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Health effects stemming from depleted uranium (DU) exposure in a cohort of Gulf War veterans who were in or on US Army vehicles hit by friendly fire involving DU munitions are being carefully monitored through the Baltimore Veterans Affairs (VA) DU Follow-Up Program initiated in 1993. DU exposure in this cohort has been directly measured using inductively coupled plasma-mass spectrometer (ICP-MS) isotopic analysis for DU in urine specimens. Soldiers with embedded DU fragments continue to excrete elevated concentrations of U in their urine, documenting ongoing systemic exposure to U released from their fragments. Biennial surveillance visits provide a detailed health assessment that includes basic clinical measures and surveillance for early changes in kidney function, an expected target organ for U. Tests also include measurements of genotoxicity and neuroendocrine, neurocognitive and reproductive function. With the exception of the elevated urine U excretion, no clinically significant expected U-related health effects have been identified to date. Subtle changes in renal function and genotoxicity markers in veterans with urine U concentrations greater than 0.1 μg−1 creatinine, however, indicate the need for continued surveillance of these DU-exposed veterans.

To relate medical surveillance outcomes to uranium biomonitoring results in a group of depleted uranium (DU)-exposed, Gulf War I veterans. Thirty-two veterans of Gulf War I who were victims of 'friendly fire' involving DU weapons, in whom exposure assessment can accurately be measured, had urine uranium concentrations determined using ICP-MS technology. Clinical laboratory parameters were measured and related to urine uranium concentrations. Data were examined by stratifying the cohort into a low U group, <0.10 mug/g creatinine versus a high U group, >/=0.10 mug/g creatinine and assessing differences between groups. Over a decade after first exposure, soldiers possessing embedded DU fragments continue to excrete elevated concentrations of uranium in urine. No clinically significant uranium related health effects were observed in blood count, blood chemistries including renal markers, neuropsychological measures, and semen quality or genotoxicity measures. Markers of early changes in renal glomerular and tubular function were not statistically different between groups; however, genotoxicity measures continue to show subtle, mixed results. Persistent urine uranium elevations continue to be observed more than 12 years since first exposure. Despite this, renal and other clinical abnormalities were not observed, likely due to the 'relatively' low uranium burden in this cohort compared to historical uranium-exposed occupational groups. Continuing surveillance is indicated, however, due to the on-going nature of the exposure. These results are an important finding in light of the on-going controversy regarding health effects observed in soldiers of the Gulf War and other conflicts, whose uranium exposure assessment is unable to be accurately determined.

BackgroundYouth vaping poses a significant public health concern as metals have been detected in e-cigarette aerosols and liquids. This study investigated factors associated with biomarkers of metal exposure.MethodsData were drawn from Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study Youth Panel, a nationally representative sample of US adolescents aged 13–17 years. Urinary biomarkers of exposure to cadmium, lead, and uranium were assessed by vaping frequency (occasional (1–5 days), intermittent (6–19 days), and frequent (20+ days)) in the past 30 days and flavour type (menthol/mint, fruit, and sweet).ResultsAmong 200 exclusive e-cigarette users (median age 15.9 years, 62.9% female), 65 reported occasional use, 45 reported intermittent use, and 81 reported frequent use. The average number of recent puffs per day increased exponentially by vaping frequency (occasional: 0.9 puffs, intermittent: 7.9 puffs, frequent: 27.0 puffs; p=0.001). Both intermittent (0.21 ng/mg creatinine) and frequent users (0.20 ng/mg creatinine) had higher urine lead levels than occasional users (0.16 ng/mg creatinine). Frequent users also had higher urine uranium levels compared with occasional users (0.009 vs 0.005 ng/mg creatinine, p=0.0004). Overall, 33.0% of users preferred using menthol/mint flavours, 49.8% fruit flavours, and 15.3% sweet flavours. Sweet flavour users had higher uranium levels compared with menthol/mint users (0.009 vs 0.005 ng/mg creatinine, p=0.02).ConclusionsVaping in early life could increase the risk of exposure to metals, potentially harming brain and organ development. Regulations on vaping should safeguard the youth population against addiction and exposure to metals.

