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MINISTRY OF DEFENCE
Page 1
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 4644
Helpline
0800 169 4495
Fax
020 7305 2374
Our Reference:
D/GVIU/7/1/8/2
Date:
10
th
January 2003
MINUTES OF THE SEVENTH DEPLETED URANIUM SCREENING
PROGRAMME OVERSIGHT BOARD MEETING ON 21
st
OCTOBER 2002
Present:
Board:
Observers:
Professor David Coggon
Surg. Cdre Nick Baldock
Mr Ron Brown
Dr Chris Busby
Dr Peter van Calsteren
Mr Jim Glennon
Miss Beverley Green
Mr Norman Green representing
Miss Frances Fry
Professor Malcolm Hooper
Dr David Lewis
Dr Gordon Paterson
Mr Shaun Emery
Air Cdre Simon Dougherty
Mr Alan Duncan
Mr Neville Higham
Mrs Brigid Rodgers
Dr Hilary Walker
Mrs Janie Walker
Miss Rosie Wane
Wg Cdr Charlie Wilcock
MRC
INM
DRPS
LLRC
OU
NGV&FA
RBL
NRPB
GVA
INM
BRC
GVIU
SGD
HJA
HSE
GVIU
DH
GVIU
GVIU
SGD
Chair
Secretary
Apologies:
Mr Ivor Connolly
Professor Nick Day
Miss Frances Fry
Professor Ian Gilmore
Dr Muir Gray
Dr Len Levy
Dr Margaret Spittle
Professor Brian Spratt
NGV&FA
IPH
NRPB
RBL
NSC
MRC IEH
MH
RS
Item
Discussion and Decisions
Actions
Page 2
(Action date)
1.
Introduction
a) The Chairman welcomed Jim Glennon who was replacing Ray Bristow as the
NGV&FA representative, Wg Cdr Charlie Wilcock observing on behalf of
Surgeon General’s Dept and Mr Norman Green representing NRPB.
b) The Chairman noted that Professor Nick Day had not yet been able to attend a
DUOB meeting and proposed to write to him to ask about his future plans
with regard to the Board.
c) The Chairman stated that the main business of the meeting was to progress
the Statement Of Requirement for the next stage of the pilot study.
2.
Minutes of Last Meeting
a) Malcolm Hooper asked for a line to be added to the minutes of the sixth
meeting regarding Andrew Taylor’s statement that the NEQAS laboratory
were not used to dealing with ng/L quantities of analytes.
b) Chris Busby queried the statement in Section 6c of the last minutes which
stated ‘the questionnaire would be sent to the co-ordinating office’. Chris
asked if it had been decided that each sample should be split and one aliquot
sent to a representative of the veterans. The Chairman stated that no exact
details had been decided but that the DUOB was aware of the need to
maintain sample security
c) The minutes were accepted as a true record subject to the change detailed at
2a.
Action 7.1. Secretary to amend minutes of 6
th
DUOB and circulate
Secretary
(8/11/02)
3.
Matters arising from last meeting
a) A full list of actions arising from previous meetings and their current status is
attached at Annex A.
b) The Chairman stated that the meeting of the laboratories involved in the pilot
exercise had taken place on 13
th
August 2002 and asked whether the minutes
of that meeting had been circulated. He also stated that he had circulated his
ideas on the next stage of the pilot exercise. The Secretary confirmed that
these had been circulated by email but undertook to circulate a hard copy.
Action 7.2. Secretary to circulate minutes of ‘Laboratory’ meeting on 13/8/02
and the Chairman’s ideas on the next stage of the pilot exercise
c) All members of the DUOB agreed on the need for an extension to the pilot
exercise.
d) Brigid Rodgers gave an update on the MOD’s correspondence with Professor
Schott. MOD had written to Prof. Schott on a number of occasions asking for
a protocol for his proposed study of chromosome aberrations. Prof. Schott
had provided a questionnaire that was given to those he had tested but not a
protocol. Malcolm Hooper said that he believed that ethical review was
treated differently in Germany from in the UK and that the ethical
acceptability of the investigation was covered by the presence of a notary to
witness the testing. Jim Glennon confirmed this, having been one of the
veterans tested by Prof. Schott. The Chairman said that any application for
assistance in the recruitment of subjects from a UK body such as MOD would
Secretary
(8/11/02)
Page 3
need to satisfy the UK’s ethical requirements.
e) David Lewis said he had some papers on chromosome aberrations that might
be of interest to the DUOB. He offered to send these to the Secretary for
circulation.
Action 7.3. David Lewis to forward ‘Chromosome Aberration’ papers to
Secretary.
