+-----------------------------------------------------------------------+
| Department of                                                         |
|                                                                       |
| Veterans Affairs                                                      |
+-----------------------------------------------------------------------+

**IONIZING RADIATION BRIEF**

**Prepared by the Environmental Agents Service (131)**

VA Central Office, Washington, DC 20420 December 2004

# 

The IONIZING RADIATION BRIEF fact sheets were designed to help veterans
who were exposed to ionizing radiation while serving our nation in the
military, their families, and others who may have concerns about the
possible long-term health consequences of such exposure. The BRIEFs
answer many frequently asked questions about the health issues. The
Environmental Agents Service (EAS) at the Department of Veterans Affairs
(VA) Central Office prepared this fact sheet series and is responsible
for its content. This is the initial publication of these fact sheets.
EAS will update them periodically, when needed. This edition was
completed in December 2004.

The Environmental Health Coordinators at all VA Medical Centers should
maintain this edition or future updates at all VA Medical centers and
they are also available online at
[www.va.gov/Irad](http://www.va.gov/Irad). The IONIZING RADIATION BRIEFs
are modeled on the fact sheets that EAS developed and expanded upon
regarding Agent Orange concerns. Those fact sheets were initiated in
1978 and revised and improved on many occasions since then.

Comments about the IONIZING RADIATION BRIEFs, including ideas for future
editions, should be sent to Mr. Donald J. Rosenblum, Deputy Director,
Environmental Agents Service (131), ATTN: IR BRIEFs, Department of
Veterans Affairs, 810 Vermont Avenue, N.W., Washington, DC 20420. The
following IONIZING RADIATION BRIEFs are now available from or are
planned by that office and at the Web site mentioned above.

**General (A)**

A1. General Information

**Programs (B)**

B1. Ionizing Radiation Registry

B2. Special Health Care Eligibility of Atomic Veterans

B3. Disability Compensation

B4. Information Resources on Radiation Health Effects

**Scientific Investigations (C)**

C1. Research (Planned)

**Conditions (D)**

D1. Illnesses Linked to Ionizing Radiation

**Miscellaneous (E)**

E1. Radiation Dose Reconstruction -- The Purpose, The Process

E2. Coordination with Other Federal Departments and Agencies (Planned)

E3. Advisory Committee Role (Planned)

E4. Depleted Uranium

E5. Women Veterans Were Exposed Too

+-----------------------------------------------------------------------+
| Department of                                                         |
|                                                                       |
| Veterans Affairs                                                      |
+-----------------------------------------------------------------------+

**IONIZING RADIATION BRIEF**

**Prepared by the Environmental Agents Service (131)**

A1 VA Central Office, Washington, DC 20420 December 2004

**GENERAL INFORMATION**

**What is Ionizing Radiation?**

The term "ionizing radiation" refers to a group of subatomic particles,
electromagnetic waves or photons that have enough energy to break
chemical bonds and create ions (electrically charged particles) when
they interact with atoms or molecules such as in the human body, which
can lead to short- and long-term health consequences.

**What are the types and common sources of Ionizing Radiation?**

The following are types of ionizing radiation.

Alpha particles are relatively large particles compared to other types
of radiation, and are made of parts of the nuclei of helium atoms.
Sources include some radioactive elements. They are not able to
penetrate the intact skin. Therefore, alpha emitters are hazardous
primarily if they are taken into the body (for example, via the mouth
and nose) and function as sources of internal radiation.

Beta particles are high-energy electrons that also come from many
radioactive elements. They can penetrate a short distance into the body,
but are hazardous primarily if radioactive elements that produce beta
radiation are taken into the body and become sources of internal
radiation.

Gamma rays and similar x rays are types of electromagnetic radiation.
Common sources are radioactive elements, and x ray medicine. These rays
can penetrate the body readily so both external and internal gamma
sources are hazardous.

Neutron particles emitted from atomic nuclei are another type of
ionizing radiation to which some veterans were exposed (for example, by
being nearby during or immediately after atomic weapons explosion).
Neutron radiation is also produced by a few radioactive elements, and
can penetrate the body readily.

**Where does ionizing radiation come from?**

Sources of ionizing radiation include radioactive atoms present in
radioisotopes (radioactive forms of natural elements), as a result of
nuclear fission (splitting of the atom such as in a nuclear reactor or
detonation of an atomic bomb, which produces radioactive elements),
nuclear fusion (fusion of atoms as in from detonation of a hydrogen
bomb), and certain mechanical devices, such as x-ray machines.

**What are the health concerns from exposure to Ionizing Radiation?**

Many veterans who were present during the construction and later testing
of atomic weaponry, and those serving in the occupation of Japan, are
continuing to seek treatment for health problems believed to be caused
by ionizing radiation for themselves or their families. Family members
understandingly have related concerns. Other veterans were exposed to
ionizing radiation as submariners or as Gulf War participants who came
in contact with depleted uranium (DU) and their families also have
concerns.

**What is the government doing to help veterans exposed to Ionizing
Radiation?**

Over the years, the Department of Veterans Affairs (VA previously known
as the Veterans Administration), has developed comprehensive programs to
respond to the needs of veterans exposed to ionizing radiation. VA
provides special health care services to certain veterans who were
exposed to radiation while on active duty. Veterans can receive our
Ionizing Radiation Registry Health examination (see Ionizing Radiation
Brief, B1, for additional information about the Registry) and have
special eligibility for medical treatment for conditions possibly
related to their exposure. (See Ionizing Radiation Brief, B2, for health
care eligibility). These veterans are also eligible for the wide range
benefits offered by VA to most veterans, including home loan guarantees,
educational payments, and, under certain circumstances, disability
compensation. (See Ionizing Radiation Brief, B3, for information
disability compensation).