A novel fluorescence/colorimetric dual-mode detection strategy for uranium ions (UO 2 2+ ) is presented based on a cerium-sulfonyl calix[4]arene (SC4A) platform. The exo- and endo-rim sites of SC4A can coordinate with Ce 3+ and Ce 4+ ions, respectively, quenching Ce 3+ fluorescence and influencing the oxidase-like activity of Ce 4+ . In the absence of UO 2 2+ , the solution of 3,3,5,5-tetramethylbenzidine (TMB) remains blue, but upon UO 2 2+ binding, Ce 3+ dissociates from SC4A, restoring fluorescence, while UO 2 2+ interacts with oxTMB, turning the solution from blue to colorless. This dual-mode system provides a linear fluorescence detection range of 30–800 nM with a detection limit of 20.20 nM, and a colorimetric range of 30–800 nM with a detection limit of 27.78 nM. By combining high-sensitivity fluorescence with visual colorimetric analysis, the proposed method possesses high sensitivity, accuracy, and reliability. Notably, smartphone-based color capture facilitates rapid and convenient sample analysis, enabling straightforward quantification at varying UO 2 2+ concentrations. The method has been successfully applied to real water and urine samples, demonstrating its practical utility in environmental and biological monitoring of UO 2 2+ . Graphical abstract

Uranium is common in drinking water, soil, and dust in American Indian communities. Hypertension is a cardiovascular risk factor affecting American Indians. We evaluated the association between uranium exposure and incident hypertension and changes in blood pressure among Strong Heart Family Study participants. We included 1,453 participants ≥14 years with baseline visits in 1998-1999 or 2001-2003, and follow-up in 2001-2003 and/or 2006-2009. We estimated the association of urinary uranium with changes in systolic and diastolic blood pressure levels over time and hypertension incidence; we accounted for family clustering. Median (IQR) baseline urinary uranium levels were 0.029 (0.013-0.059) μg/g creatinine; 17.4% (n = 253) of participants developed hypertension. In the comparison of the urinary uranium quartile 4 (highest concentration) and quartile 1 (lowest concentration), the multi-adjusted risk ratio (95% CI) of incident hypertension was 1.44 (1.04-1.99). The associations between urinary uranium with changes in systolic and diastolic blood pressure were null and nonlinear, respectively. Both associations were modified by study site, and diastolic blood pressure showed a positive association beyond 5 µg/g creatinine. The association between urinary uranium and change in systolic blood pressure was inverse in Arizona and Oklahoma, and positive in North Dakota/South Dakota at higher ends of the uranium distribution. Findings suggest a higher risk for hypertension at uranium levels typical of the Southwest and Great Plains than at levels in other regions (<0.01 µg/g creatinine); the associations with changes in systolic and diastolic blood pressure levels were consistent with a positive association with higher uranium exposure. Prospective research is critical to characterize the cardiovascular effects of uranium and develop preventive strategies for US Indigenous communities disproportionately exposed.

Background . Najaf governorate was recorded as one of the most polluted Iraqi governorates with increased cancer, autoimmune, and abortion cases. Study Groups . A total of 88 adult volunteers from three test groups were divided based on their inhabitance in different geographical regions in Najaf governorate. Group 1 (G1; n , 29) inhabitants of Al‐Ansar, Al‐Abbaseyeh, and Al‐Manathera districts, Group 2 (G2; n , 27) inhabitants of 22 different scattered districts of the governorate, Group 3 (G3; n , 32) inhabitants of Kufa city and center districts in the old Najaf city. According to previous authors′ findings, all participants had uranium contamination in their urine and blood samples, and also, they had DNA damage according to the level of urinary 8‐OHdG compound. The control group 4 (G4; n , 25) were adult healthy Iraqi volunteers who were residents of the Sulaimaniyah governorate, which has low‐level uranium pollution. The present study aims to determine the effect of uranium pollution and DNA damage on the immune system function in terms of estimating the levels of serum interleukin (IL)‐6, interferon‐gamma (IFN‐ γ ), and IL‐1 beta ( β ). Method . Enzyme‐linked immunosorbent assay (ELISA) (Sandwich method technique) was used for estimating the serum cytokines levels in test and control groups. Results . A significant elevation of cytokines levels was reported as compared with the control groups ( p ≤ 0.01). The level of IL‐6 was 764.64 ± 24.12 pg/ml, 768.87 ± 19.64 pg/ml, and 735.62 ± 18.47 in G1, G2, and G3, respectively. The level of IFN‐ γ was 264.55 ± 19.17 pg/ml, 259 ± 18.76 pg/ml, and 261.20 ± 12.99 pg/ml for G1, G2, and G3, respectively. The level of IL‐1 β was 99.85 ± 10.81 pg/ml, 116.8 ± 10.71 pg/ml, and 83 ± 19.24 pg/ml in G1, G2, and G3, respectively. The levels of IL‐6, IFN‐ γ , and IL‐1 β were 86.5 ± 22.9 pg/ml, 19.4 ± 2.8 pg/ml, and 16.1 ± 3.2 pg/ml in the sera of control (G4). The results showed significant statistical elevation with the corresponding p value cut‐off p ≤ 0.01 in IL‐6, IFN‐ γ , and IL‐1 β in the sera of three test groups as compared with the results of the control group. Conclusion . The change in the proinflammatory cytokines (IL‐6, IFN‐ γ , and IL‐1 β ) levels indicates a persistent inflammatory response in the participants and may reflect immune system impairment as a consequence of exposure to long‐term low‐dose ionizing radiation.