Action 7.4. Secretary to circulate ‘Chromosome Aberration’ papers.
f) Gordon Paterson asked about ethical panels within the MOD. Simon
Dougherty explained that there were a number of ethical committees for the
Army, Navy, RAF and other agencies – the appropriate committee would
have to be satisfied for any study that the MOD was involved with.
g) Jim Glennon asked if the MOD would accept German troops as a control
group for the Schott study. The Chairman said that that was a matter of
scientific validity and not for the MOD to decide. Chris Busby stated that
there appeared to be a cultural problem with regard to the definition of a
protocol and perhaps Prof. Schott should be given some guidance on what
was expected. Brigid Rodgers said that guidance had been given. Prof Schott
had not replied to recent GVIU correspondence, and the initiative lay with
him at the moment. The Chairman stated that the production of a protocol
was a standard part of any scientific study.
h) A paper by George Etherington on the translocation of particles had been
circulated. Chris Busby commented that the paper did not consider the
behaviour of very small ceramic particles and suggested that a few quick tests
could be carried out, acidifying urine samples with different materials to see
if this affected the measured uranium content. The Chairman said that if
appropriate, this could be addressed when the main testing programme began.
i) Malcolm Hooper’s second draft of the questionnaire that would be filled out
by those being tested was tabled. Comments on this were to be sent to the
Secretary
Action 7.5. Comments on questionnaire to be sent to the Secretary
j) The Chairman stated that he had written to the MRC to inform them of the
delay to the screening programme
k) The Secretary stated that he had not yet approached the laboratory offering
the AMS method as he was waiting until the details of the pilot exercise were
better known. The action was ongoing.
Lewis
(15/11/02)
Secretary
(15/11/02)
All
(15/11/02)
4.
Update on Pilot Exercise
a) The Chairman stated that the Secretary had circulated a draft version of the
Statement Of Requirement (SOR) for the extended pilot exercise. Following
the discussions at this meeting the Secretary would redraft this document and
then arrange a meeting with the laboratories involved to discuss and finalise
the SOR. The following items were discussed.
Which Laboratories Should Take Part in the Studies
b) There was general agreement that the three laboratories which had provided
consistent results in the initial pilot exercise should take part in the next stage
of the study. There was also the possibility of the AMS laboratory being
included – see 3k above. Jim Glennon suggested that the other laboratory that
Page 4
produced results in the first pilot exercise be included in the next stage. The
Secretary reported that this laboratory had contacted him and indicated that it
did not want to be involved in further DUOB work.
Number of Samples to Send to Each Laboratory
c) There was some discussion about the number of samples that should be used
in the next stage of the pilot study. It was agreed that each laboratory should
produce one unspiked sample and two spiked samples. These should then be
divided and aliquots sent to the other laboratories in the study. Assuming
there were three laboratories in the study Laboratory A would therefore test
the following:
• Its own samples (one unspiked and two spiked)
• Three samples from Lab B (one unspiked and two spiked)
• Three samples from Lab C (one unspiked and two spiked)
A total of nine samples in all.
Volume of Urine
d) There was some discussion about the volume of the urine samples to be tested
by each laboratory. The Chairman said that he believed the initial pilot
exercise demonstrated that there was little difference in testing 100ml or 1L
samples. Peter van Calsteren disagreed with this and said that larger samples
would yield better results. Jim Glennon expressed concern that some of the
samples should be kept back for reference. The Chairman confirmed that this
would be done. It was agreed that 500mL samples would be suitable for the
task as a compromise between collecting large amounts of urine and
providing enough urine for an accurate test.
How to Specify Preparation of Spiked Samples
e) There had been some disagreement in the comments received on the SOR as
to how the contract should specify the preparation of the spiked samples. At
one end of the scale the SOR could specify the exact step-by-step method for
the production of the samples. The other extreme would be just to state the
approximate isotope ratio required and let the laboratory produce it in their
own way (with appropriate documentation).
f) There was considerable discussion on this topic. David Lewis stated that
specifying the exact method would take a potential source of variability out of
the scheme. Norman Green believed that if the three laboratories used three
different methods then one laboratory might blame another laboratory's
preparation of the samples if things went wrong. Ron Brown argued that the
preparation of the samples needed to be traceable back to international
standards. Peter van Calsteren was of the opposing view and stated that the
preparation of the samples would be less accurate than the measurement of
the samples. He did not see a problem as each laboratory would be analysing
the same samples.
g) It was agreed that the laboratories should be consulted over this issue.
Whichever route was chosen, the laboratories would be required to document
their methods to fully ensure traceability.
Uranium Standards
Page 5
h) There was some discussion about the standard that should be used to prepare
the spiked samples. A suggestion had been made by one of the laboratories
that ‘a solution of NATO Impactor DU’ could be provided to each laboratory,
and that this would provide a more appropriate standard. Ron Brown and
David Lewis argued against this approach and insisted that a recognised
international standard should be used. Ron Brown stated that the Board had
would not know exactly what was in the solution proposed by the laboratory.