**How does a veteran qualify to participate in this program?**

To qualify for VA's program for veterans exposed to ionizing radiation,
individuals must meet specific criteria. By law, veterans with special
eligibility include those who:

Participated in atmospheric (above ground) nuclear weapons testing;

Participated in American occupation of Hiroshima and Nagasaki, Japan;

In some cases, were held as Prisoners of War in Japan;

Veterans who served at gaseous diffusion plants in Paducah, KY,
Portsmouth,

OH, and area K25 at Oak Ridge, TN (during specified time periods); or

Participated in certain underground nuclear weapons tests in Alaska.

Individuals in the first three groups are sometimes referred to as
"Atomic Veterans."

Other eligible veterans include those who received nasopharyngeal (NP)
radium treatments during their military service are also eligible to
participate in VA's Ionizing Radiation Registry examination program.

**What are the advantages and limitations of the Ionizing Radiation
Registry?**

Because of the self-selected nature of Registry participants (that is,
the individuals decide themselves to be part of the Registry rather than
being "chosen" in a scientific manner), this group of veterans are not
truly representative of radiation-exposed veterans as a whole.
Therefore, the health-related information collected cannot be used for
scientific research. The information can , however be used to detect
possible health occurrences and can provide useful facts about the group
itself, and serve as an opportunity to address health concerns of
veterans exposed to radiation while in service.

**How many veterans have been exposed to radiation during their military
service?**

VA estimates that more than 400,000 service members participated in
activities, which may have involved exposure to radiation. This includes
about 210,000 individuals who participated in atmospheric nuclear tests
between 1945 and 1962, and an estimated 195,000 service members who
participated in post-World War II occupations of Japan. The number of
veterans with other sources of exposures is considerably smaller.

**How does a concerned veteran get an Ionizing Radiation Registry
examination?**

Examinations are provided upon request to all eligible veterans.
Examinations, with few exception are conducted at VA medical center
nationwide. For information about eligibility and a possible
appointment, veterans are encouraged to call the local VA medical
center. Veterans are also urged to visit the following VA web site for
additional information: [www.va.gov/irad](http://www.va.gov/irad). They
can also learn more about these programs and benefits and may file a
claim online at
[www.va.gov/vabenefits.vba.va.gov/vonapp](http://www.va.gov/vabenefits.vba.va.gov/vonapp),
or can reach their local VA Regional Office for benefit information by
calling 1-800-827-1000.

**How does a veteran get disability compensation?**

Any veteran who believes his or her health medical problems were
incurred in or aggravated by military service is encouraged to apply for
disability compensation. VA provides billions of dollars each year to
compensate veterans for injuries and illnesses thet have had while on
active duty. Veterans Services Representatives (VSR), located at all VA
regional offices and many VA medical centers, can explain the
compensation programs in greater detail and can assist veterans who need
help in filing a claim for service-connected disability compensation.
Some survivors of certain veterans are eligible for dependency and
indemnity compensation (DIC). A VSR can also help the survivors complete
the necessary forms for this benefit program. Also, veterans can reach
the VA Regional Office serving their area by calling 1-800-827-1000.

**What is the difference between presumptive and nonpresumptive
service-connected disability compensation?**

"Presumption" means disability compensation will automatically be
granted (assuming that the veteran applies for this benefit and meets
certain conditions, such as documentation of participation in a
"radiation risk activity"). "Non-presumption" means compensation may be
awarded if they is evidence supporting the veterans claim that it is at
least at likely as not that the illnesses was incurred in or aggravated
by military service. These are two programs under which VA provides
monthly payments to eligible veterans.

Several categories of veterans are automatically eligible for
compensation for one or more of 21 cancers specified in Federal law or
VA regulations to be "presumed" to be associated with radiation
exposure. For example, 21 cancers are known as presumptively recognized
service-connected conditions. Radiation-exposed veterans with exposure
situations or conditions not covered by the presumptions may also be
eligible for disability compensation depending on how much radiation
they received and consideration of other factors. For additional
information about disability compensation, see Ionizing Radiation Brief,
B3.

**Where can a veteran obtain additional information about ionizing
radiation?**

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/Irad](http://www.va.gov/Irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources on
Radiation Health Effects; C1. Research (Planned); D1. Illnesses Linked
to Ionizing Radiation; E1. Radiation Dose Reconstruction -- The Purpose,
The Process; E2. Coordination with Other Federal Departments and
Agencies (Planned); E3. Advisory Committee Role (Planned); E4. Depleted
Uranium; E5. Women Veterans Were Exposed Too.

This fact sheet was prepared in early December 2004 and does not include
any subsequent developments. It is not copyrighted and may be duplicated
without written permission.

+-----------------------------------------------------------------------+
| Department of                                                         |
|                                                                       |
| Veterans Affairs                                                      |
+-----------------------------------------------------------------------+

IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

B1 VA Central Office, Washington, DC 20420 December 2004

**IONIZING RADIATION REGISTRY**

**What is it?**

The Ionizing Radiation Registry (IRR) is a service provided to veterans
who were exposed to ionizing radiation during their military service.
For eligible veterans, VA performs a complete physical examination (and
various other tests) for each veteran who requests it.

