides indicating that the Rand review of non-existent DU literature is not helpful, the Institute of Medicine was perhaps indicating that such information belonged in the public sector and not in classified military archives. In general, this report stressed the lack of knowledge available on the health effects of DU used in battle.

U.K. Royal Society: The U.K. has also published a Report [Ref 23] which considered the radiological and chemical toxicity of DU. While quoting the literature on uranium exposure in the workplace, this report does suggest:

«the typical form of the inhaled particles in industrial settings and on the battlefield will be different, and these alternative forms might not have the same adverse effects.»

They also summarize:

«There are no data on the long term effects of the use of DU munitions on humans and the environment because they were first used in a military conflict in 1991 during the Persian Gulf War. Consequently the long term risks to health and the environment have been evaluated in the absence of data over appropriate time-scales.»

The Royal Society used a standard ICRP approach to radiological damage and standard toxicological approach to uranium renal toxicity. These methodologies assume that only the risks of «radiation induced fatal cancer» and uranium induced «kidney disease» be considered. This appears to be a non-scientific restriction of biological endpoints. Moreover, the micro and nanometer size of the particles, their smooth spherical shape, hollow in the larger diameters, and ceramic characteristics were ignored.

These studies do not represent the best choices of biological endpoints (cancer death and renal failure) for addressing the wartime DU exposure health effects. They do not effectively address the veterans' actual health problems, and do not provide appropriate answers to the veterans' questions. For example, the veteran's were experiencing CNS damage and damage to offspring, and they were not being told that nanometer size particles can easily pass through the blood-brain barrier, had been found in seminal fluid and can cross the placenta [Ref. 24]. Veterans have asked for an explanation of their symptoms, and suggested cures or medical mitigation. This problem is not one of calculating risks of artificial «negative health endpoints» chosen by researchers.

United Nations Environment Program (UNEP): Another document of interest is the UNEP Report of investigations after the war in the Balkans [Ref 25]. This mission had five elements.

1. Environmental assessment of the worst damaged industrial sites.

2. Complementary measurement, to assess the environmental impacts of the conflict on the Danube River.

3. Assessment of damage to the biodiversity in nature conservation areas.

4. Assessment of the potential long term health and environmental effects due to the conflict (including DU).

5. Assessment of the human settlement situation in Kosovo.

A small part of this study, part of mission (4), is devoted to DU. The UNEP study was self-proclaimed to be a «desk study», as opposed to a field study.

UNEP reported on the Specific Activity of DU (assuming that U₂₃₅ was 0.2% of the uranium isotopes) as 39.42 Bq/mg. Analyzed particles contained U₂₃₈, U₂₃₅, U₂₃₄, and traces of Th₂₃₄, Pa₂₃₄ and Th₂₃₁. In the case of skin contamination, through contact with solid pieces of DU, there is at most a beta dose of about 2 millisieverts per hour.

According to the UNEP report levels in the ambient air, outside of war zones, ranged from 0.02 to 0.76 nanograms per cubic meter, implying that the daily background intake of uranium from the air in normal circumstances, is about 1 nanogram (ng) or less per day.

With respect to the metabolism of DU, UNEP points out the rapid (less than 24 hours) clearance of systemically available uranium. It points out, however:

«if the pH is low, the complex dissociates to a variable degree, and the uranyl ion may then bind to cellular proteins in the tubular wall of the kidney, which may then impair tubular function.»

The affinity of uranium for the DNA molecule is worrisome for both somatic and genetic problems. However, the estimates of clearance of uranium from the body, used by UNEP, was for uranium dust, not for ceramic uranium particles of micro and nanometer size.

One scientist who worked on the UNEP, Report, Dr. Gatti, prepared a separate report on DU nanogram diameter particles, which has been discussed in Part 2 of this series of articles.

.

The inclusion of health in the UNEP Study was provoked by veteran concerns that the DU weaponry used during the Gulf War in Iraq may have been responsible for an increase in cancer, birth defects (congenital anomalies) and diseases of the immune system. The environment programme staff .had little expertise in the health effects of radiation!

The International Atomic Energy Agency (IAEA): IAEA has prepared a «Fact Sheet» on DU. [Ref 26] The IAEA, together with the International Labour Organization, the Food and Agriculture Organization and the World Health Organization, have established Basic Safety Standards (BSS) based on the recommendations of the International Commission of Radiological Protection (ICRP) and the United Nations Scientific Committee on Atomic Radiation (UNSCEAR). This BSS merely formalized what was the practice, namely, letting the 13 man Main Commission of ICRP dictate all radiation protection policies.

