Shiu Jessica, Gaitens Joanna, Squibb Katherine S, Gucer Patricia W, McDiarmid Melissa A, Gaspari Anthony A
From the Departments of *Dermatology and †Medicine, University of Maryland School of Medicine; ‡Department of Veterans Affairs and §Managed Care Service, Baltimore VA Medical Center, MD.
Dermatitis. 2015 May-Jun;26(3):142-7. doi: 10.1097/DER.0000000000000110.
Depleted uranium (DU)-containing weapons have been used in military operations since 1991. There is interest in following veterans who were occupationally exposed to DU by either inhalation or retention of fragments. A cohort of DU-exposed Gulf War I veterans has been followed longitudinally at the Baltimore Veterans Administration Medical Center since 1993.
The aim was to monitor chronic dermatological findings associated with occupational DU exposure in the 2013 cohort.
Thirty-five veterans were evaluated. This study was reviewed and approved by the institutional review board and the Baltimore Veterans Administration Medical Center research service. Depleted uranium exposure was measured using creatinine-adjusted urine uranium concentrations (micrograms of uranium per gram of creatinine [μgU/gCrea]). Detailed medical histories, physical examinations, and exposure histories were performed.
Using a cutoff level of 0.1 μgU/gCrea, 11 veterans were placed in the high-uranium exposure group, whereas 23 veterans were placed in the low-uranium exposure group. Retained fragments were documented in 91% of the high-exposure group versus that in 13% of the low-exposure group (P < 0.001), and fragment-related scarring was significantly increased in the high-exposure group (P = 0.002). Other dermatological findings such as dermatitis were also assessed.
Fragment retainment and related scarring was significantly increased in veterans exposed to high levels of DU. Continuous monitoring of this cohort will yield interesting dermatological findings related to DU exposure.
自1991年以来,含贫铀(DU)武器已被用于军事行动。人们对追踪那些因吸入或留存碎片而职业性接触贫铀的退伍军人很感兴趣。自1993年以来,一组接触贫铀的海湾战争一期退伍军人一直在巴尔的摩退伍军人管理局医疗中心接受纵向跟踪。
旨在监测2013年那组队列中与职业性接触贫铀相关的慢性皮肤病学发现。
对35名退伍军人进行了评估。本研究经机构审查委员会和巴尔的摩退伍军人管理局医疗中心研究服务部审查并批准。使用肌酐校正后的尿铀浓度(每克肌酐中铀的微克数[μgU/gCrea])来测量贫铀暴露情况。进行了详细的病史、体格检查和暴露史调查。
以0.1 μgU/gCrea的临界值划分,11名退伍军人被归入高铀暴露组,而23名退伍军人被归入低铀暴露组。高暴露组中有91%记录到有留存碎片,而低暴露组中这一比例为13%(P < 0.001),且高暴露组中与碎片相关的瘢痕形成显著增加(P = 0.002)。还评估了其他皮肤病学发现,如皮炎。
高剂量接触贫铀的退伍军人中,碎片留存和相关瘢痕形成显著增加。对这一队列的持续监测将得出与接触贫铀相关的有趣的皮肤病学发现。