**What is eligible for this program?**

Veterans who participated in atmospheric nuclear weapons testing, served
with the U.S. occupational forces in Hiroshima or Nagasaki or was a POW
there, was exposed to ionizing radiation while participating in another
"radiation risk" activity as defined in VA regulations, or received
nasopharyngeal (NP) radium treatments while in military service may
participate.

**Are veterans required to enroll in the VA health care system to
participate in the Registry?**

No. Veterans need not be enrolled for general VA health care to be
eligible for the Registry.

**How many veterans have participated in this program and where can a
veteran join the Registry?**

Approximately 23,000 veterans have participated in this program, offered
at virtually all VA medical centers throughout the Nation.

**Under what authority was the Registry established?**

Public Law 99-576, the "Veterans Benefits Improvement and Health Care
Authorization Act of 1986," enacted October 28, 1986, required VA to
establish and maintain an Ionizing Radiation Registry of veterans
exposed to radiation. In addition, Public Law 105-368, the "Veterans
Programs Enhancement Act," enacted November 11, 1998, states that VA may
provide a medical examination, hospital care, medical service, and
nursing home care that the Secretary finds may be associated with the
veteran's receipt of nasopharyneal (NP) radium irradiation treatments
while in the active military, naval, or air service.

**What does the Ionizing Radiation Registry consist of?**

The IRR consists of data from veterans who participated in the IRR
program along with information about compensation claims and radiation
exposures from the Veterans Benefits Administration, an agency of VA and
Department of Defense (DoD) agencies. VA compiles and consolidates
information maintained by VA and DoD. Additional specialized tests and
consultations are provided to veterans participating in the IRR exams
program, as medically needed. This program potentially serves as an
entry point for VA care.

**Does participation in the Registry make a veterans eligible for
disability compensation from VA?**

No. Veterans are advised that the examination or treatment for
radiation-related diseases does not constitute a formal claim for
compensation. Although the results of an IRR examination may be used to
support a compensation claim, the examination will not, in and of
itself, be considered such a claim.

**Where can a veteran go to receive an Ionizing Radiation examination?**

Contact the nearest VA medical center and request an Ionizing Radiation
Registry examination, or go online at
[www.va.gov/irad](http://www.va.gov/irad ) for additional information.

**Where should a veteran go to get compensated?**

Veterans who wish to submit a claim for conditions possibly related to
radiation exposure should do so via the normal claims process at the
nearest VA regional office, through a veterans services representative
at the nearest VA medical center, or online at
[www.va.gov](http://www.va.gov/) or by calling their local VA Regional
Office at 1-800-827-1000.

**Where can a veteran obtain additional information about ionizing
radiation?**

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/Irad](http://www.va.gov/Irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources on
Radiation Health Effects; C1. Research (Planned); D1 Illnesses Linked to
Ionizing Radiation; E1. Radiation Dose Reconstruction -- The Purpose,
The Process; E2. Coordination with Other Federal Departments and
Agencies (Planned); E3. Advisory Committee Role (Planned); E4. Depleted
Uranium; E5. Women Veterans Were Exposed Too.

This fact sheet was prepared in December 2004 and does not contain any
subsequent developments. It is not copyrighted and may be duplicated
without written permission.

+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| # Department of                                                       |
|                                                                       |
| ##  Veterans Affairs                                                  |
+-----------------------------------------------------------------------+

IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

B2 VA Central Office, Washington, DC 20420 December 2004

**SPECIAL HEALTH CARE ELIGIBILITY OF ATOMIC VETERANS**

Atomic veterans exposed to ionizing have special eligibility (priority
level 6) to enroll in VA health care for treatment of conditions that VA
recognizes as potentially due to radiation.

**Are veterans required to make a copayment?**

Care for health problems potentially related to radiation exposure is
provided without regard to the veteran's age, service-connected status,
or ability to cover the cost of medical care. No copayment is required.
Even if an eligible veteran has never filed a compensation claim or if
the claim has been denied, the veteran can still receive free care for
these medical conditions.

**Where can a veteran get additional information regarding health care
eligibility?**

More information about eligibility can be obtained from the staff in the
nearest VA medical center health administration service (or other office
with similar responsibilities depending on the facility's local
organization structure). Additional information is available online at
www.va.gov/irad.

**Where can a veteran get more information about exposure to ionizing
radiation?**

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/irad](http://www.va.gov/irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources on
Radiation Health Effects; C1. Research (Planned); D1 Illnesses Linked to
Ionizing Radiation; E1. Dose Reconstruction -- The Purpose, The Process;
E2. Coordination with Other Federal Departments and Agencies (Planned);
E3. Advisory Committee Role (Planned); E4. Depleted Uranium; E5. Women
Veterans Were Exposed Too.

This fact sheet was prepared in December 2004 and does not contain any
subsequent developments. It is not copyrighted and may be duplicated
without written permission.

