To ensure that all veterans with retained embedded fragments are properly monitored for potential health effects of embedded materials.
Urine biomonitoring and health surveillance programs were developed to gather information about health risks associated with chemicals released from embedded fragments.
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.
Knowledge gained from these programs will help to develop guidelines for surgical removal of tissue-embedded fragments.
From the Department of Veterans Affairs Medical Center (Ms Squibb, Ms Gaitens, Ms Engelhardt, and Ms McDiarmid), Baltimore, Md; Department of Medicine Occupational Health Program (Ms Squibb, Ms Gaitens, and Ms McDiarmid), University of Maryland School of Medicine, Baltimore, Md; and Division of Biophysical Toxicology (Mr Centeno, Ms Xu, and Mr Gray), The Joint Pathology Center, Malcolm Grow Medical Center, Joint Base Andrews Naval Air Facility, Washington, DC.
Address correspondence to: Katherine S. Squibb, PhD, Occupational Health Program, UM School of Medicine, 11 South Paca Street, Suite 200, Baltimore, MD 21201.
This work was supported by the Department of Veterans Affairs.
The authors declare no conflict of interest.