MINISTRY OF DEFENCE Final

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Final

Gulf Veterans’ Illnesses Unit

MINISTRY OF DEFENCE

Zone A, Floor 7, St Georges Court,

2-12 Bloomsbury Way,

London, WC1A 2SH

Telephone

Direct dial

020 7305 4669

Helpline

0800

169

4495

Fax

020 7305 4166

Final

Our Reference:

D/GVIU/7/1/8/2

Date:

30 September 2003

MINUTES OF THE TWELFTH DEPLETED URANIUM SCREENING

PROGRAMME OVERSIGHT BOARD MEETING ON 22

SEPTEMBER 03

Present:

Board:

Observers:

Professor David Coggon

Surg. Cdre Nick Baldock

Mr Ron Brown

Dr Chris Busby

Mr Ivor Connolly

Maj Gen (Retd.) R P Craig

Mr Jim Glennon

Dr David Lewis

Dr Gordon Paterson

Professor Brian Spratt

(Charles Williams

Air Cdre Simon Dougherty

Wg Cdr Charlie Wilcock

Mrs Brigid Rodgers

Mrs Janie Walker

Miss Rosie Wane

MRC

INM

DRPS

LLRC

NGV&FA

RBL

NGV&FA

INM

BRC

GVIU

DMSD

GVIU

Chair

Secretary)

Apologies:

Dr George Etherington

Professor Ian Gilmore

Dr Muir Gray

Dr Gideon Henderson

Mr Neville Higham

Professor Malcolm Hooper

Dr Len Levy

Dr Margaret Spittle

Dr Hilary Walker

Mr Alan Duncan

NRPB

RBL

NSC

Ox Uni

HSE

GVA

MRC IEH

HJA

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Item Discussion

and

Decisions Actions

(Action date)

Introduction

a) The Chairman welcomed Maj Gen (Retd.) R P Craig to his first meeting of

the Oversight Board.

b) The Chairman explained that the main business of the meeting would be:

i. To update members on the tendering exercise for the main testing and

decide the way forward; and

ii. To hold a final discussion on the second pilot study in preparation for a

separate meeting with the laboratory representatives scheduled to follow

the DUOB.

Minutes of last meeting

a) One minor grammatical correction was agreed by the Board.

Action 12.1 Secretary to finalise minutes of 11

DUOB and circulate

Secretary

(completed

23.09.03)

Matters arising from last meeting

i. Discrepancy in Pilot Study Reports

a) The secretary was unaware of an outstanding action and was asked to look

into it. [Post-meeting note: 10

meeting item 4a – possible discrepancy

between two tables in one of the laboratory reports.]

Action 12.2 Secretary to investigate possible discrepancy

ii. Committee Examining Radiation Risks from Internal Emitters (CERRIE)

a) Dr Busby said that DU would be discussed by CERRIE at its meeting in

January 2004.

iii. DUOB Terms of Reference (TOR)

a) The secretary confirmed that the TOR had been dated.

b) The Chairman confirmed that he had written to the Minister, Ivor Caplin MP,

concerning a possible extension to the role of the Oversight Board. [Copies of

the Minister’s reply were circulated at the meeting.] The Minister had

suggested that he meet with Professor Coggon. However, the Minister did not

wish the Board to undertake formal oversight of DU testing arising from the

2003 conflict in Iraq and did not wish to extend the retrospective urinary

uranium test developed for veterans of the Balkans and 1991 Gulf war to

personnel involved in Op TELIC (the UK component of the 2003 conflict in

Iraq). Professor Coggon said that he felt the view on this might change with

time. Dr Busby said he believed that the decision was unacceptable and the

matter should be pursued.

iv. Op TELIC personnel DU intake research

a) Mrs Rodgers said it had been decided that research into the urinary uranium

levels of UK military personnel deployed in the 2003 Iraq conflict would be

carried out as part of broader post-TELIC health research by Professor Simon

Wessely’s group at King’s College London. She had written to Professors

Coggon and Spratt and to Dr Etherington to ask them to assist Professor

Wessely with the DU aspects of the work.