+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| # Department of                                                       |
|                                                                       |
| ##  Veterans Affairs                                                  |
+-----------------------------------------------------------------------+

IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

B3 VA Central Office, Washington, DC 20420 December 2004

# 

# DISABILITY COMPENSATION

**Are there financial programs to help disabled veterans?**

VA provides monthly payments -- known as disability compensation -- to
radiation-exposed veterans who suffer disabling radiation-related
diseases, under the following two programs:

## 1. Presumptive Service-Connection

The following categories of veterans are automatically eligible for
disability compensation for one or more of 21 cancers specified in
Federal law: Veterans who participated in nuclear tests by the U.S.,
including certain underground tests at Amchitka Island, Alaska, prior to
January 1, 1974, or who served with the U.S. occupation forces in
Hiroshima or Nagasaki, Japan, between August 1945 and July 1946, or who
were prisoners of war in Japan, or some who served at the gaseous
diffusion plants in Paducah, KY, Portsmouth, OH, and area K25 at Oak
Ridge, TN.

The 21 cancers are ***presumed*** to be service-connected for veterans
who participated in "radiation-risk activities," a term defined by VA
regulations, include all forms of leukemia (except for chronic
lymphocytic leukemia); cancer of the thyroid, breast, pharynx,
esophagus, stomach, small intestine, pancreas, bile ducts, gall bladder,
salivary gland, urinary tract (renal pelvis, urethra, urinary bladder,
and urethra), brain, bone, lung, colon, and ovary, bronchiolo-alveolar
carcinoma, multiple myeloma, lymphomas (other than Hodgkin's disease),
and primary liver cancer (except if cirrhosis or hepatitis B is
indicated).

## 2. Non-presumptive -- Direct Service Connection

To determine service-connection for other conditions or exposures *not*
eligible for presumptive compensation, VA adjudicators consider each
case individually, looking at number of factors, including the amount of
radiation exposure, duration of exposure, elapsed time between exposure
and onset of the disease, gender, family history, age at the time of
exposure, the extent to which a nonservice-related exposure could
contribute to the disease, and the relative sensitivity of exposed
tissue.

VA regulations define all cancers as possibly caused by radiation. Other
non-malignant conditions might be caused by radiation include, posterior
subcapsular cataracts; non-malignant thyroid nodular disease;
parathyroid adenoma; and tumors of the brain and central nervous system.
For a given individual, VA will also consider the possibility that other
diseases were caused by radiation, if supported by medical or scientific
evidence. To be eligible for compensation, VA must be able to establish
that it is at least as likely as not that a veterans' illnesses was
caused by their exposure to radiation during military service.

**What about benefits for the survivors?**

Surviving family members of deceased veterans who had a disease or
diseases from exposure to radiation may be eligible for monthly payments
known as dependency and indemnity compensation (DIC).

When the evidence in favor of service-connection is equal to the
evidence against such a relationship, VA policy require that the
adjudicator find in the claimant's favor.

### 

### How much compensation will a veteran/survivors receive?

The amount of money provided in the monthly payments depends on the
degree of disability (and loss of the ability to work).. The degrees
range from 0 to 100 percent. They are expressed in 10 percent rating
increments. A veteran with a 80 percent rating would receive
considerably more than one with a 50 percent rating and much less than a
veterans with a 100 percent rating. These rates change frequently, and
are set by Congress. The monthly rate in 2004, for a 50 percent
disability rating was \$646; for 80 percent, \$1,195, and for 100
percent, \$2,239.

The amount received by the surviving spouse eligible for DIC depends on
the date of the veteran's death. For veterans who died before January 1,
1993, the spouse is entitled to a monthly amount based on the deceased
veteran's pay grade. In 2004, the amount ranged from \$967 for E-1 top
E-6 to \$2,063 for 0-10.

In 2004, the monthly DIC basic rate for the spouses of veterans who died
on or after January 1, 1993 was \$967, but increased by \$241 for each
dependent child, \$241 if aid and attendance was required for the
veteran, and \$115 if housebound. The monthly amount was increased by
\$208 if the deceased was totally disabled for 8 continuous years prior
to death.

Claims for disability compensation or DIC may be filed at a VA regional
office. The national toll-free telephone number to locate the nearest VA
regional offices is 1-800-827-1000. Veterans can also file a claim
online at [www.va.gov](http://www.va.gov/). Veterans service
representatives, located at all VA regional offices, and many VA medical
facilities can assist veterans and their family members in filing. The
Department of Defense (DoD) also has a toll-free number to provide
veterans with information about their nuclear test participation. The
DoD number is 1-800-462-3683.

The following summary shows the evolution of VA presumptive compensation
program, as it relates to radiation.

**Summary of Laws and Regulations authorizing "Presumptive" Compensation
Based on Participation In a "Radiation Risk Activity"**

#### Public Law 100-321 -- Enacted May 20, 1988

This law made following diseases presumptive for veterans who
participated in a \"radiation risk activity\":

Leukemia other than chronic lymphocytic leukemia (CLL)

Cancer of the thyroid

Cancer of the breast

Cancer of the pharynx

Cancer of the esophagus

Cancer of the stomach

Cancer of the small intestine

Cancer of the pancreas

Multiple myeloma

Lymphomas (except Hodgkin\'s disease)

Cancer of the bile ducts

Cancer of the gall bladder

Primary liver cancer except if cirrhosis or hepatitis B is indicated

[**Public Law 102-578 \--** Effective October 1, 1992]{.underline}

This law added the following to the presumptive condition list:

Cancers of the salivary gland

Urinary tract cancer (kidney, renal, pelvis, ureter, urinary bladder and
urethra)