If a member nation makes a formal request of the IAEA, to study a radiological situation, it will:

· Determined the source term through environmental monitoring program.

· Model potential pathways from the environment to humans.

· Assess the radiation dose to representative groups of individuals.

· Check for compliance against its Basic Safety Standards.

Intervention, in the way of clean up of the environment, is based on cost, not human health. «It is almost always justifiable, if an individual effective dose (according to BSS recommendations) exceeds 100 mSv per year». It «may be necessary, if the dose exceeds 10 mSv per year».

When dealing with facilities emitting radiation, the BSS requires the doses to the public be less than 1 mSv per year [Ref 27]. These changing radiation protection standards reflect realizations in the aftermath of the Chernobyl disaster, and changing costs of cleanup, not changing human sensitivity to radiation injury!

Science and Global Security: A highly publicized paper by S. Fetter and F.N. von Hipple, published in Science and Global Security [Ref 28], using what they assumed to be maximum assumptions, estimated theoretically that doses of ionizing radiation to the military or civilians from DU in battle would be between 30 and 100 micro Seiverts in a year. They used the standard ICRP methodology for internal contamination from uranium, assuming S, or slow, dissolution in body fluid. They did not seem to consider implications resulting from insoluble ceramic glass-like nature of the DU fraction which might change the properties of uranium oxide, or increase the possibility of life-time retention. Nor did they discuss the nature, intensity and frequency of the DU metal fume, and the release of nanometer particles of all materials formed in to, to which veterans had been exposed. They seem not to be aware of the physical difference between the fire-polished smooth spheres of mixed inorganic particles and the rough surface of uranium dust in a mine. The calculation is mathematically correct but it is an inadequate explanation of the battlefield phenomenon.

World Health Organization (WHO): The last official report of interest is that prepared by WHO: «Depleted Uranium: Sources, Exposure and Health Effects» [Ref 29]. In addition to discussing the specific activity of DU, as did most of the other studies, WHO noted that, as well as decay through the emission of alpha particles, atoms of U₂₃₈ may also decay through spontaneous fission, an energetic process that releases approximately 40 times more energy per nuclear decay [Ref 30]

The spontaneous fission half-life of U₂₃₈ is estimated to be 8.5 X 10¹⁷ years [Ref 31], which results in approximately two atoms of U₂₃₈ in every milligram of uranium decaying by this process each year. Similarly, spontaneous fission rates for the other natural or anthropogenic isotopes of actinides associated with DU, are available, but they are of low probability relative to the rates of other decay modes. Fissioning of DU, inside the delicate tissues of the body can be devastating to the victim.

The WHO estimates natural ambient levels of uranium in air, in non-war situations, to range from 0.01 to 0.2 nanograms per cubic meter. This is more conservative than the UNEP Report, which estimates that uranium in the ambient air, outside of war zones, in Bosnia, ranges from 0.02 to 0.76 nanograms per cubic meter. WHO estimates that the daily background intake of uranium from the air is about 1 nanogram (ng) per day Higher levels are due to smoking of cigarettes, or the presence of a range of industrial processes such as mining of uranium ore, gas releases from coal-fired power stations and nuclear fuel manufacturing facilities [Ref 32]. WHO estimates that smoking two packs of cigarettes a day (which WHO does NOT recommend) contributes about 25 ng per day, and it is clear that this is exposure is harmful to health.

In the WHO summary [Ref 33] it is reported that the uranyl nitrate is cytotoxic and genotoxic in Chinese hamsters ovary cells. The genotoxic effects were thought to have occurred through the binding of the uranyl nitrate to the phosphate groups of DNA.

«It was suggested that these results provide a possible mechanism for observed teratogenic effects.

WHO notes:

«The database for the toxicity of uranium is limited, most of the studies are old, meaning that not all present methods available to assess renal toxicity were available at the time of these studies. Information, especially on long-term affects of different uranium species, is based on studies from a limited number of researchers. Information is very limited for many uranium species, especially for those with limited water solubility.»

The WHO Report identified two important information gaps: biokinetics data on DU aerosols, with emphasis on the effect of variable physical-chemical composition resulting from the use of DU munitions, and bio-availability of uranium after dispersion and re-suspension of DU dusts and aerosols.