It was agreed that a recognised international standard should be used in the
pilot exercise and this should be discussed at the meeting with the
laboratories.
i) The Chairman noted that it would be better to minimise the use of the
uranium standard in concentrated form by the laboratories to reduce the risk
of contamination. He suggested that one of the laboratories could dilute the
standard and distribute it to the other laboratories – this would be discussed at
the meeting of the laboratories.
j) There was some discussion about the merits of testing for U236. Ron Brown
said that U236 was not critical to the assessment of exposure to DU, and that
the Durakovic paper (The Quantitative Analysis of Depleted Uranium
Isotopes in British, Canadian, and US Gulf War Veterans, Military Medicine,
Vol 167, August 02) supported this view. Jim Glennon suggested that it was
relevant as it indicated exposure to man-made uranium and identified the
exposure as due to ‘weapons grade’ uranium. Ron Brown pointed out that the
U236 content of DU munitions would probably not be known, so U236 would
not provide a reliable quantitative index of exposure.
Aqueous Samples
k) Chris Busby had commented by email that aqueous samples should also be
tested as in the initial pilot exercise. The Chairman thought that this was
unnecessary. It had originally been done in case there was a particular
problem in measuring uranium in urine that did not occur with aqueous
samples, but this appeared not to be the case. Each laboratory would measure
their own blanks anyway. There was general agreement that aqueous samples
would not be included in the next stage.
Natural Uranium
l) There was general agreement that the spiking should be done only with
depleted uranium and that there was no need for any additional spiking with
natural uranium.
Nitric Acid
m) Chris Busby debated whether dilute nitric acid was sufficient to prevent
precipitation in the urine. After some discussion, it was generally agreed that
there was no problem with using dilute nitric acid.
Thymol
n) There was some discussion about whether thymol should be used as a
disinfectant in the urine. There was general agreement that thymol should not
be used although the laboratories taking part in the study would be asked if
they had concerns over this.
Threshold for Rejecting Pooled Urine
Page 6
o) It was agreed that 10ng/l was a suitable maximum concentration for the pool
of urine collected by the laboratories. If a higher concentration was found
then the pool should be rejected and a new pool collected.
Actual Ratios and Concentrations to be Used
p) The Secretary asked who was going to be involved in deciding the isotope
ratios in the spiked samples. There was some discussion of this and a set of
ratios was decided upon. The Chairman pointed out that the total uranium
concentrations would be determined by the amount of spiking solution
needed to obtain the specified ratio (as the same spiking solution would be
used for all samples). Ron Brown queried this as all the concentrations would
be bunched together. The Chairman accepted this but said that it was a
realistic situation.
Post meeting note: It should also be noted that the total uranium concentration will
also depend on the concentration in the unspiked pooled urine, which will vary
between the three laboratories.
Other
q) Gordon Paterson commented on the complexities of the issues discussed in
relation to the initial and extended pilot exercises and their implications for
the design and timescale of the definitive testing programme. He suggested
that to ensure clarity and understanding, both now and in the future and
particularly for individuals who were external to the deliberations of DUOB,
it would be helpful to produce a summary document. This might cover the
key points relating to both pilot exercises and to the design of the testing
programme. Placing such a ‘status and progress report’ summary document
on the website would seem to be helpful to all parties. It would be appropriate
to update such a document continuously. It would certainly reflect the spirit
of openness and avoid possible misinterpretation of minutes by individuals
who had not participated in DUOB meetings.
Action 7.6. Secretary to produce a summary document detailing what is
happening with the pilot studies.
Action 7.7. Secretary to redraft SOR/Protocol.
Action 7.8. Secretary to arrange meeting with labs to discuss SOR/Protocol.
Secretary
(15/11/02)
Secretary
(1/11/02)
Secretary
(1/11/02)
5.
Epidemiological Studies
a) See 3j.
6.
Background/Scientific Issues
a) There was a discussion regarding epidemiological findings in Italian
personnel who had served in the Balkans. The Secretary had circulated copies
of all email correspondence on this subject to inform the debate. Chris Busby
introduced the topic saying that he believed it was relevant to the work of the
DUOB. He stated that, while there had previously been anecdotal evidence
suggesting health effects of DU, he believed that these data provided stronger
evidence of an elevated risk of lymphoma from exposure to DU.
b) The Chairman noted the small number of lymphoma cases in the Italian
study, and that in many the onset of illness had occurred within 12 months of
deployment to the Balkans. He said that an environmental carcinogen,
Page 7
particularly if acting through a genotoxic mechanism, would not be expected
to produce overt cancer after such a short interval.
c) Chris Busby stated that all theories regarding cancer accept that it is a
multistage process and that up to five mutations are required to start the
cancer growth. Some people already have some of these mutations. Hence
there is a sub-group of people who are in a position where exposure to a
mutagen might trigger cancer more rapidly. He believed, therefore, that an
immediate rise in incidence was to be expected. He suggested that this theory
was supported by two pieces of evidence – an increase in cancer in Wales
after Chernobyl, and an increase in cancer mortality in nuclear workers over
the first 12 months after starting radiation work.
d) The Chairman stated that the last observation was likely to reflect a healthy
worker effect. A worker would be unlikely to start a new job as a radiation
worker when suffering from the late stages of cancer. Therefore, in
comparison with the general population, mortality from cancer among
radiation workers would be unusually low over the first few months after
appointment. Over time, however, this differential would be expected to
wear off.
e) Chris Busby asked where the latest MOD mortality figures for Gulf War
veterans could be found. Brigid Rodgers stated that these could be found in
Hansard. The Secretary undertook to circulate the latest figures.