Uranium is found in geological deposits around the world. Toxicology of uranium includes nephrotoxicity, carcinogenicity, genotoxicity, diminished bone growth, and developmental defects. Mining and agricultural practices have escalated the regional exposure. A family of six living in the Phoenix, AZ area had concerns about uranium exposure. For intervention, a dietary supplement of modified citrus pectin: sodium alginate (2:1) was recommended based on research supporting abilities to lower heavy metal toxicity. Baseline urine and fecal samples were analyzed using inductively coupled plasma mass spectrometry. The supplement was self-administered at 3 capsules (750 mg/capsule) twice daily. Samples were taken at baseline, 6-days, and 6-weeks, additional fecal samples before stopping supplement and then after a 6-week washout period. Home water system was tested as well for heavy metals. Urine showed no detectable uranium whereas feces had significant change at 6-days, which persisted at 6-weeks. After a post-treatment period of 6-weeks, a decrease in excretion was seen in 5 of the 6 subjects. Home water showed cautionary levels of uranium. The supplement promoted fecal excretion of what is likely ongoing low-level exposure via ingestion. This is the first report of a supplement promoting uranium excretion suggesting it may reduce negative health effects in regions where chronic uranium exposure is known.

Objective: To ensure that all veterans with retained embedded fragments are properly monitored for potential health effects of embedded materials. Methods: Urine biomonitoring and health surveillance programs were developed to gather information about health risks associated with chemicals released from embedded fragments. Results: Elevated systemic exposure to depleted uranium (DU) that continues to occur in veterans with DU fragments remains a concern, although no clinically significant DU-related health effects have been observed to date. Other metals and local tissue reactions to embedded fragments are also of concern. Conclusions: Knowledge gained from these programs will help to develop guidelines for surgical removal of tissue-embedded fragments.

Context: Private wells that tap groundwater are largely exempt from federal drinking-water regulations, and in most states well water is not subject to much of the mandatory testing required of public water systems. Families that rely on private wells are thus at risk of exposure to a variety of unmeasured contaminants. Case Presentation: A family of seven-two adults and five children-residing in rural northwestern Connecticut discovered elevated concentrations of uranium in their drinking water, with levels measured at 866 and 1,160 µg/L, values well above the U.S. Environmental Protection Agency maximum contaminant level for uranium in public water supplies of 30 µg/L. The uranium was of natural origin, and the source of exposure was found to be a 500-foot well that tapped groundwater from the Brookfield Gneiss, a geologic formation known to contain uranium. Other nearby wells also had elevated uranium, arsenic, and radon levels, though concentrations varied widely. At least one 24-hr urine uranium level was elevated (> 1 µg/24 hr) in six of seven family members (range, 1.1-2.5 µg/24 hr). To assess possible renal injury, we measured urinary beta-2-microglobulin. Levels were elevated (> 120 µg/L) in five of seven family members, but after correction for creatine excretion, the beta-2-microglobulin excretion rate remained elevated (> 40 µg/mmol creatinine) only in the youngest child, a 3-year-old with a corrected level of 90 µg/mmol creatinine. Three months after cessation of well water consumption, this child's corrected beta-2-microglobulin level had fallen to 52 µg/mmol creatinine. Significance: This case underscores the hazards of consuming groundwater from private wells. It documents the potential for significant residential exposure to naturally occurring uranium in well water. It highlights the special sensitivity of young children to residential environmental exposures, a reflection of the large amount of time they spend in their homes, the developmental immaturity of their kidneys and other organ systems, and the large volume of water they consume relative to body mass.

Uranium is a ubiquitous metal that is nephrotoxic at high doses. Few epidemiologic studies have examined the kidney filtration impact of chronic environmental exposure. In 684 lead workers environmentally exposed to uranium, multiple linear regression was used to examine associations of uranium measured in a 4-h urine collection with measured creatinine clearance, serum creatinine- and cystatin-C-based estimated glomerular filtration rates, and N -acetyl- β - D -glucosaminidase (NAG). Three methods were utilized, in separate models, to adjust uranium levels for urine concentration— μ g uranium/g creatinine; μ g uranium/l and urine creatinine as separate covariates; and μ g uranium/4 h. Median urine uranium levels were 0.07  μ g/g creatinine and 0.02  μ g/4 h and were highly correlated ( r s =0.95). After adjustment, higher ln- urine uranium was associated with lower measured creatinine clearance and higher NAG in models that used urine creatinine to adjust for urine concentration but not in models that used total uranium excreted ( μ g/4 h). These results suggest that, in some instances, associations between urine toxicants and kidney outcomes may be statistical, due to the use of urine creatinine in both exposure and outcome metrics, rather than nephrotoxic. These findings support consideration of non-creatinine-based methods of adjustment for urine concentration in nephrotoxicant research.