[**Public Law 106-117 \--** Effective November 30, 1999]{.underline}

This law added bronchiolo-alveolar caricoma (a rare form of lung cancer)

[**Amendment to 38 Code of Federal Regulations, Section 3.309 \--**
Effective March 26, 2002]{.underline}

This regulation added the following cancers and expanded the definition
of \"radiation-risk activity\"

Cancer of the bone

Cancer of the brain

Cancer of the colon

Cancer of the lung

Cancer of the ovary

**Where can a veteran obtain additional information about ionizing
radiation?**

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/Irad](http://www.va.gov/Irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources on
Radiation Health Effects; C1. Research (Planned); D1 Illnesses Linked to
Ionizing Radiation; E1. Radiation Dose Reconstruction -- The Purpose,
The Process; E2. Coordination with Other Federal Departments and
Agencies (Planned); E3. Advisory Committee Role (Planned); E4. Depleted
Uranium; E5. Women Veterans Were Exposed Too.

**This fact sheet was prepared in December 2004 and does not contain any
subsequent developments. It is not copyrighted, and may be duplicated
without written permission.**

# 

+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| #  Department of                                                      |
|                                                                       |
| ##  Veterans Affairs                                                  |
+-----------------------------------------------------------------------+

IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

B4 VA Central Office, Washington, DC 20420 December 2004

**INFORMATION RESOURCES ON RADIATION HEALTH EFFECTS**

Today there is a great deal of information regarding the long-term
health effects of exposure to ionizing radiation. Readers are cautioned
that some of the statements presented in the popular media or on the Web
as "facts" may be misleading or false.

The following listing provides the reader with a great deal of valuable
information resources on this subject:

**VA Web** **site**: <http://www.va.gov/Irad>. This site provides some
of the publications mentioned below, and other information on radiation
health effects for veterans.

**Ionizing Radiation Review** **newsletter** -- This VA publication,
modeled on the Agent Orange Review, provides information to veterans and
family members concerned about the long-term health problems associated
with ionizing radiation exposure. The newsletter is released on an
irregular basis as new information becomes available. Many copies of
this newsletter are mailed to VA field facilities. The first issue was
dated February 2004. Anyone interested in getting a copy of the past
issues of this newsletter or getting on the mailing list for future
issues of the "Review" should contact the Environmental Health
Coordinator at the nearest VA medical center or the Environmental Agents
Service, 131, Ionizing Radiation Review, Department of Veterans Affairs,
810 Vermont Avenue, N.W., Washington, DC 20420.

**Ionizing Radiation Registry** **health examination program** \--
Nearly every VA Medical Center offers the VA's Ionizing Radiation
Registry health examination. Veterans who were exposed to radiation
during their military service are eligible for this program are
encouraged to participate in this voluntary program. Interested veterans
should call the nearest VA medical center for an appointment. The
telephone number should be included in the in the local telephone
directory under the "U.S. Government" listing. See the "Department of
Veterans Affairs."

VA Medical Centers also have designated an Environmental Health
Clinician and an Environmental Health Coordinator who performs and
oversees the Registry examination. The Coordinator is responsible for
handling the administrative aspects of this program.

For general information about VA's health benefits and enrollment in
VA's health care system, veterans are invited to call:
**1-877-222-8387** or go online at [www.va.gov](http://www.va.gov/). .
Veterans are not required to enroll in the system to participate in the
Ionizing Registry program.

**Medical Treatment** -- In addition to the examination program
described above, VA offers health care services to eligible veterans.
Veterans are encouraged to contact the nearest VA medical center to
learn more about their eligibility for medical treatment for conditions
that may be related to their exposure to ionizing radiation during
military service. Atomic veterans seeking care solely for health
problems associated with exposure to radiation have been assigned to
priority category six in VA's enrollment priorities system. Veterans can
call the number above or can visit the VA web site for additional
information on this subject.

**Patient Advocate or Patient Representative** -- Veterans who encounter
difficulties at a VA medical center should contact the Patient Advocate
or Patient Representative at that facility. They receive special
training in assisting patients and resolving their problems. They are
often located in the medical center Director's office.

**Veterans Health Initiative: Veterans and Radiation**

This 191-page independent study course for VA health care providers is
designed to provide an introduction to radiation issues, including
possible adverse health consequences of exposure to ionizing radiation.
The program provides the reader with information about ionizing and
nonionizing radiation, major types of exposures to radiation and health
effects, special programs to help veterans, adjudication, and radiation
exposure in VA facilities

This book in one of a series of self-study guides created by VA to keep
VA health care providers up-to-date on a variety of health issues. While
the primary audience is health care professionals, many veterans may
find the book useful as well. In addition to the Radiation program,
independent guides are available on Agent Orange, cold injury, Gulf War
veterans health, hearing impairment, post-traumatic stress disorder,
prisoners of war, spinal cord injury, amputation and prosthetics, health
effects from Chemical, Biological, and Radiological weapons, and more.
All of these programs can be seen at
[www.va.gov/VHI](http://www.va.gov/VHI). The Radiation course was
recently revised and expanded. The new and improved course book was
released in November 2004.

**Ionizing Radiation Briefs** -- This "Brief" is one in a series of fact
sheet, prepared by the Environmental Agents Service in VA Central
Office, to help answer questions about Ionizing Radiation and related
matters. The series will be updated as new information becomes
available. The Environmental Health Coordinator located at nearly every
VA medical centers should have copies the "Briefs," plus they are
available online at www.va.gov/irad. Question, ideas, suggestions
concerning these fact sheets should be directed to Mr. Donald J.
Rosenblum, Deputy Director, Environmental Agents Services,131, ATTN:
IRBRIEFs, Department of Veterans Affairs, 810 Vermont, Avenue, N.W.,
Washington, DC 20420.