Action 7.9. Secretary to circulate mortality figures.
Secretary
(15/11/02)
7.
Statement of Requirement for Main Contract
a) The Secretary had circulated a draft version of this paper some ago. No
comments had been received. The following relevant topics were discussed:
Number of Samples
b) The SOR in its current version stated that an initial contract would be placed
for the testing of 500 samples. As up to three contracts were likely to be
placed, this meant that the initial contracts would cover the testing of up to
1500 samples. It was stressed that this was just an initial estimate to give a
basis for contractors to price their bids. The contracts would be extended as
required to allow for further testing- all Gulf and Balkan veterans who wish to
have a test will be able to have one.
c) Jim Glennon expressed concern that the MOD might try to influence the
findings of the testing programme by encouraging a large number of veterans
with no exposure to DU to be tested, thereby diluting the proportion that
tested positive. The Chairman pointed out that this was a voluntary testing
programme, not a research study, and that any gulf or Balkan veteran would
be eligible for a test. The Chairman also noted that in research studies,
information would be collected about participants' potential sources of
exposure to DU. This would be taken into account in interpreting the
distribution of exposures.
Security of samples
d) David Lewis again stressed the importance of sample security.
Size of samples
e) The Chairman stated that, initially, 24-hour samples would be obtained as
Page 8
some veterans were unlikely to be happy with anything else. Veterans could
probably be sent a container in which to make the collection, and then return
it in person to a regional centre. A questionnaire could be completed at that
time giving details of potential exposures etc.
f) The Chairman asked if there would be any particular risk of contamination
associated with collecting samples in this way. Norman Green pointed out
that any contamination was likely to be with natural uranium, which would
not affect the measured DU levels.
g) There was some discussion about when the acidification of the urine should
be carried out. It was agreed that this would have to be done at the regional
centre when the veteran returned the sample or in the laboratory to which the
sample was then sent.
Creatinine
h) The Chairman stated that once the samples were at the laboratory a small
aliquot would need to be sent away to be tested for creatinine. This test is
considered to be routine and there are a large number of laboratories that
could do this test.
Values to be reported
i) It was agreed that the values reported for each sample would need to include:
• Total uranium concentration
• U238/U235 ratio
• U238/U236 ratio (if possible)
• the uncertainties involved in the above measurements.
Laboratory Report
a) The Chairman questioned a reference in the draft SOR to a report that the
laboratory would produce after every 500 tests. It was generally agreed that as
well as the reports for each individual there needed to be a report on the
aggregation of the results. This would be used to monitor the performance of
the laboratory.
8.
Statement of Requirement for Health Provider Contract
a) It had previously been agreed that urine samples would be collected via
regional centres. The Chairman proposed that there would need to be enough
centres to ensure that those being tested would not have to travel
unreasonable distances. Also, plans would have to be put in place to cater for
those veterans who could not travel to the centres. This would ideally be
done by a single organisation.
b) The Secretary stated that he had produced a SOR for this contract but had not
yet circulated this as the SOR for the pilot study was required more
immediately. He undertook to revise the SOR for the Health Provider contract
and circulate it.
Action 7.10. Secretary to revise and circulate SOR for Health Provider
contract.
c) The Chairman outlined a proposed procedure for carrying out the testing, as
had been detailed previously in Section 6c of the minutes of the 6
th
meeting.
Secretary
(15/11/02)
Page 9
9.
Statement of Requirement for Background Study
a) The Chairman restated that the aim of the background study would be to
assess the distribution of depleted and natural uranium excretion (if any) in people
with no potential exposure to DU through military service or work in the nuclear
industry. The study could also incorporate some assessment of whether the time
of day that a urine sample is given affects the uranium measurement.
b) The Secretary stated that he had also produced a draft of this SOR but had not
yet circulated it for comments. He undertook to revise the draft and circulate to
the Board.
Action 7.11. Secretary to revise and circulate SOR for background study.
c) Malcolm Hooper stressed that the study should take account of any known
‘hot spots’ of uranium in the environment.
d) Malcolm Hooper again raised the question of DU in fireworks. David Lewis
said that he had talked to a renowned expert in the field of fireworks who did
not believe that DU had been used in fireworks. Malcolm Hooper pointed out
that a considerable number of fireworks are imported.
e) Jim Glennon pointed out that there might be other people with higher
background DU levels such as aviators.
Secretary
(15/11/02)
10.
Information to GPs and Subjects
a) The Chairman stated that he was still working on the next draft of these
documents.
b) There was some discussion about whether any treatment for DU exposure
was available. Malcolm Hooper mentioned possibility of chelation therapy.
Gordon Paterson suggested that veterans with high exposure might benefit
from periodic screening for certain diseases.
c) Gordon Paterson suggested that the DUOB should consider how the results of
tests would be interpreted when passed back to the individuals concerned.
