DoD has established policies and procedures to ensure that Service members are evaluated for possible DU exposures. The Army first adopted a "Policy for the Treatment of Personnel Wounded by Depleted Uranium" in 1999, to address DU combat casualty care, and this was incorporated into a DoD Health Affairs policy in 2003. DoD Health Affairs published the "Policy for the Operation Iraqi Freedom Depleted Uranium (DU) Medical Management", HA Policy: 03-012, which recognized three levels of possible exposure to DU:
Handling intact DU munitions or spending time in undamaged DU armored vehicles, such as an Abrams tank, is not considered an exposure in which DU could become internalized in the body. Service members do not ordinarily come into contact with DU in undamaged munitions and equipment.
On April 9, 2004, DoD Health Affairs published a supplemental memorandum on "Operation Iraqi Freedom Depleted Uranium Medical Management", requesting the semiannual reporting of DU Urine Bioassay results by the Services. DoD also described the procedure for assessing the level of possible exposure using a DU questionnaire, and the archival of all DoD patient information related to DU exposure, at the Deployment Health Clinical Center (DHCC).
Personnel who are tested for DU Exposure
DU exposure evaluations of personnel serving in Operation Iraqi Freedom are initiated based on positive responses to the Post-Deployment Health Assessment, DD 2796, or participation in an event or with a unit that would have placed the individuals at risk of DU exposure. The Military Services are identifying all Operation Iraqi Freedom Service members who have had Level I and Level II exposures. Other personnel are identified through their responses to specific questions about possible DU exposure on the DD 2796. The identified personnel are asked to complete a DU Exposure Questionaire DD Form 2872, which a medical provider reviews to assess the exposure level. Those who are determined to possibly have had a significant exposure (Level I or II), submit 24-hour urine specimens. Based on the concerns of the provider or patient, health care providers may also order DU testing for personnel in low exposure groups, such as those with incidental exposures. This gives every Service member the opportunity to verify possible exposure to DU. The most recent report of the results of DU urine monitoring are attached.
Procedures for Testing for DU Exposure
DU bioassays are required for all personnel with Level I and II exposures as soon as possible and within 180 days of their most recent exposure incident. 24-hour urine collections are analyzed for total uranium, depleted uranium, and creatinine to determine the total amount of uranium (natural and depleted) that the individual is passing in the urine per day. For Level III, DU bioassays are not required, although medical providers may order a bioassay for medical management or to address concerns of the individual. These procedures are summarized in the fact sheet on "Urine Testing for Depleted Uranium". Any embedded fragments removed from injured personnel with suspected Level I exposures are sent to a DoD-approved laboratory for analysis of the metal composition of the fragment. The Services ensure that the results of these analyses are entered into the individualís medical record. Further details on the personnel included in each level are contained in the Guidance for Depleted Uranium (DU) Bioassay Urinalysis, Attachment I to Policy for the Operation Iraqi Freedom Depleted Uranium (DU) Medical Management, HA Policy: 03-012, and Guidance and Procedures for Depleted Uranium (DU) Bioassay DU Urine Analysis, Attachment 3 to "Department of Defense Deployment Biomonitoring Policy and Approved Bioassays for Depleted Uranium and Lead", HA Policy: 04-004.
Those who have confirmed results indicating the presence of DU in their urine are offered referral to the Veterans Affairs (VA) DU Follow-Up Program after consultation with the Deployment Health Clinical Center (DHCC). Complete instructions are included in the DHCC website.