The following Briefs are currently available or are planned:

**A1. General Information**

**B1. Ionizing Radiation**

**B2. Special Health Care Eligibility of Atomic Veterans**

**B3. Disability Compensation**

**B4. Information Resources on Radiation Health Effects**

**C1. Research (planned)**

**D1. Illnesses Linked to Ionizing Radiation**

**E1. Radiation Dose Reconstruction---The Purpose, The Process**

**E2. Coordination with Other Federal Departments and Agencies
(planned)**

**E3. Advisory Committee Role (planned)**

**E4. Depleted Uranium**

**E5. Women Veterans Were Exposed Too**

**VA Field Staff** -- Nearly every VA medical centers has an
Environmental Health Clinician and an Environmental Health Coordinator.
The Environmental Clinicians are responsible for the clinical management
of the Ionizing Radiation Registry program at the VA facility where they
work. These clinicians meet with concerned veterans, conduct
examinations, document medical problems, and answer health-related
questions from ionizing radiation-exposed veterans and their families.
The Environmental Health Coordinators handle the ionizing radiation
program administrative matters at VA health care facilities. They
schedule appointments, review records for accuracy and completeness, and
collect data for reporting purposes.

**Veterans Services Representatives (VSR)** located in VA regional
offices and many medical centers possess a wealth of information about
the wide range of VA benefits. These counselors have all the forms
necessary to apply for VA benefits, including disability compensation
and dependency and indemnity compensation. VSR's also assist veterans
and their survivors in completing these forms, if necessary. The
national toll-free telephone number for information on VA benefits is
1-800-827-1000. Also, VA applications are available on the Internet at
[www.vabenefits.vba.va.gov/vonapp](http://www.vabenefits.vba.va.gov/vonapp).

**Vet Centers** - VA Vet Center personnel also are very helpful to many
veterans experiencing difficulties readjusting to civilian life. This
program is administered by the Readjustment Counseling Service. There
are more than 200 Vet Centers nationwide. Vet centers offer individual,
group, and family counseling. (More information about the vet center
program can be see online at www.va.gov/rcs).

**VA Central Office (National Headquarters)** - The Office of Public
Health and Environmental Hazards and its subgroup the Environmental
Agents Service (EAS) in Washington, DC, is an excellent source of
information about environmental health issues for veterans involved with
nuclear testing, for Vietnam veterans, and for veterans who serve in
Southwest Asia. The Service was organized more about 25 years ago to
deal with the new issue of Agent Orange. While the staff is quite small,
many veterans have found the personnel to be very helpful. Comments,
suggestions, and criticisms about VA's ionizing radiation program are
always welcome. The mailing address is EAS (131), 810 Vermont Avenue,
N.W., Washington, DC 20420.

**Non-VA sources** -- Many veterans service organizations (such as The
American Legion, Veterans of Foreign Wars of the United States, Disabled
American Veterans, National Association of Atomic Veterans, AMVETS,
Vietnam Veterans of America) and State government entities (such as
Divisions of Veterans Affairs, Departments of Health) have also assisted
many veterans.

Congressional committees, especially the House Committee on Veterans'
Affairs and the Senate Committee on Veterans' Affairs, have collected a
great deal of information regarding the long-term health consequences of
exposure to ionizing radiation. Some of this material may be available
online.

This fact sheet was prepared in December 2004 and does not include
subsequent developments. It is not copyrighted and may be duplicated
without permission.

+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| #  Department of                                                      |
|                                                                       |
| ##  Veterans Affairs                                                  |
+-----------------------------------------------------------------------+

IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

D1 VA Central Office, Washington, DC 20420 December 2004

# 

**ILLNESSES LINKED TO IONIZING RADIATION**

**What diseases or illnesses have been associated with exposure to
ionizing radiation?**

VA has recognized an association between a number of cancers and
exposure to ionizing radiation for purposes of "presumptive
compensation" for veterans who participated in a "radiation risk
activity." Namely, all forms of leukemia (except for chronic lymphocytic
leukemia); cancer of the thyroid, breast, pharynx, esophagus, stomach,
small intestine, pancreas, bile ducts, gall bladder, salivary gland,
urinary tract (renal pelvis, urethra, urinary bladder, and urethra),
brain, bone, lung, colon, and ovary, bronchiolo-alveolar carcinoma,
multiple myeloma, lymphomas (other than Hodgkin's disease), and primary
liver cancer (except if cirrhosis or hepatitis B is indicated).

VA regulations define all cancers as possibly caused by radiation. Other
non-malignant conditions might be caused by radiation include, posterior
subcapsular cataracts; non-malignant thyroid nodular disease;
parathyroid adenoma; and tumors of the brain and central nervous system.
For a given individual, VA will also consider the possibility that other
diseases were caused by radiation, if supported by medical or scientific
evidence.

**Aren't these the same illnesses that are recognized for service
connection?**

Yes, indeed. To be eligible for compensation, VA must be able to
establish that it is at least as likely as not that a veteran's illness
was caused by their exposure to radiation during military service. VA
gives the benefit of any doubt to the veteran.