Secretary

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b) Professor Coggon confirmed that he had been asked to collaborate with the

King’s College team. He said that there was some urgency to the work

because of the inevitable fall off in urinary uranium concentration over time.

The study protocol would be drawn up mainly by the three DUOB members.

The Oversight Board as a whole would have the opportunity to comment on

the protocol, but would not have the authority to veto it. Professor Spratt said

he was pleased with the decision and felt that the study would make a useful

addition to the literature.

c) Mr Glennon asked for it to be minuted that he had not been told about the

decision to place the Op TELIC DU study with King’s. He felt that all

members of the DUOB should be involved. The Chairman responded that

everything was totally open. The letters had gone out only a matter of days

before the meeting and the matter was now being discussed. He could not see

that there was a problem. Dr Paterson expressed his contentment with the

arrangements.

d) Mr Connolly enquired about the timescale. Professor Coggon said that the

study was to take place early in the new year (2004). The KCL team would be

visiting major military centres. The DU study was additional to the main

elements of their work, and it was crucial to co-ordinate it properly with them.

Professor Spratt commented that knowledge of the extent of DU exposure on

the battlefield had long been wanted, and thus the study would be a positive

step.

e) Dr Busby said that the DUOB existed in part for the purpose of external

credibility. He was concerned about a large portion of the DU research going

to a psychiatrist; and asked why neither he nor Professor Hooper had been

invited to advise Professor Wessely. He said that there was a lack of trust in

‘establishment’ figures, and people outside would not believe the results of

research carried out in the way proposed.

f) The Chairman explained that the study had to be handled separately from

other activities connected with DU because it was part of a larger post-TELIC

health investigation for which the DUOB was not competent. The wishes of

the Minister were clear. The Oversight Board existed to oversee DU research

arising from the 1991 Gulf war and Balkans deployments.

g) Maj Gen Craig was concerned that the Institute of Naval Medicine (INM) was

seeking accreditation for urinary uranium analysis. He felt that as a MoD

laboratory, INM would not have credibility. Professor Coggon explained that

the INM laboratory would be involved in biological monitoring, not in the Op

TELIC DU study or analysis of historical DU exposure. Dr Busby said that he

did not want INM involved at all.

h) Dr Busby enquired why Professor Spratt and Dr Etherington had been chosen.

Mrs Rodgers replied that both were scientists with relevant experience and

expertise.

i) Professor Coggon said that Dr Busby and the other members of the Board

would be able to comment on the design of the questionnaire used in the KCL

DU study. Professor Spratt said that the questionnaire would be concerned

with exposure only, not health. Dr Busby said that there was anecdotal

evidence of health problems among Op TELIC veterans, and therefore state of

health should be included. He asked to see the health data being collected (in

other ways) from the TELIC personnel. The Chairman felt that this was an

unreasonable request; Dr Paterson said that the information would be

medically confidential. Dr Busby pointed out that it could be anonymised, as

he required only statistical data.

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j) Mr Glennon expressed concern about collaboration of DUOB members with

Professor Wessely, whom he said the veterans did not trust. The Chairman

asked who could be called upon to do work of this kind if all scientists

associated with the MoD were excluded. Dr Busby proposed Professor

Hooper. Mr Glennon suggested that his organisation might withdraw from the

DUOB if its wishes were not respected.

v. Main testing contract tender evaluation

a) The Chairman confirmed that a marking scheme had been produced and used

to assess the tenders. [Details were discussed later in the meeting.]

vi. Information for veterans and GPs

a) The Chairman confirmed that he had drafted advice for use after negative

urinary DU test results. This had been modified on the basis of comments

received.

b) Mr Brown asked whether the reference to normal uranium levels meant that

the advice could be given only after completion of the normative values study.