There was some lack of consensus on the implications of DU exposure for
health. The advice given would therefore have to reflect the varying views of
experts.
d) Jim Glennon suggested that War Pensions Agency (now the Veterans’
Agency) data could be used to establish the incidence of various diseases
suffered by Gulf veterans. Malcolm Hooper also mentioned the Manchester
and Kings College databases which he believed could provide additional data.
Post meeting note: The VA do not have a database - they treat each case
individually and do not collate data.
11.
Timescales
a) The timing of the screening programme is currently dependent on the second
stage of the pilot exercise. A programme will be drawn up following the
meeting of the three laboratories, when the timescale should be better known.
Page 10
12.
Biological Monitoring Policy
a) Brigid Rodgers provided an introduction to an MOD Biological Monitoring
Policy paper dated 23 August 2002 which had previously been circulated to
DUOB members for comment. She stated that following the Minister’s
statement in January 2001 about the voluntary screening programme, there
were two public consultation papers followed by two ‘summary of responses’
papers (all available on
www.mod.uk)
. As well as the testing programme,
these documents considered Biological Monitoring for current and future
operations. The consultation process endorsed the implementation of
biological monitoring. The policy would include technical details of the test
to be carried out. In order to be as open as possible, the DUOB would be
asked to comment on the technical aspects of the policy. The DUOB Terms
Of Reference, which were agreed at the 2
nd
DUOB meeting include the
following lines:
‘The Oversight Board will be invited to comment on:
a. The development of biological monitoring tests to be used by the MOD
for future operations where DU is used’
b) Brigid Rodgers explained that any exposures would be relatively recent.
Hence the test required for biological monitoring in current and future
operations need not be so sensitive as for the retrospective testing
programme.
c) Brigid Rodgers tabled a document summarising the comments received on
the Biological Monitoring paper. She stated that some editorial comments had
also been received and these had been taken on board. Most items discussed
are covered in the summary document. However, the following sections detail
additional discussions:
Levels 1,2 and 3
d) There was some debate over the relevance of the Royal Society categories of
potential exposure. Brigid Rodgers explained that the MOD had extended the
Royal Society’s definition of Level 3 to include everyone in theatre. Those in
Levels 1 and 2 would be encouraged to receive testing, but it also would be
available for everyone in Level 3 who wanted to be tested. It was considered
that these Levels were a useful way of categorising personnel and the actions
required, and would allow those with the greatest potential for exposure to be
treated as priority cases.
e) Jim Glennon expressed concern about how Level 3s would know they were
categorised as such and that DU had been used in theatre. Brigid Rodgers
explained that if DU were used, all service personnel would be notified
through their chain of command. Jim Glennon and Malcolm Hooper
expressed the view that all personnel should be tested regardless of their
category. It was pointed out that a test would be made available, that
everyone would be offered a test and that you could not force people to take
the test.
f) Jim Glennon and Malcolm Hooper expressed reservations over the Royal
Society categories, believing that they excluded certain personnel. There was,
however, no consensus on how the levels should be altered. Further
discussion confirmed that all personnel had been covered. Jim Glennon
undertook to suggest changes to the categorisation. Other members of the
DUOB including the Chairman and Gordon Paterson stated that the levels
were a good way of prioritising exposed personnel
Page 11
.
g) The Chairman said he believed the proposals were a good way forward and
showed that the MOD was committed to ensuring that, if DU were used in
theatre, then the correct testing regime would be implemented and that it
would make sense to test Levels 1 and 2 as a priority.
Timing of Sample Collection
h) Samples would be taken back at the home base within one year of potential
exposure. Research to date indicated that any urinary excretion of uranium as
a consequence of exposure would be relatively high over this period. Also, it
might be impractical to take samples in theatre, and there would be a greater
risk of contamination with sampling in theatre. Jim Glennon asked whether
repeat sampling would be carried out. Ron Brown stated that re-testing would
be carried out in accordance with statutory requirements. If a sample gave a
high reading then a new sample would be sought straight away. Repeated
sampling would then be considered on a case-by-case basis.
Isotopes 234 and 236
i) Brigid Rodgers stated that the MOD did not propose testing for U234 and
U236 as part of the biological monitoring as the U238/U235 ratio is
considered adequate as an index of exposure to DU, and there were concerns
about delaying the testing while suitable methods for U234 and U236 are
established. Malcolm Hooper expressed the view that it was necessary to
establish the characteristics of the DU that had caused the potential
contamination. However, it was not clear to other members what the purpose
of this would be.
Way-ahead
j) Brigid Rodgers stated that she would re-formulate the paper and re-circulate
it. The Chairman asked how this policy would be put into practice. Gordon
Paterson expressed the view that it should be implemented as soon as possible
bearing in the mind the potential for future operations in Iraq. Brigid Rodgers
replied that the policy was already being implemented.
13.
Date of next meetings
a) The date of the next DUOB meeting was set for 9
th
January 2003. A
prospective date for the following meeting is 11
th
March 2003.
b)
14.