**Where can a veteran obtain additional information about ionizing
radiation?**

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/Irad](http://www.va.gov/Irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources on
Radiation Health Effects; C1. Research (Planned); D1. Illnesses Linked
to Ionizing Radiation; E1. Radiation Dose Reconstruction -- The Purpose,
The Process; E2. Coordination with Other Federal Departments and
Agencies (Planned); E3. Advisory Committee Role (Planned); E4. Depleted
Uranium; 5. Women Veterans Were Exposed Too.

This fact sheet was prepared in December 2004 and does not include
subsequent developments. It is not copyrighted and may be duplicated
without permission.

+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| # Department of                                                       |
|                                                                       |
| ##  Veterans Affairs                                                  |
+-----------------------------------------------------------------------+

### IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

E1 VA Central Office, Washington, DC 20420 December 2004

# 

# DOSE RECONSTRUCTION -- THE PURPOSE, THE PROCESS

# The Defense Threat Reduction Agency (DTRA), formerly the Defense Nuclear Agency, is an organization within the Department of Defense, with the responsibility for documenting participation and assessing the extent of exposure to ionizing radiation for Atomic Veterans. VA utilizes information from DTRA, along with other relevant information, in adjudicating claims for disability compensation.

Ionizing radiation can be measured with a variety of instruments
including personal dosimetry devices such as film badges. However, these
badges primarily measure exposure to external gamma and xrays. The film
badges have been replaced by thermo luminescent dosimeters (TLDs), which
measure exposure from gamma, neutrons, and skin doses. The TLD are more
accurate. According to the DTRA about 45 percent of the atmospheric
nuclear weapons test participants had film badges.

Atomic Veterans with questions about their radiation estimates may wish
to contact the DTRA. The toll-free telephone number is **800-462-3683**.

**Where can a veteran obtain additional information about ionizing
radiation?**

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/Irad](http://www.va.gov/Irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources,
Where to Get Information, Education and Outreach; C1. Research
(planned); D1 Illnesses Linked to Ionizing Radiation; E1. Dose
Reconstruction -- The Purpose, The Process; E2. Coordination with Other
Federal Departments and Agencies (planned); E3. Advisory Committee Role
(planned); E4. Depleted Uranium; E5. Women Veterans Were Exposed Too.

# This fact sheet was prepared in December 2004 and does not include subsequent developments. 

# 

+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| # Department of                                                       |
|                                                                       |
| ##  Veterans Affairs                                                  |
+-----------------------------------------------------------------------+

### IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

E4 VA Central Office, Washington, DC 20420 December 2004

# 

DEPLETED URANIUM (DU)

What is depleted uranium (DU)?

DU is a by-product of the uranium enrichment process. It is derived from
the heavy metal uranium, which occurs naturally as mineral deposits that
are mined and processed for use in nuclear power plants or nuclear
weapons. DU is the natural uranium left over after more of the highly
radioactive uranium isotopes used in these power plants and weapons are
removed. DU contains about half of the radioactivity of natural uranium.
It is considered a very low-level radioactive material. However, as with
other heavy metals, such as lead, uranium can be toxic to the kidneys
and other organs including the lungs. Depleted uranium was first used in
the development of major weapon systems because of its high density and
superior physical properties, and because it is relatively abundant and
cost effective.

**How were U.S. troops in the Gulf War exposed to DU?**

Americans were exposed in several ways. A few were injured by "friendly
fire," more were crewmembers in relatively close contact with munitions
in tanks or other vehicles. U.S. soldiers may have been exposed to smoke
or particles containing DU while fighting a fire at Doha Depot or by
entering or salvaging vehicles or bunkers that were hit by DU
projectiles.

**What do we know about the health effects of exposure to DU in Iraq?**

Information on the possible health effects of DU exposure in military
settings is very limited. Most information about possible effects on
humans comes from studies of uranium miners and millers and associated
occupations, which are somewhat different from Gulf War veterans. For
example, miners were possibly exposed to radon and other toxic
substances present in the mines, making their experience not directly
comparable to Gulf War veterans. Other significant differences relate to
the length and intensity of exposures. Miners are typically exposed over
a long period of time while veterans typically had a short exposure
period.

## 

## The miners studies did find that uranium could affect the kidneys and the respiratory system. Long-term chemical exposure is thought to affect the kidneys and long-term inhalation may cause lung problems. Uranium miners who inhaled uranium dust for extended periods showed increased risks of lung cancer. However, exposure to radon accounts for virtually all of this increase lung cancer risk. Animal studies have not conclusively demonstrated that natural uranium causes lung cancer in animals. At present, it is not known to what extent, if any, DU exposures will affect the health of Gulf War veterans.

What is VA doing to help them?

The Department of Veterans Affairs (VA) has established a DU Follow-Up
program for individuals with the greatest DU exposure (primarily those
with DU shrapnel in their bodies) and a screening program for Gulf War
veterans who are concerned about the possible long-term health effects
of DU exposure.

Gulf War veterans who are concerned about potential DU exposure are
invited to contact the Gulf War Health Registry Coordinator at their
nearest VA Medical Center. Interested veterans may request a DU protocol
examination that includes a complete Gulf War Registry examination (if
not already done), a DU exposure questionnaire, and if needed, a 24-hour
urine collection for total uranium.

Eligible veterans who are concerned they may have been exposed to DU
outside the Gulf region may also have a DU screening test performed.