Professor Coggon replied that enough was already known for some

approximate bounds to be put on “normal”. Mr Brown then asked about the

situation if an individual showed a natural uranium isotope ratio but

abnormally high total uranium concentration. Professor Coggon said that

separate advice would be needed in that case. Mr Brown suggested it should

be made clear for whom the draft advice was intended.

c) Mr Connolly queried whether a large DU exposure that had occurred ten

years before the test could really be ruled out on the strength of a negative

result. Professor Coggon thought that it could. Mr Glennon asked whether

that included lung burden. Professor Spratt said that it did, as shown by the

Durakovic paper (“Estimate of the time zero lung burden of Depleted

Uranium in Persian Gulf war veterans by the 24-hour urinary excretion and

exponential decay analysis”, Military Medicine, 168, 8:600, 2003). Mr Brown

said that the Durakovic approach to estimation of lung burden had been

satisfactory, in as much as it suggested broadly similar intakes to those

predicted by a number of theoretical assessments.

d) Professor Coggon said that within the Board only the likelihood of health

consequences from small internal exposures to DU was contentious, and the

difference of opinion on that issue was mentioned in the draft advice. Dr

Busby said that he was content. He added, however, that without an autopsy it

was not possible to know for certain that an individual showing low urinary

uranium concentration did not have an insoluble depot of DU lodged

somewhere in their body.

e) Professor Spratt asked whether it were necessary to report the total uranium

concentration in addition to the presence or absence of DU. Professor Coggon

said that as the value would have been measured, it would have to be

disclosed. Some advice on the interpretation and possible consequences

would also have to be given. Professor Coggon expressed his gratitude to Dr

Busby for the assistance he had provided in the choice of appropriate

language.

f) Mr Connolly asked whether measurements could be affected by past medical

treatments, such as diuretic flushing. Professor Coggon said that diuretics

should affect only the DU fraction in solution, and not any insoluble reservoir

of material.

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g) Maj Gen Craig asked if any work had been published on DU levels in autopsy

tissue. Professor Spratt was not aware of any. However, it was felt that the

Americans might be doing something in this area. The Chairman asked that

the MoD make enquiries.

Action 12.3 Secretary to request autopsy information from the USA

h) Professor Coggon said that he would revise the draft advice again.

Action 12.4 Chairman to amend the draft advice on ‘negative’ test results

i) Mr Glennon remarked that from the point of the view of the recipient, the

advice was hardly unambiguous. Mr Brown agreed. Professor Spratt said the

DUOB might be keen to tell a veteran who had been tested that they had

nothing to worry about, but could not, since that was a matter of scientific

dispute. Dr Busby agreed, and said that a book could be written on the

possible consequences of low-level DU exposure.

j) The Chairman asked if the Board wanted a stronger negative statement. Mr

Brown suggested saying that people with higher levels of DU contamination

were still healthy after 12 years. Professor Coggon said that would be

unacceptable to the veterans’ organisations. He added that the test results

would be sent to the individual’s GP (provided permission were given), so

there should be scope for veterans to discuss the meaning of their results with

their doctor. Veterans would of course also be free to consult Dr Busby and

others for further advice if they wished. The equivocal wording of the draft

was a compromise, but probably the best that could be achieved.

k) Dr Paterson said that people tended to think a negative result meant no risk at

all, but that was not the case. He was therefore comfortable with the

compromise. Professor Spratt said that the orthodox scientific view should be

put first. Dr Busby said he was happy with that, since it would give his

minority view the last word.

vii. Kuwaiti cancer registry

a) The Chairman said that he had emailed a request about information from the

Kuwaiti cancer registry and was awaiting a response.

viii. Age data on Gulf war veterans

a) Dr Busby said that he still required an age and gender breakdown of (1991)

Gulf war veterans by 5-year interval up to age 80. Mrs Rodgers said that an

analysis of cancer figures could not be released before publication of the

MacFarlane paper. [The paper in question is a cancer mortality and morbidity

study of the entire Gulf deployment.]