A.O.B.
a) Malcolm Hooper asked if members of the DUOB had seen the Dai Williams
paper entitled ‘Hazards of Suspected Uranium Weapons in the Proposed War
on Iraq’.
Post meeting note: This report is available at www.eoslifework.co.uk/u231.htm
Page 12
Distribution:
All members
All observers
Devolved Health Administrations
Page 13
Annex A - DUOB Action List
Action
Date
placed
Action
Date
Detail
Owner
Comments
1.1
27/9/01
16/11/01
‘Definitions of Terms’ appendix to be
drafted and circulated for comment
Lewis/
Calsteren
COMPLETE – Definitions attached
to draft protocol distributed at 2
nd
meeting
1.2
27/9/01
16/11/01
Nominations for toxicologist and radiation
medicine experts to be sent to GVIU
All OB
Members COMPLETE – See actions 2.2, 2,3
1.3
27/9/01
26/10/01
CVs and declarations of interest to be sent
to GVIU
All OB
Members
Still awaiting Hooper (short)
1.4
27/9/01
12/10/01
Secretary to establish if payments can be
made for Board members to attend
meeting
Secretary COMPLETE – Payments will be
considered on an individual basis.
Written justifcation must be
forwarded by Board member to
GVIU for consideration.
1.5
27/9/01
12/10/01
Secretary to create a claim form for
expenses
Secretary COMPLETE - Form distributed on
23/10/01
1.6
27/9/01
26/10/01
Secretary to distribute a copy of the press
release to board members
Secretary COMPLETE – Press release
distributed on 23/10/01
1.7
27/9/01
Ongoing
Board members to write to GVIU with
suggestions for further background reading
All OB
Members
Ongoing
1.8
27/9/01
26/10/01
GVIU to obtain permission and distribute
responses to the 2
nd
consultation paper to
Board Members
Secretary COMPLETE – distributed by email
on 13/11/01
1.9
27/9/01
26/10/01
GVIU to distribute list of email addresses
Secretary COMPLETE – Distributed on
23/10/01
1.10
27/9/01
26/10/01
Board members to suggest suitable
laboratories to GVIU
ALL OB
Members
COMPLETE – 30/11/01
1.11
27/9/01
26/10/01
Secretary to arrange for invitation to
express an interest in the ‘pilot study’ to be
advertised in the relevant journals
Secretary COMPLETE - Advert in MOD
Contracts Bulletin on 21/11 and
OJEC on 13/11/01
1.12
27/9/01
16/11/01
Produce and circulate draft protocol prior
to next meeting
Lewis/
Calsteren
COMPLETE – 30/11/01
2.1
30/11/01
4/1/02
GVIU to send TOR to Minister for
comment
Secretary COMPLETE - Sent on 11/1/02.
Minister has approved the TOR.
2.2
30/11/01
8/1/02
CVs for toxicologist to be sent to GVIU.
GVIU to forward to Minister
Secretary COMPLETE – Sent on 15/1/02
2.3
30/11/01
8/1/02
Suggestions for radiation medicine experts
to be sent to GVIU
All
COMPLETE
2.4
30/11/01
8/1/02
GVIU to consult Royal College of
Radiologists
Secretary COMPLETE – RCR
recommendation received on 24/1/02
2.5
30/11/01
12/12/01
GVIU to notify members of expressions of
interest
Secretary COMPLETE – emailed on 13/12/01
2.6
30/11/01
7/12/01
Draw up Statement Of Requirement for the
sample preparation
Van
Calsteren
COMPLETE – 1
st
draft discussed at
meeting with NEQAS on 18/12/01.
Will be revised in discussion between
LEWIS, van Calsteren and NEQAS
2.7
30/11/01
10/12/01
David Lewis to contact the preferred
supplier of spiked samples (and other
suppliers if required) to assess interest and
costs
Lewis
COMPLETE
2.8
30/11/01
13/12/01
Arrange meeting with supplier of spiked
samples
Lewis
COMPLETE – see 2.9 below
Page 14
2.9
30/11/01
20/12/01
Subgroup to visit supplier
Coggon/
Lewis/
van C/
GVIU
COMPLETE – lab visited on
18/12/01
2.10
30/11/01
28/1/02
Nick Day to review protocol and proposed
statistical methods
Day
Ongoing
2.11
30/11/01
21/12/01
David Lewis to redraft protocol for pilot
study of analytical methods
Lewis
COMPLETE
2.12
30/11/01
21/12/01
David Lewis to draft the SOR for the urine
testing in the pilot study, to be distributed
to the OB by 21/12/01
Lewis
COMPLETE – ITT sent to NEQAS
on 14/1/02
2.13
30/11/01
10/1/02
OB to comment on the SOR for urine
testing by 12.00, 10 Jan 02
All
COMPLETE
2.14
30/11/01
28/1/02
Chairman to appraise MRC of the planned
timetable for the development of the
testing method
Chair
COMPLETE – Chairman talked to
Catherine Moody of MRC
2.15
30/11/01
21/1/02
Chairman to produce paper for next
meeting summarising the different types
of epidemiological study that might be
relevant
Chair
COMPLETE – Paper circulated on
11/1/02
2.16
30/11/01
21/1/02
GVIU to produce a paper on the options
for a chain of custody of urine samples
Secretary COMPLETE – Paper circulated on
25/1/02
2.17
30/11/01
28/1/02
GVIU to identify the position of MOD
funding of regional centres
Secretary COMPLETE – MOD will fund
regional centres but the details of this
need to be decided
2.18
30/11/01
28/1/02
NRPB to obtain advice on the feasibility of
testing for DU in tissue samples obtained
at autopsy
NRPB
COMPLETE – paper distributed on
2.19
30/11/01
14/1/01
GVIU to circulate Annexes A and D (on
the current ICRP models and Organ Doses
from intakes) from the Royal Society
report
Secretary COMPLETE – Circulated on
11/1/02
2.20
30/11/01
21/1/02
GVIU to provide Contracts Branch with
the draft protocol in time for ITT issue on
31 Jan 02
Secretary COMPLETE – ITT issued 26
th
Feb
2002. Response date = 9
th
April.
