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depleted uranium health statistics

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2003 June 13 Friday.
Yesterday I started looking at DU health statistics and started to understand why DU problems might be statistically invisible, at least as far as the bureaucratic mind is concerned.

I got as far as the page:

some Gulf War Syndrome publications

Here I found this this page:-

Hospitalizations for unexplained illnesses among U.S. veterans of the Persian Gulf War

.... on which there was this:-

The U.S. Department of Defense (DoD) conducted an epidemiologic comparison of the postwar DoD hospitalizations of service members deployed to the Gulf War and service members of the same era not deployed (15). In the 2-year period after the war, no consistent increase in the overall risk for hospitalization (or specific risk for hospitalization for various broad diagnostic categories) was found for those deployed. This study relied upon diagnoses based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9) system (19). Medical providers may not consistently classify a new or poorly recognized syndrome, and consequently a true difference in hospitalization risk could be spread across numerous diagnostic categories and remain undetected.

In other words, in modern medicine every medical problem has a magic number, so if something new and unnumbered pops up, then statistically it doesn't exist.

To get round this problem, a study was designed which would look at computerized records for unexplained illnesses. The procedure and the findings are summarized as follows:-

Persian Gulf War veterans have reported a variety of symptoms, many of which have not led to conventional diagnoses. We ascertained all active-duty U.S. military personnel deployed to the Persian Gulf War (552,111) and all Gulf War era military personnel not deployed (1,479,751) and compared their postwar hospitalization records (until 1 April 1996) for one or more of 77 diagnoses under the International Classification of Diseases (ICD-9) system. The diagnoses were assembled by the Emerging Infections Program, Centers for Disease Control and Prevention, and are here termed "unexplained illnesses." Deployed veterans were found to have a slightly higher risk of hospitalization for unexplained illness than the nondeployed. Most of the excess hospitalizations for the deployed were due to the diagnosis "illness of unknown cause" (ICD-9 code 799.9), and most occurred in participants of the Comprehensive Clinical Evaluation Program who were admitted for evaluation only. When the effect of participation in this program was removed, the deployed had a slightly lower risk than the nondeployed. These findings suggest that active-duty Gulf War veterans did not have excess unexplained illnesses resulting in hospitalization in the 4.67-year period following deployment.

Later in the report, the findings are again summarized, as follows:-

Model analysis showed that Gulf War veterans were more likely than their peers to be hospitalized for unexplained illness. After 4.67 years of follow-up, the cumulative probability of hospitalization for unexplained illness was 0.0185 in the deployed and 0.0166 in the nondeployed (Figure 1). This increased hospitalization risk of 11% for the deployed was a consequence of the recruiting for free clinical evaluations beginning in June 1994, with most of the resulting CCEP hospitalizations being for medical evaluation and not for clinical management. When CCEP participants were censored on 1 June 1994, deployed Gulf War veterans were not at greater risk than those not deployed. The slightly lower hospitalization risk for the deployed than for the nondeployed (Figure 2) is consistent with a healthy service member effect; that is, those selected for deployment are, on average, slightly healthier than those not selected.

Obviously this raises the question of what happens when someone is faced with something that they could, conceivably, classify as "unexplained." Do they do that? Or, if a possible diagnosis is available, do they use the possible diagnosis?

Point: the autopsy is referred to as "the gold standard of medicine" because it is sometimes only when you cut up the dead body that you find out what someone died of, which may be nothing like what they were diagnosed with.

It also seems that the statistics had to be massaged a little because they got messed up by people being added for some kind of evaluative purposes. The massaging sounds legitimate ... even so, it's worth remembering that we eat our statistics in a processed form.

This morning I went back to the page above to take another look at it, and also looked at a page last revised 2000 December 18, a page about:

CDC testimony pertaining to Gulf War veterans' illnesses



This includes the following:-

Shortly after the end of the Gulf War, reports began to emerge that veterans were experiencing a variety of somatic symptoms generally not accompanied by physical signs or laboratory abnormalities. The most commonly reported symptoms include complaints of chronic fatigue, headache, muscle and joint aches and pains, and cognitive disturbances.

This report, by the way, is labeled as being:-

"TESTIMONY OF DRUE H. BARRETT, PH.D. DIVISION OF ENVIRONMENTAL HAZARDS AND HEALTH EFFECTS NATIONAL CENTER FOR ENVIRONMENTAL HEALTH CENTERS FOR DISEASE CONTROL AND PREVENTION U.S. PUBLIC HEALTH SERVICE BEFORE THE SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION COMMITTEE ON APPROPRIATIONS U.S. SENATE OCTOBER 5, 2000.