Action 12.5 Secretary to provide Dr Busby with age and gender data for the

1991 Gulf war veterans

Secretary

Chairman

Secretary

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Pilot study results summary tables

a) The Chairman said that results in tabulated form had been received from the

pilot study laboratories, and that he had collated them with a summary text.

[The document had been circulated to all members of the Board]. He noted

that there were quite large differences in the concentration of the spiking

solution as measured by the three laboratories, and suggested that an

explanation should be sought at the wash-up meeting. Mr Brown said that at

less than 20%, he did not feel the differences were very significant with

regard to any potential health effects.

b) Professor Coggon said that the accuracy of the results seemed to be somewhat

lower than had been estimated by the laboratories, and he thought some

sources of error had not been taken into account. However, the accuracy of

the

238

235

U ratio was very good: mostly within 1% for two of the

laboratories, and within 2% for the third. These were well within the

uncertainties reported by Durakovic.

c) Mr Brown said he would expect the two laboratories using identical

instruments and techniques to agree. In some instances the error ranges of

corresponding results did not overlap, so the actual uncertainties must have

been larger than stated and this was important when assessing the significance

of the results.

d) Professor Coggon said that the measurements of total uranium concentration

had been less accurate than the isotope ratios: generally they agreed to within

10-15%. The

238

236

U ratio was really only measured satisfactorily by one

laboratory, which had achieved quite good internal consistency. The

236

U ratio

was a difficult measurement.

e) Professor Coggon said there was no indication that the 400 ml urine samples

had given markedly more accurate results than the 100 ml samples. There was

also no systematic difference between urine samples before and after storage.

These observations could have significant bearing on the procedures used for

the main testing.

f) Dr Lewis wondered about the calculation of the quoted 95% confidence

intervals. Professor Coggon said they had not been derived in the way he

would do it, and clarification was needed from the laboratories. He had

looked at how individual results varied from the mean for each sample across

laboratories, and the confidence intervals seemed too narrow.

g) Dr Lewis asked whether it was worthwhile keeping the

236

U measurement as

part of the test. Professor Spratt said that he would be happy with the

235

ratio only, since potential exposure of personnel to DU was not in question.

He suggested that the

236

U ratio be examined only as a confirmation in

ambiguous cases.

h) Mr Glennon stated that the veterans wanted the

236

U measurement retained as

a means of confirming the presence or otherwise of DU. Other Board

members questioned the scientific validity of that view. The Chairman ruled

that the Board would not yet decide on the matter.

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Update on screening programme contracts

i. Main testing contracts

a) The Chairman and secretary reported on the technical evaluation of the main

testing tenders. Seven organisations had been invited to tender and six had

done so. A technical assessment panel comprising Professors Coggon and

Hooper and Dr Henderson had met on August 12

and reached a conclusion,

which was subsequently supported in a separate evaluation by Dr Lewis.

b) The panel had rejected two of the tenders, which were considered technically

inadequate. The remainder were allocated scores against a range of technical

criteria. Professor Coggon said that in his view the lowest-scoring laboratory

was good enough to be involved in the programme, possibly in an

independent audit role. The secretary said that the MoD contracts branch had

written to each of the four acceptable tenderers, requesting clarification on a

number of points highlighted by the panel. Answers were awaited. [Post

meeting note: all responses have now been received.]

c) Dr Busby asked whether it was the intention to place contracts with three

laboratories or all four, and whether there would be sufficient testing capacity.

