Gulf War Veteran Health: Are We Seeing New Long-Term Effects?
"A recent study sheds light on potential bone density issues in veterans exposed to depleted uranium, raising new questions about long-term health surveillance."
For over 25 years, the U.S. Department of Veterans Affairs (VA) has been closely monitoring the health of Gulf War I veterans who experienced combat incidents involving depleted uranium (DU). This effort was initiated to assess potential adverse health effects from DU exposure, ensuring these veterans receive appropriate medical management.
A recent study focusing on this cohort has revealed a potential new concern: a possible association between depleted uranium exposure and bone density loss, which wasn't apparent in earlier assessments. This article explores these findings, what they might mean for veterans' health, and the ongoing efforts to understand the long-term consequences of DU exposure.
The study, conducted in 2017, evaluated 42 veterans, examining uranium levels in their urine and conducting comprehensive health assessments, including bone mineral density (BMD) measurements for those over 50. The results offer new insights into the potential long-term effects of DU exposure.
Depleted Uranium Exposure and Monitoring
The VA says long-term adverse health effects from depleted uranium (DU) exposure would not be expected, while noting that DU can be a potential health hazard if it enters the body through embedded fragments, contaminated wounds, inhalation, or ingestion. Veterans who think they may have been exposed can contact a VA Environmental Health Coordinator or provider, or call VET-HOME at 833-633-8846 and ask to be screened. A small group of Gulf War I veterans wounded in DU friendly-fire incidents has been monitored at the Baltimore VA Medical Center since 1994; 33 members were seen for surveillance in spring 2024.
How the Evidence Is Reviewed
The National Academies committee began by searching the scientific literature for human studies of long-term health outcomes that might be associated with depleted uranium (DU). It developed criteria to evaluate the relevance and quality of studies, and reviewed literature on DU, pyridostigmine bromide, sarin and cyclosarin, and anthrax and botulinum toxoid vaccines. A separate 2021 study applied its methods to a highly studied, population-representative sample of theatre-deployed and non-deployed Gulf War-era U.S. veterans in whom Gulf War Illness had been reported. These sources describe review and research approaches, but the supplied material does not specify their limitations.
DU’s First Large-Scale Gulf War Use
The VA says depleted uranium (DU) was first deployed on a large scale during the Gulf War. The U.S. military uses the dense metal in tank armor and projectiles, including for its ability to penetrate enemy armored vehicles. Health.mil describes the Gulf War as the first battlefield use of armor-piercing munitions and reinforced tank armor incorporating DU, and says DU is leftover uranium from the enrichment process, with 40% less radioactivity than natural uranium. A 2006 article described the debate over DU’s health effects among Gulf War veterans and others as unresolved after 15 years.
What Does Depleted Uranium Exposure Have To Do With Bone Health?
Depleted uranium (DU) is a byproduct of uranium enrichment, used in military applications due to its high density. Gulf War veterans may have been exposed through:
- Inhalation of particulate aerosols at the time of impact.
- Superficial wound contamination.
- Absorption from retained fragments.
Recent DU Surveillance and GWI Research
In spring 2024, 33 Gulf War I veterans wounded in depleted uranium (DU) friendly-fire incidents were seen at the Baltimore VA Medical Center for surveillance related to their combat exposure. The protocol included monitoring total and isotopic uranium concentrations in urine and a comprehensive health assessment. A separate 2021 telehealth evaluation assessed 37 members of a DU-exposed Gulf War I cohort using a protocol adapted for COVID-19 safety practices. In another line of research, a 2025 study’s secondary analysis found serum C18:0 ceramide was more than 56% higher in male Gulf War Illness veterans than in non-veteran healthy controls.
Evidence Remains Inconclusive
The National Academies committee concluded that there is still not enough evidence to determine whether depleted uranium exposure is associated with long-term health problems. Its report was sponsored by the U.S. Department of Veterans Affairs. A 2020 review also notes that Gulf War syndrome was a term created to describe veterans’ health problems and mentions reports of congenital disabilities among veterans’ children and elevated mortality among Gulf veterans.
Exposure Concerns and Evidence
A review of depleted uranium (DU) describes its military use in the Gulf and Balkans and discusses concerns that exposure could contribute to Gulf War Syndrome or cancer clusters. The 2025 Health Physics Society fact sheet says concerns about DU exposure, especially among veterans and healthcare professionals, have been raised since the 1991 Gulf War, and that it explains DU’s uses and potential health risks. The supplied source material does not provide comparative outcome figures or evidence that resolves those concerns.
What Does This Mean for Veterans and Future Research?
While the study reveals a potentially significant link between DU exposure and bone density loss, it's important to interpret the findings cautiously. The researchers emphasize that this is a novel observation requiring further investigation to confirm.
Long-Term Follow-Up of Exposed Veterans
The Baltimore VA DU Follow-Up Program was initiated in 1993 to monitor health effects in Gulf War veterans who were in or on U.S. Army vehicles hit by friendly fire involving DU munitions. Longitudinal surveillance of Gulf War I veterans injured in DU friendly-fire incidents has been reported since 1994. In spring 2019, 36 cohort members were evaluated using a protocol that included total and isotopic uranium measurements in urine and a comprehensive review of health outcomes.
Longitudinal surveillance of this cohort is crucial to fully understand the long-term effects of DU exposure. This includes:
Future research should also explore potential mechanisms by which DU might affect bone health, potentially through direct toxicity to bone cells or indirect effects on vitamin D metabolism. Continued monitoring and research are essential to ensure the health and well-being of veterans exposed to depleted uranium.