Although the WHO uses ICRP methodology, as mentioned above, it is careful to note that protection limits set by ICRP are not borders between what is safe and not safe from a human health point of view, but rather reflect an ICRP judgment about the balance between the risks and the benefits. [These benefits range from medical uses, to uses in nuclear power and nuclear war]. ICRP methodology approaches the health effect problem by setting permissible dose limits, and assuming that both the individual and society accept the health effects which will occur below these limits in exchange for the benefit of the activity. The military have been known to say that, given the other hazards of the battlefield, the risk from using DU is acceptable.

Researchers, administrators and judges frequently consider exposures below ICRP recommended limits as «safe». So, for example, workers, atomic veterans, and those with Gulf War Syndrome, whose exposure to radiation does not exceed permissible levels, find it impossible to obtain worker or veteran compensation, in spite of serious disability and cancer.

With respect to using the permissible limits recommended by the ICRP for DU exposure in war, it has never been clear whether Gulf War veterans are to be considered nuclear workers or civilians, or whether, in foreign countries, the U.S. or the I.C.R.P. guidelines for exposure should be used. Similarly, should military decisions to introduce hazardous munitions, be allowed to threaten the health of non-combatants: children, infants and pregnant women? Do uranium metal fumes extend into territories not involved in the conflict?

The WHO report called attention to the biokinetics not only of U₃O₈, UO₂ and UO₃, but also mixed uranium-iron oxides which may also be present on the battlefield. As default absorption parameters for DU, WHO recommends using 0.2, because of the presence of «ultra fine metal or oxides particles».

DISCUSSION:

One of the most likely causes of the Gulf War Syndrome and the adverse health and reproductive experiences by Western and Iraqi veterans, and civilians in Iraq, is DU ordnance. Governments that undertook this experiment with humans should be held responsible both financially and legally through appropriate courts.

Governments, in particular the U.S. and U.K., have tried to silence protests against the use of DU weapons, and discredit complaints by sarcasm, or appeals to ICRP methodology. However, they have not undertaken epidemiological studies or well designed and consistent collection of medical, clinical, and autopsy information. Even in the second decade of DU use in war, citizens are still being challenged to undertake scientific research and produce evidence of harm by themselves, without access to government scientific and medical personnel, technological assistance, professional clinical and laboratory facilities and financial resources.

It is my understanding that in wars subsequent to the first Gulf War, troops have been warned against entering DU hit tanks or buildings, taking of war souvenirs, or any unnecessary exposure to potentially harmful radioactive debris. On the other hand, Iraqi citizens, especially the children, have not been so warned, and no cleanup of debris has been undertaken by trained radiation personnel.

The millions of dollars spent on official studies of DU done by the official international agencies, UNEP, WHO and IAEA, have done more to blur the human dimensions of the science than to clarify it. Insistence on studying the environmental hazard and pathways, and applying ICRP methodology and recommendations, without looking at the victims, has caused serious misdiagnosis of the true problems of the suffering veterans and civilians.

The useful radiological information provided by these official studies is limited to confirming the presence of DU in the contaminated environment, calculation of average doses predicted for these contamination levels, and comparison with ICRP recommended yearly maximum permissible dose levels of exposure. In contrast to this, the DU metal fume would be expected to contain many different metals and metal compounds which were formed in the very high temperature, in ceramic aerosol form. Since aerosols remain suspended for long periods of time, and can be resuspended by wind and vehicle or human movement, calculations of inhalation may be seriously underestimated. The ceramic nature of these inorganic particles means that there will be little solubility in body fluid, and little or no homogeneous dispersion in organs or tissues.

It is not even clear which radiation standards apply to international wars waged primarily by the U.S. abroad, the standards developed by ICRP or by the U.S.. It is also not clear if combatants should refer to the standards for nuclear workers or members of the public.

No clinical study or research for mitigating the effects of DU contamination of veterans and civilians have been provided by governments initiating and advocating the use of DU. Many are now sick and disabled. Although about 12,000 veterans from the first Gulf War in the U.S., and another 600 veterans in the U.K. are deceased, neither country has initiated systematic autopsy studies. In my experience the use of distilled water for all drinking and cooking can serve to reduce the body burden of inorganic debris without damage to the health of the individual. Unfortunately, this therapy is less successful with nanometer size particles since they are too small to be captured for excretion by the kidneys. However, even the atomic veterans found this to be a safe and helpful therapy. Distilled water is a safe option even for pregnant women.