The Chairman said that the recommendation of the technical panel was to

award contracts to the three top-scoring laboratories. The promised total

capacity of those laboratories was 1300 samples per annum.

d) Mr Brown said that he felt the sample throughput promised was optimistic,

and wondered whether the Board should encourage the fourth laboratory to

resubmit. Dr Busby supported that idea. Dr Paterson remarked that the MoD

could not work outside its formal contract procedures. Mr Brown reminded

the Board that the normative value study would be adding to the number of

samples for analysis.

e) Mr Connolly asked about the order in which veterans’ samples would be

tested. The secretary said that the Board had yet to decide on a procedure for

accepting people into the programme and arranging the test. However, he

thought it most likely that the tests would happen according to the order in

which people came forward for them.

ii. Healthcare provider

a) The secretary said that two companies had been invited to tender, but only

one had done so. One company decided not to participate on the grounds that

the activity required was not its core business. The sole tender received was

technically assessed on August 29

by a panel comprising Professors Coggon

and Hooper (in person) and Dr Paterson (by correspondence). The panel

wanted clarification on a number of points in the bid, and the MoD contracts

branch wrote to request this from the company. Subsequently the company

withdrew its offer, saying that it had underestimated the extent of the

requirement and did not have the necessary resources.

b) Professor Coggon explained that the company had no experience in handling

samples for uranium analysis and lacked advisory expertise in radiation

medicine and toxicology. However, the logistics arrangements had looked

satisfactory, and the panel had been willing to help the company identify

suitable experts. Professor Coggon stressed that the MoD had actively

searched for potential contractors and discussed the requirement with several

organisations. There appeared to be no-one in the market with all the

attributes needed. Therefore the Board must rethink. One possible way

forward was to place contracts with a number of regional NHS occupational

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health departments for the basic sample collection; and get another

organisation for the central co-ordination role and dealing with the results.

The DUOB itself could help with finding suitable experts to advise on the

interpretation of test results.

c) Professor Coggon suggested that it would be useful at this stage to carry out a

‘pilot’ exercise with, say, 30 veterans in a single geographical area in order to

test the procedures. Spot samples of urine as well as 24 hour collections could

be requested. Analysis would be carried out by more than one laboratory and

the results from the spot samples would be compared with those from the 24

hour samples. A similar comparison could be done as part of the civilian

normative values study. If the spot results proved to be as good as those from

the 24 hour collections in both cases, the logistics of the main testing

programme could be greatly simplified. Professor Coggon recommended this

approach to the Board. He said it would provide extra useful information and,

importantly, get the testing programme started.

d) Dr Lewis said that spot samples must definitely be ratioed to creatinine.

Professor Coggon agreed.

e) Dr Busby said that the Board might as well invite all the veterans who wanted

a test in the area concerned to participate in the pilot. He had no objection to

the proposal and considered it a good way forward. The geographical area

could be chosen on the basis of how many veterans there were to be tested in

various parts of the country. Professor Coggon said that for practical reasons,

London would be the easiest area.

f) Mr Glennon said that he had reservations about the proposal, and wanted to

discuss it with the members of his organisation. Professor Coggon said that

participants in a pilot exercise would gain the advantages of having their tests

done earlier than most and multiply analysed. The drawback was that more

would have to be asked of them, in giving both 24 hour and spot samples.

g) Dr Paterson supported the proposal. He said it would be embarrassing for the

Board if contracts had been let with the analytical laboratories but no samples

were being collected. He also felt that the Occupational Health department

involved in a pilot exercise could be asked to continue into the main

programme.

h) The Chairman asked whether Dr Paterson would be willing to take on the

advisory role in relation to a limited pilot of testing in veterans . Dr Paterson

declined, saying that he did not have all the specialised expertise required and

the job should preferably be done by one person. Mr Brown said that it would

not be possible to find a single individual able to advise expertly on all

aspects. The Chairman suggested that alternatively a panel of members drawn

from the DUOB might undertake the work.

i) Mr Glennon asked that the proposed way ahead for the healthcare provision

be discussed at the next Oversight Board meeting. He was uncomfortable at

the way, as he saw it, the subject was being pushed. Dr Paterson asked Mr

Glennon to state his concerns. Mr Glennon replied that the proposal was too

close to the official ‘side’, and differed from the protocol agreed by the Board.