2.21
30/11/01
21/1/02
David Lewis/ van Calsteren to prepare a
paper on laboratory methods
Lewis/
van
Calsteren
Ongoing
2.22
30/11/01
7/12/01
GVIU to arrange a meeting between
Chairman and US of S
Secretary COMPLETE – Chairman met with
US of S on 16/1/02
3.1
28/1/02
15/2/02
GVIU to distribute NRPB presentation
Secretary COMPLETE – Sent out on 19/202
3.2
28/1/02
15/2/02
GVIU to seek permission and distribute
Durakovic presentation to RS
Secretary COMPLETE – Durakovic paper
circulated
3.3
28/1/02
15/2/02
Brian Spratt to investigate if advance
copies of urine excretion section of RS
report can be made available to members
of the Board
Spratt
COMPLETE – RS report published
12/3/02
3.4
28/1/02
N/A
GVIU to distribute part 2 of the RS report
when available
Secretary COMPLETE – Distributed by the
RS
3.5
28/1/02
15/2/02
GVIU to contact proposed specialist in
radiation medicine
Secretary COMPLETE – Dr Spittle appointed
to the OB
3.6
28/1/02
15/3/02
GVIU to produce a paper on requirements
for main testing programme contract
Secretary COMPLETE – Discussed at 4
th
DUOB meeting
Page 15
3.7
28/1/02
15/3/02
David Lewis to produce a paper on how
laboratories can be judged against each
other
Lewis
Ongoing
3.8
28/1/02
15/2/02
GVIU to circulate the McDiarmid paper
Secretary COMPLETE – Distributed on
19/2/02
4.1
18/4/02
17/6/02
Secretary to improve content and
presentation of DUOB website
Secretary COMPLETE
4.2
18/4/02
7/6/02
OB Members to provide comments on
DUOB website to Secretary
All
COMPLETE
4.3
18/4/02
17/5/02
Secretary to contact RS re. distribution of
RS paper
Secretary COMPLETE – Missing reports
distributed
4.4
18/4/02
16/4/02
Secretary to circulate the MOD research
proposals
Secretary COMPLETE – Sent 26/4/02
4.5
`
17/5/02
Secretary to edit and distribute protocol
document
Secretary COMPLETE – sent by email
20/5/02
4.6
18/4/02
ASAP
Secretary to arrange for the two bidders to
requote for pilot exercise
Secretary COMPLETE
4.7
18/4/02
26/4/02
Secretary to arrange for pilot study
contracts to be placed
Secretary COMPLETE - 5 contracts placed
on 29/4/02
4.8
18/4/02
26/4/02
PvC to visit NEQAS in the week
beginning 22/4
Van
Calsteren
COMPLETE - Overtaken by events
4.9
18/4/02
17/6/02
Secretary to draft advert for main testing
contract for approval for the DUOB
Secretary COMPLETE – Draft circulated prior
to 5
th
DUOB meeting
4.10
18/4/02
11/6/02
Muir Gray to produce a paper on sample
collection/provision of advice
Muir
Gray
COMPLETE - Papers distributed
on 17/6/02
4.11
18/4/02
17/5/02
Chairman to produce a draft of information
to be given to GPs
Chair
COMPLETE – Circulated by email
on 24/402
4.12
18/4/02
17/5/02
RBL reps to produce a draft of advance
advice to veterans and advice once results
are known
Green/
Gilmore
COMPLETE – Circulated by email
on 20/5/02
4.13
18/4/02
17/5/02
Secretary to circulate the McDiarmid
paper on spot samples
Secretary COMPLETE – distributed on
16/7/02
4.14
18/4/02
17/5/02
Suggestions for ways of communicating
the availability of voluntary testing
All
COMPLETE
4.15
18/4/02
17/5/02
Chairman to write to MRC re.