Micro and nanometer particles contain tens of thousands of uranium atoms, each particle capable of nuclear transformations at a rate of hundreds or thousands a year, each transformation emitting more the 4 MeV (million electron volts) of energy. Nano particles can enter through the cell wall into the cell and its nucleus. They can also pass through the lung-blood barrier, the blood-brain barrier, the placenta and reach other sensitive tissues and organs, including reproductive organs. The nuclear bond between atoms in the long proteins, and the DNA of the cells can be broken with a force as small as 6-10 eV. Moreover, given the long residence time of nanometer particles in the body, there is potential for an occasional fission of some uranium atom, releasing energy forty times more powerful than its alpha energy. It is clearly probable that these energy bursts will do major biological damage to cells, organs and to the individual.

DU friction and impact fires cause the sublimation of all metals and other materials within the range of the fire. These will produce novel compounds and inorganic micro and nanometer particles which when inhaled or ingested are injurious to humans and animals. This debris will continue to pollute the food web at large distances from the source and for many years after the end of hostilities.

Enough is known, through direct examination of DU exposed persons, historical contamination studies, nuclear chemistry, microbiology, animal studies and from the occupational medical literature, about the toxicity of uranium, and the potential for harm when it is used in war, to call for a complete ban on its use. Of prime concern is its known affinity for phosphorus containing groups in the DNA, and its ability to reside in the body for years.

Empirical science has clearly demonstrated that the radioactive, physical and chemical properties of this novel ordnance, depleted uranium weapons, interact to produce a toxic often lethal mixture of effects. It poses unique dangers to humans, animals and to the environment, both during and after the conclusion of armed conflict. No amount of knowledge of radiation itself can predict the many ways in which living systems will react to the toxicity of this mixture of metals and metallic compounds.

Forcing all international agencies, including the World Health Organization, to limit their investigation to decision on determination of compliance or non-compliance with ICRP recommendations is unreasonable. Each science must use its own methodology so as to give a more complete assessment of the reality being studied. ICRP recommendations are not health based, but are risk-benefit trade-offs made by those who work with radioactive materials. ICRP has no authority or scientific backing for claiming that there is no harm to health at low doses of radiation below their recommended standards. ICRP has no authority to limit radiation injury «of concern» to radiation caused fatal cancers or serious genetic disease in a live born offspring. Most normal people care about all cancers, whether radiation initiated or radiation promoted, fatal or not. They care about benign tumors and autoimmune diseases which are radiation related. They also grieve over miscarriages, still births, congenital malformations or diseases and all teratogentic damage caused by radiation, whether it is inheritable (genetic) or not.

It seems clear that the WHO physicians should make up the lead agency for understanding and documenting the complex human health problems posed by depleted uranium.

World Health Assembly Resolution 12-40 between the WHO and the IAEA needs to be amended. The United Nations must seek basic radiation protection information from the WHO assessment of the physical and mental condition of the victims, and not be limited to determining whether or not environmental exposure complies with the recommendations of the non-governmental organization, ICRP.

Damage from ceramic radioactive particles and the fire related debris produced when DU impacts a hardened target can cause damage to humans and animals across national boundaries because of its aerosol properties. Due to Brownian motion, nano particle can remain suspended in air indefinitely. This metallic debris will also stay in the environment causing physical harm after the war is over.

Leaving DU debris in the environment is very much like leaving land mines, which continue to kill long after the war is over. Because of its radiological properties, DU would be expected to effect women and children more than men. Women are more susceptible to radiation related cancer because of their radio-sensitive breast and uterine tissue. Children are more sensitive to radiation because of their growth metabolism, and also because of their long prospective life-span, which allows for the latency period of most cancers. They will also be more susceptible to all ceramic metal particles left to contaminate soil. The embryo and fetus would be expected to receive the most damage from this long lasting environmental hazard capable to crossing the placenta and contaminating the embryo and fetus.

The empirical data suggest an immediate ban on the use of DU for military exercises or in warfare, and provision of medical care and compensation for the victims of its prior use. Once empirical data is available it should replace predictive theories, just as an audit replaces a financial projection. Sufficient empirical data on DU is now gathered, to discredit the denials of harm based on theoretical dose recommendations for limiting radiation exposures set by the ICRP.

DU generates a poison gas, known commonly as a metal fume, which is highly toxic when inhaled. It can also be classed as a radiological weapon of indiscriminate destruction which does not respect national boundaries, and which persists long after a conflict is over.

Use of DU in war is a clear violation of the Geneva Protocol on the use of Gas (metal fumes constitute a gas) in War, Geneva 1925, which was ultimately signed, with reservation (i.e. use for crowd control) by President Ford for the U.S. 22 January 1975. This Protocol was proclaimed in the U.S. on 29 April 1975. The U.K. signed this Protocol on 9 April 1930. The commitment to this Geneva Protocol was clearly known by the U.S. and U.K. prior to the 1991 war against Iraq [Ref 34].