j) Dr Busby asked who would carry out the administrative functions. Professor

Coggon said that either members of the DUOB or the Occupational Health

department could write to the participating veterans.

k) Maj Gen Craig said that the proposal made eminent sense. The information

obtained from a pilot exercise could change totally what happened next. Dr

Lewis said the proposal was a good idea, but an area must be chosen where

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the background uranium concentration was low so that any DU was not

masked. London would be satisfactory.

l) Professor Coggon suggested that St. Thomas’, Guy’s, and King’s hospitals

would be a good starting point. Dr Paterson said that the Board should try to

deal with the matter by correspondence before the next meeting. Professor

Coggon said that if the veterans’ representatives were unhappy with the

proposal, they would need to suggest an alternative plan in order not to

compromise the programme.

m) The secretary reported that the MoD contracts branch had been trying to

identify an organisation that might take on the ‘central’ co-ordinating

function. The Department of Health had been contacted for advice and had

suggested the Health Protection Agency. The agency had declined since its

remit was public health issues only, and in turn had suggested the NRPB. Dr

Busby and Mr Glennon responded that the NRPB would be totally

unacceptable to the veterans. [Post meeting note: The NRPB advised MoD

contracts branch that it could not undertake work of this kind.]

n) The Chairman said that it should not be difficult to find a suitable

organisation. Suggestions were welcome.

Action 12.6 DUOB members to suggest potential contractors for the central

co-ordination and advisory function

o) Dr Busby said that the ‘pilot’ exercise should simply be the first stage of the

main testing programme. Mr Connolly said that no answer from the veterans’

side on the acceptability of the ‘pilot’ proposal was likely until the return of

Professor Hooper. The Chairman said that Professor Hooper was already

aware of the plan and appeared to be content with it. Maj Gen Craig said that

there would be a big advantage in using spot samples.

p) Mr Brown asked how veterans for a pilot exercise would be recruited. The

Chairman replied that GVIU had a list of names and addresses of people who

had enquired about the test; in addition, perhaps the veterans’ organisations

could assist. The Chairman stressed that the veterans’ representatives must be

comfortable with what was done.

q) Mr Connolly said that a meeting of the NGV&FA would be needed in Hull to

discuss the proposal. He asked whether the MoD could offer support by

reimbursing the members’ travel costs. Mrs Rodgers said this was unlikely.

[Post meeting note: The matter is under consideration by the MoD.]

r) Due to shortage of time, the Chairman deferred discussion on the purpose and

choice of the “independent third party”.

iii. Civilian normative values study

a) Professor Coggon explained that an organisation specialising in occupational

medicine had been invited to tender for the normative values study and had

done so. However, the protocol the organisation had put forward, which

involved using hospital inpatients, was more elaborate and expensive than

anticipated. Again, the logistics of the work would be much simpler if spot

samples could be used.

b) Professor Coggon had met staff from the prospective contractor and suggested

breaking the study into two parts. The first part (“A”) would involve

collecting both a combined 24 hour urine sample and a series of spot samples

over a second period of 24 hours. The results of the analyses would then be

compared and the main study (part “B”) designed accordingly. Even if a 24

All members

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hour collection proved to be necessary, the contractor could write in advance,

inviting participation from people with forthcoming outpatients’

appointments, rather than rely on inpatients. This would be more efficient

than the original proposal. If a spot sample were acceptable, so much the

better. Professor Coggon reported that the staff were open to the new idea,

and the MoD was exploring its contractual aspects.

c) Dr Busby said he agreed with the use of outpatients. It was not perfect, but

probably the best practical option. Maj Gen Craig remarked that the NHS had

very few convalescent inpatients nowadays in any case: people tended to be

admitted to hospital immediately before surgery and discharged very quickly

afterwards.

d) Maj Gen Craig asked whether the Occupational Health world had established

any time of day excretion profiles for heavy metals. Other members of the

Board had no firm information on the subject. However, Dr Busby made the

point that taking a bath tended to increase the excretion of lead due to the

equilibration of internal and external cell pressures.