# Baltimore DU Follow-Up Program

In 1993, the VA set up the Depleted Uranium Follow-up Program at the
Baltimore VA Medical Center. This clinical surveillance program was
designed for identifying, characterizing and following individuals
exposed to significant amounts of DU during the Gulf War. The goals of
the follow up project are to provide an on-going clinical surveillance
of Gulf War veterans who have known or suspected imbedded DU fragments,
DU contaminated wounds, or significant amounts of inhaled DU. The
clinical surveillance is designed to detect the health effects, if any,
of DU containing shrapnel or inhalation exposure, and to provide
recommendations for treatment to participating veterans and the
physicians caring for them.

The medical follow-up program is also involved in the coordination and
distribution of urine analysis materials for the DU screening program.
The staff assists with processing specimens, coordinating specialized
tests and analysis, and reporting results to patients, physicians, and
the Gulf War database.

Most of the people participating in the DU follow-up program were
exposed to DU when their U.S. Army vehicle was struck by DU containing
munitions. Veterans of friendly fire incidents during the Gulf War are
being invited to participate in the scheduled clinical evaluations as
their exposure histories and current locations are confirmed. So far, no
clinically-significant problems that can be attributed to DU exposure
have been identified.

In addition to helping individual veterans, the information gained
through the DU screening and medical follow-up programs will improve our
understanding of the potential health effects of DU and expand our
knowledge about fragment removal, uranium absorption and distribution,
and how uranium is eliminated from the body. Program officials hope that
the program will also improve methods of the evaluation of uranium dose
and the detection of health effects.

The evaluation of the toxicological and radiological effects of DU are
intended to improve the scientific basis for providing advice about
fragment removal, and to better understand uranium absorption in the
body, uranium distribution in human tissue, and how uranium is excreted.
Improved methods to assess uranium dose in humans may also result from
these efforts. In addition, the DU program hopes to improve ways to
detect toxic effects from low dose uranium exposure.

# Other Problems

Other Gulf War veterans who think that their health problems are related
to service in the Gulf War, including but not limited to DU exposure,
are encouraged to contact their nearest VA Medical Center for a Gulf War
Registry health examination. The telephone number of the medical center
can be found in local telephone directories under Department of Veterans
Affairs in the "U.S. Government" listings. Gulf War veterans may wish to
contact the nearest VA veteran center for readjustment counseling. Many
of the counselors there are themselves military veterans. The telephone
number can be found in the local directories as described above.

Veterans with service-related disabilities may wish to file a claim for
disability compensation. A Veterans Services Representatives (VSR) at
the nearest VA regional office or medical center can provide the
application form and any needed assistance. The national toll-free
number to reach a VSR is 1-800-827-1000.

**Where can a veteran obtain additional information about ionizing
radiation?**

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/Irad](http://www.va.gov/Irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources,
Where to Get Information, Education and Outreach; C1. Research
(planned); D1. Illnesses Linked to Ionizing Radiation; E1. Dose
Reconstruction -- The Purpose, The Process; E2. Coordination with Other
Federal Departments and Agencies (planned); E3. Advisory Committee Role
(planned); E4. Depleted Uranium; E5. Women Veterans Were Exposed Too.

This fact sheet was prepared in December 2004 and does not include
subsequent developments.

+-----------------------------------------------------------------------+
| #                                                                     |
|                                                                       |
| #  Department of                                                      |
|                                                                       |
| ##  Veterans Affairs                                                  |
+-----------------------------------------------------------------------+

IONIZING RADIATION BRIEF

**Prepared by the Environmental Agents Service (131)**

E5 VA Central Office, Washington, DC 20420 December 2004

# 

# WOMEN VETERANS WERE EXPOSED TOO

For many years some young women with military service did not consider
themselves veterans. But this is not true. Women are veterans too. Some
of them were exposed to ionizing radiation just like the men were. Many
of them voluntarily made great sacrifices on behalf of the Nation and
deserve our praise and intention.

Although not in as large numbers as men, some women veterans were
exposed to ionizing radiation during their military service. They are
entitled to the same benefits and services as their male counterparts.
That includes the Ionizing Radiation Registry (in fact, as of July 31,
2004, there are 140 women in that Registry), medical treatment, and for
those with service-connected disability, monthly compensation.

Women veterans are welcome at VA Medical Centers nationwide!! They may
wish to contact an Environmental Health Coordinator or the Women
Veterans Program Manager at the nearest VA medical.

Where can a women veteran get more information about exposure to
ionizing radiation?

The following Ionizing Radiation Brief fact sheets (including the one
you are reading) are available at VA medical centers nationwide and
online at [www.va.gov/Irad](http://www.va.gov/Irad): A1. General
Information; B1. Ionizing Radiation Registry; B2. Health Care
Eligibility; B3. Disability Compensation; B4. Information Resources on
Radiation Health Effects, Where to Get Information, Education and
Outreach; C1. Research (planned); D1. Illnesses Linked to Ionizing
Radiation; E1. Dose Reconstruction -- The Purpose, The Process; E2.
Coordination with Other Federal Departments and Agencies (planned); E3.
Advisory Committee Role (planned); E4. Depleted Uranium; E5. Women
Veterans Were Exposed Too.

This fact sheet was prepared in December 2004 and does not include
subsequent developments. It is not copyrighted and may be duplicated
without written permission.