epidemiological studies
Chair
COMPLETE – letter sent on 24/5/02
4.16
18/4/02
17/5/02
Chairman to discuss research with
LSHTM
Chair
COMPLETE – discussed following
4
th
meeting
4.17
18/4/02
17/5/02
GVIU to report on MOD research into
health effects of DU
GVIU
COMPLETE – post meeting note in
minutes of 4
th
meeting
4.18
18/4/02
17/5/02
Secretary to distribute new schedule
Secretary COMPLETE – circulated by email
on 22/5/02
4.19
18/4/02
17/6/02
Muir Gray to produce report on the
potential for screening for myeloma …
Muir
Gray
COMPLETE – tabled at meeting on
17/6/02
4.20
18/4/02
17/5/02
GVIU to check if abdominal ultrasound is
a standard procedure at the MAP
GVIU
COMPLETE – post meeting note in
minutes of 4
th
mtg
4.21
18/4/02
17/5/02
Secretary to circulate web address of the
UNEP report
Secretary COMPLETE – post meeting note in
minutes of 4
th
mtg
5.1
17/6/02
24/7/02
Secretary to collate and distribute all
information regarding Italian peacekeeper
discussion
Secretary COMPLETE – Information
circulated prior to 7
th
meeting
5.2
17/6/02
24/7/02
Chris Busby to write a short introduction
to the Italian peacekeepers information
Chris
Busby
COMPLETE – tabled at DUOB mtg
on 24/7/02
5.3
17/6/02
24/7/02
Secretary to check on ultrasound diagnoses
of renal cancer at MAP
Secretary COMPLETE – details given at
DUOB mtg on 24/7/02
5.4
17/6/02
28/6/02
Peter van Calsteren to obtain uranium and
zinc concentration data from NEQAS
PvC
COMPLETE
5.5
17/6/02
28/6/02
Secretary to revise and distribute draft
Secretary COMPLETE
Page 16
advertisement
5.6
17/6/02
24/7/02
Secretary to redraft SOR and distribute
Secretary COMPLETE – new draft circulated
on 28/8/02
5.7
17/6/02
24/7/02
Len Levy to investigate if creatinine can
be measured in acidified urine
Len Levy COMPLETE - comments circulated
by email on 26/7/02
5.8
17/6/02
24/7/02
Muir Gray to produce ‘pathway’ for
testing process
Muir
Gray
Ongoing
5.9
17/6/02
24/7/02
Chris Busby to write paper on sample
security
Chris
Busby
COMPLETE – tabled at DUOB
meeting on 24/7/02
5.10
17/6/02
24/7/02
Chairman to provide a more detailed paper
on information for GPs
Chair
Ongoing
5.11
17/6/02
24/7/02
Chairman to produce next draft of
‘information to veterans’
Chair
Ongoing
5.12
17/6/02
24/7/02
Secretary to obtain a copy of the MAP
questions
Secretary COMPLETE – MAP questions sent
to Malcolm Hooper prior to 24/7 mtg
5.13
17/6/02
24/7/02
Malcolm Hooper to draft screening
programme questionnaire
Malcolm
Hooper
COMPLETE – Questionnaire tabled
at DUOB meeting on 24/7/02
6.1
24/7/02
2/8/02
Secretary to distribute full protocol to
DUOB
Secretary COMPLETE - distributed by email
on 25/7/02
6.2
24/7/02
9/8/02
NEQAS to provide full report on pilot
study
Andrew
Taylor
COMPLETE – distributed on
12/8/02
6.3
24/7/02
23/8/02
Secretary to amend minutes of 5
th
DUOB
and circulate
Secretary COMPLETE
6.4
24/7/02
21/10/02
Malcolm Hooper to provide list of
Professor Schott’s relevant publications
Malcolm
Hooper
Ongoing
6.5
24/7/02
30/9/02
George Etherington to investigate NRPB
work on maximum size particle that can
pass through kidney
George
Etheringt
on
COMPLETE – Paper circulated by
email on 2/10/02
6.6
24/7/02
20/9/02
DUOB members to send Malcolm Hooper
suggestions for any further amendments to
the questionnaire
All
Ongoing
6.7
24/7/02
11/10/02
Malcolm Hooper to produce 2
nd
draft of
questionnaire
Malcolm
Hooper
Ongoing
6.8
24/7/02
9/9/02
Members to send comments on Chris
Busby’s ‘Security’ paper to Secretary
All
Ongoing
6.9
24/7/02
30/9/02
Secretary to provide SOR for Health
Service Provider for urine testing
programme
Secretary Ongoing
6.10
24/7/02
16/9/02
DUOB members to write to Secretary with
suggestions for a body to carry out the
‘Background’ study
All
Ongoing
6.11
24/7/02
30/9/02
Secretary to provide SOR for
‘Background’ study
Secretary Ongoing
6.12
24/7/02
31/7/02
Chairman to inform Medical Research
Council of delays in establishment of
screening programme
Chair
COMPLETE – letter sent on 25/7/02
6.13
24/7/02
6/9/02
Secretary to ascertain whether a limited
AMS study was feasible in terms of
laboratory availability and cost
Secretary Ongoing