Information to Veterans/GPs

a) Dr Paterson said that the College of Health (CoH) had now convened a focus

group of veterans that had scrutinised the draft information sheets. He

suggested that instead of the original plan of ‘basic’ and ‘advanced’ versions,

there should be a single document with a more detailed annex. Revised drafts

were now awaited from the CoH.

Questionnaire

a) Professor Coggon said he had agreed with Professor Hooper that he

(Professor Coggon) would prepare the next draft. The action therefore rested

with him.

Timescales

a) The Chairman said that contracts would be let with the analytical laboratories

within a few weeks. Subject to contractual acceptability, the go-ahead should

also be given to the prospective occupational medicine contractor for the first

stage of the normative values study on the same timescale. With regard to the

healthcare function, feedback was required from the veterans’ representatives;

but preliminary work to identify Occupational Health departments and other

potential collaborators could proceed immediately. The whole process would

probably take about two months.

b) Professor Coggon requested nominations from the Board for the expert

advisory role. Dr Busby offered himself, asserting that as low-dose radiation

effects amounted to a new area of medicine, there were no established

experts. Professor Coggon said that really someone with a medical

background was needed.

c) Professor Coggon said that the communication tools would not be needed

until after the pilot exercise (if done). It was still possible for the test

programme to begin before the end of 2003.

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DU background and scientific issues

i. Chromosomal aberration

a) Dr Busby reported that the July meeting of CERRIE had involved a

discussion with contributors from around the world on the validity of the

ICRP radiological hazard model. It emerged that the chairman of the

European Committee on Radiation Risks (ECRR) had written on chromosome

damage in the 1980s. Good correlation was observed between the amount of

damage and the external radiation dose. When applied to the Schott results,

the implied dose was about 50 mSv: which in turn implied the presence of a

depot of uranium within the body. The dose was not consistent with the ICRP

approach.

b) Dr Busby went on to explain that absorption of all gamma radiation is

proportional to the fourth power of the atomic number. Thus uranium, with its

high atomic number, absorbs the radiation strongly, converting its energy into

photo-electrons. He suggested that most of these would be re-absorbed within

the bulk of a substantial mass of uranium; but from fine particles (less than 3

microns) lodged in the body, electrons at an energy level below about

100 keV might reach surrounding tissue, creating a much higher local field.

Dr Busby said there was some controversy about the influence of particle size.

It was claimed that the effect disappeared at very small particle size, though

he felt this observation could be an artefact.

c) The Chairman requested the CERRIE position on the outlined theory. He said

the Oversight Board was interested in new ideas and any experimental data

that supported them. There was obviously a good deal of uncertainty.

d) Dr Busby said that he wanted research to be done on chromosomal

aberrations. Professor Spratt shared this view.

ii. Durakovic paper on retrospective estimation of DU exposure from urinary

uranium measurements

a) Professor Spratt said that of the eleven test subjects in the paper, six had given

a negative result, four had shown only a tiny lung burden of DU, and one had

shown a significant lung burden (in the range 1-5 mg). Professor Spratt did

not think it was valid to average the results as Durakovic had done.

b) Professor Coggon said that he found the Durakovic paper interesting.

Professor Spratt said the work suggested that the lung dose was actually a

good deal lower than might be expected for battlefield DU exposure.

c) Maj Gen Craig and Mr Brown discussed the work of the Bremen Institute.

Professor Spratt said that chromosomal aberrations should be assessed in

veterans showing various different levels of urinary DU.

iii. NERC research on DU in the environment

a) Professor Coggon asked about the role of the Natural Environment Research

Council (NERC) in regard to DU. Mrs Rodgers replied that the NERC had

been asked to call for proposals to carry out research on various aspects of

DU in the environment. It had issued the call a few weeks previously. NERC

involvement was described in the MoD’s DU research programme proposal,

which had been sent to the DUOB in early 2002. Professor Coggon asked for

the Board to be kept informed.