References:

1. «Avoidable Tragedy Post-Chernobyl», by Rosalie Bertell, Journal of Humanitarian Medicine, Vol II, No.3, 21-28, 2002.

2. «Biological Hazards of Atomic Energy», editor: A Haddow, Oxford at the Clarendon Press, 1952

3. ibid Ref. 46,p 93.

4. ibid Ref. 46, p 95.

5. Proceedings Amer. Phil. Soc. Vol 90, No. 1, 1946.

6. «Principles of Radiation Protection», Editors K.Z. Morgan and J.E. Turner, John Wiley and Sons, New York,1967, p.63.

7. ibid. Ref. 2, p.95.

8. By an Agreement (Res. WHA 12-40, 28 May 1959) stating that the IAEA and the WHO recognize that ... «the IAEA has the primary responsibility for encouraging, assisting and coordinating research on, and development and practical applications of atomic energy for peaceful uses throughout the world without prejudice to the right of the WHO to concern itself with promoting, developing, assisting and coordinating international health work, including research, in all its aspects.»

9. Quoted by WV Maynford, in Ref. 2, page 99.

10. 2004 Independent Digital (UK) Ltd.

11. «CERRIE Minority Report 2004, by Richard Bramhall and Chris Busby. Sosumi Press 2004.

12. «The Current Mortality rates of Radiologists and other Physician Specialists: Specific Causes of Death» by Matanowski, G.N et al.Amer. Journal of Epidemiology, Vol 101: 179-195,1978.

13. ibid. Ref. 11, p. 48.

14. Memorandum to Brigadier General L.R. Groves from Drs. Conant, Compton, and Urey, War Department of the U.S. Engineering Office, Manhattan District, Oak Ridge, Tennessee, October 30 !943. Declassified June 5, 1974.

15. UNSCEAR Reports to the United Nations are available from the United Nations Book Store. Each contains a list of members, who contributed to the report. The reader can confirm that many of these UNSCEAR Members are also (or have been) members of ICRP Main Committee.

16. «Effects of radiation on human heredity», WHO. Report of Study Group, 1957.

17. «Genetic Epidemiological study of 70,000 people living in eight coastal villages of Kerala. exposed to high natural radiation from the natural deposit of monazite -1988-1998» , by VT Padmanabhan, International Journal of Health Service. 2004; 34(3):483-515.

18. ICRP Publication 63: Principles for Intervention for Protection of the Public in Radiological Emergencies. ICRP 22: (4) 1991.

19. ICRP Publication 60: Recommendations of the ICRP: Risks associated with ionizing radiation. Vol 21: 1-3. 1990.

20. Personal Communication from Dr. Michel Fernex, who attended the WHO meeting on Chernobyl, and later spoke with the former Secretary General of WHO.

21. A Review of the Scientific Literature as it Pertains to Gulf War Illness, Volume 7: Depleted Uranium, by Naomi H. Harley et al. published by RAND, Santa Monica, 1999.

22. «Gulf War and Health: Vol. I: Depleted Uranium, Sarin, Pyridostigmine, Bromide, Vaccines.» NAS 2000, September 2000.

23. «The Health Effects of Depleted Uranium Munitions: Part I and Part II» May 2001 and March 2002. This Report can be found at: www.royalsoc.ac.uk

24. See Part 2, of this series: «Understanding the Negative Health Effects of Depleted Uranium», by R Bertell.

25. «The Potential Effects on Human Health and the Environment Arising from Possible use of Depleted Uranium during the 1999 Kosovo Conflict», UNEP, October 1999.

26. «Depleted Uranium», IAEA Division of Public Information, 01-01198/FS Series 3/20.E. (There is no date on the document).

27. ibid. Ref. 26.

28. Science and Global Security, Vol 8: 125-161, 1999.

29. WHO/SDE/PHE/01.1, Department of Protection of the Human Environment, World Health Organization, Geneva,April 2001.

30. ibid. Ref. 29, page 6.

31. De Carvalho, et al. 1982.

32. ibid. Ref. 29, page 21.

33. ibid. Ref. 29, page 22.

34. Prohibition of the Use of Asphyxiating, Poisonous or Other Gases and Bacteriological methods of Warfare. Geneva 17 June 1925. Ratified by the U.K. 9 April 1930; Ratified with Reservation, by the U.S. 10 April 1975.