(The capital letters are not mine - I just cut and pasted them. I'm not that mad. Yet.)

The testimony goes on to say:-

In 1994, CDC initiated an epidemiologic study of Gulf War veterans from Iowa. The Iowa study, conducted in collaboration with the Iowa Department of Public Health and the University of Iowa, was one of the first population-based epidemiologic studies to document that Gulf War veterans are reporting more medical and psychiatric conditions than their non-deployed military peers.

It also says:-

The Iowa study found that the Gulf War military personnel were more likely than those who did not serve in the Gulf War to report symptoms suggestive of cognitive dysfunction, depression, chronic fatigue, post-traumatic stress disorder, and respiratory illness (asthma and bronchitis). The conditions identified in this study appear to have had a measurable impact on the functional activity and daily lives of these Gulf War veterans. Among Gulf War veterans, minimal differences were observed between the National Guard or reserve troops and the regular military personnel.

And yet:-

More recently the Iowa data has been examined to determine whether the health complaints of Gulf War veterans represent a novel illness unique to service in the Persian Gulf. We assumed that if there was a Gulf War syndrome, the symptom pattern would vary between the deployed veterans and the non-deployed controls. Although Gulf War veterans reported nearly every symptom more often than those who did not deploy to the Gulf, we found that Gulf War veterans and non-deployed controls had the same patterns of symptoms suggesting that the health complaints of Gulf War veterans are similar to those of the general military population and are not consistent with the existence of a unique Gulf War syndrome. This study was published earlier this year in the American Journal of Medicine.

Yesterday, being in a hasty rush to put together a new DU page, I incautiously wrote "Summary: first widely used on the battlefield in the 1990-91 Persian Gulf War, DU (depleted uranium) stands accused of damaging the health of both Iraqi civilians and American veterans (the victims of Gulf War Syndrome)."

At this stage I think I have to remove the "Gulf War Syndrome" tag ... a pause for word-processing ... done ... actually, I haven't uploaded the new page yet, so it's not actually on the website, and now I think that I won't upload it for a while, although I will upload my latest "research in progress" which includes the rough draft of the new page ... but I should tag the rough draft with a "the statistics don't support a Gulf War syndrome" note.

Okay ... here's the tag:-

the rough draft of a DU page ... suggests that DU is responsible for the Gulf War Syndrome statistics. Having done just a little more reading, I now believe that such a conclusion is not supported by the evidence. In fact, I believe that most Gulf War Syndrome ill-health statistics are unrelated to DU and the Gulf War Syndrome statistics may in fact be serving to mask any statistical evidence about the health damage done by DU

At this stage, I now believe that the Gulf War Syndrome statistics have not been generated by exposure to DU.

What really convinces me of this is another part of the

CDC testimony pertaining to Gulf War veterans' illnesses



which talks about a study of air force personnel initiated in 1994. The following seems significant:-

The key observation of the study was that Air Force Gulf War veterans were significantly more likely to meet criteria for severe and mild-to-moderate illness than were non-deployed personnel. There was no association between the chronic multisymptom illness and risk factors specific to combat in the Gulf War (month of season of deployment, duration of deployment, duties in the Gulf War, direct participation in combat, or locality of Gulf War service). The finding that 15% of non-deployed veterans also met illness criteria was equally important and suggests that the multisymptom illness observed in this population is not unique to Gulf War service. The clinical evaluation component of the study found that neither mild-to-moderate nor severe cases were associated with clinically significant abnormalities on physical examination or routine laboratory tests. However, Gulf War veterans classified as having mild-to-moderate and severe illness had a significant decrease in functioning and well-being compared with non-cases.

If DU exposure was the blanket explanation for Gulf War Syndrome then there would presumably be some detectable pattern linking cases to, at the very least, duration of combat and "locality of Gulf War service."

Statistically, to zero in on DU, it seems necessary to find some body of data dealing with veterans who have, demonstrably, been contaminated with DU.

That leaves the question of the cause of "Gulf War Syndrome" unanswered, but my purpose is not to answer that question. Rather, my purpose is to analyze the DU situation and establish whether there is or is not a link between DU exposure and poor health.

But, for today, I've gone as far as I can.

Footnote: above, there's a mention of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9) system. A web page about this is:-

International Classification of Diseases, Ninth Revision, Clinical Modification, Sixth Edition

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