Action 12.7 MoD to report to the DUOB on the NERC research

Secretary

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10.

Depleted Uranium Workshop

a) Mr Brown stated that something would be said on each of the 13 topics in the

MoD’s DU research programme, although some might be very brief since

there had so far been little progress. Professor Spratt said that the biokinetic

modelling would be of most relevance to the Oversight Board.

b) Mr Glennon referred to what he called the “secret” meeting on the second day

of the workshop, and asked whether it would contain anything of interest to

the DUOB. Mr Brown replied that probably only the Operational Analysis on

possible replacements for DU munitions would be discussed.

c) Dr Busby requested an agenda for the first day of the workshop so that he

could decide whether attendance would be worthwhile.

Action 12.8 Secretary to provide Dr Busby with a workshop agenda

Secretary

11.

Date of next meeting

a) The next meeting was scheduled for Thursday November 20

2003.

b) The secretary was asked to canvass members for suitable meeting dates in

January and March 2004.

Action 12.9 Secretary to canvass DUOB for January and March dates

Secretary

12.

A.O.B.

a) The Chairman referred to the transcript of the June 19

meeting of the Inter-

Parliamentary Gulf War Group. He had been disturbed to see that Professor

Hooper twice stated there were no plans for DU research by the Oversight

Board. This was not the case. It had always been the intention to apply the

retrospective test in research, and for the Board to be involved in the research.

b) Dr Busby said it was not his understanding that the DUOB would oversee the

research, but he was glad if this were the case. The Chairman said that the

Medical Research Council (MRC) was better equipped to review the detailed

science, but the Oversight Board would define the research questions. This

could be summarised as “we propose, the MRC vets”. The most appropriate

form for the ‘oversight’ had yet to be worked out. Dr Busby said he did not

accept that the DUOB lacked expertise on medical research questions. Dr

Paterson commented that the Board could not really “stand over” the research

teams.

c) Mr Glennon said it had been stated that chromosome research was outside the

remit of the DUOB. Professor Coggon replied that it depended on the

question being asked. It was not appropriate to use chromosomal aberration as

a measure of DU exposure, but to investigate it as a biological marker of

effects from exposure would be reasonable.

d) Mr Connolly said that emails from the secretariat had started requesting a

“digital signature”, and this was creating some problems. Mrs Rodgers

responded that unfortunately that was a feature of the MoD’s IT security

arrangements on external email and could not be switched off at source. Air

Cdre Dougherty explained to the Board how the digital signature could be

deactivated on the recipient’s computer.

e) Mr Connolly requested an update on the biological monitoring of Op TELIC

personnel. Mr Brown said that approximately 70 individuals had been tested

to date. Of these, 62 showed a urinary uranium level that was considered

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Final

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average for the southern UK (less than 30 ng l

-1

); none had an exceptional

isotope ratio indicative of DU. A small number of personnel based in

Germany were found to have a natural isotope ratio, but a total uranium

concentration in their urine of several hundred nanograms per litre. The only

people in whom DU had so far been detected were those with “level 1”

exposure who had sustained shrapnel injuries in incidents with DU munitions.

Mr Brown added that of the 70 personnel tested, 24% had declared

themselves to have had level 1 exposure: but in most cases this did not

correspond to the exposure assessment made by their command.

f) Maj Gen Craig enquired whether the background uranium levels in northern

Germany were known. Mr Brown said he thought water drinking habits were

implicated. Personnel from the same camp had shown wide variation. All the

samples had been received from a single medical facility at Osnabruck.

g) The Chairman referred to a comment from veterans reported by Mr Connolly,

that journalists in Iraq seem to be able to obtain DU contamination results far

more quickly than the DUOB. He asked Mr Connolly to pass the message

back that measuring personal exposures more than 10 years retrospectively

was very different from environmental monitoring and that the Oversight

Board had a very much more complicated and exacting task.

Distribution:

All members

All observers