GAO

United States General Accounting Office

Report to Congressional Requesters

March 2000 GULF WAR 

ILLNESSES

Understanding of 

Health Effects From 

Depleted Uranium 

Evolving but Safety 

Training Needed

GAO/NSIAD-00-70

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Contents

Letter 3

Appendixes Appendix I: Scope and Methodology 24

Appendix II: Military Services’ Depleted Uranium Safety Training 29

Appendix III: Army’s Implementation of Common Task Test—Depleted 

Uranium Training Requirement 32

Appendix IV: Comments From the Department of Defense 33

Appendix V: Comments From the Department of Veterans Affairs 35

Appendix VI: GAO Contacts and Staff Acknowledgments 36

Tables Table 1: Number and Percentage of Unit Personnel Completing 

Army’s Required Common Task Test-Depleted Uranium for 

Fiscal Year 1999 for Selected Army Units 32

Figures Figure 1: 120-mm Armor Piercing Round With DU Penetrator 6

Abbreviations

DOD Department of Defense

DU depleted uranium

VA Department of Veterans Affairs
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United States General Accounting Office

Washington, D.C. 20548

National Security and

International Affairs Division

B-284646 Letr

March 29, 2000

The Honorable Lane Evans

Ranking Democratic Member

Committee on Veterans Affairs

House of Representatives

The Honorable Russell D. Feingold

United States Senate

The Honorable Bob Filner

House of Representatives

The Persian Gulf War marked the first battlefield use of armor-piercing 

munitions and reinforced tank armor that incorporated depleted uranium, 

which improved the ability of U.S. munitions to penetrate the target and of 

U.S. armor to protect against enemy munitions. Depleted uranium is a lowlevel radioactive heavy metal, and concerns have surfaced about whether 

exposure to it could be a cause of the illnesses that many servicemembers 

have experienced since the Gulf War. Moreover, because the United States 

used depleted uranium munitions in Kosovo and several other countries 

have or are developing depleted uranium munitions, concerns exist about 

potential health effects from its use in current and future engagements. 

In view of the controversy about a possible connection between depleted 

uranium exposure and Gulf War illnesses, you asked us to address the 

following objectives:

• What is the scientific understanding about health effects from exposure 

to depleted uranium?

• Are Gulf War veterans experiencing administrative problems with the 

current medical screening program for depleted uranium health effects?

• To what extent have the services implemented programs to train 

servicemembers to safely operate in a depleted uranium-contaminated 

battlefield?

As part of our review, we conducted a telephone survey of Gulf War 

veterans believed by the Department of Defense (DOD) to have received 

the highest depleted uranium exposures, and who had been notified by the 

Office of the Special Assistant for Gulf War Illnesses about participating in 
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the current medical screening program for depleted uranium. This program 

is operated by DOD and the Department of Veterans Affairs (VA). We 

attempted to survey 194 veterans who had been notified about 

participation, and reached 128 veterans (66%) to discuss their experiences 

with the program. We also reviewed the services’ depleted uranium training 

programs and the training records for selected Army units at Fort Bragg, 

North Carolina, and Fort Knox, Kentucky. Appendix I describes the scope 

and methodology for this report in more detail.

Results in Brief The scientific understanding of depleted uranium’s effect on health is still 

evolving. Because depleted uranium is a low-level radioactive heavy metal, 

the potential for health effects are twofold: effects from radiation and 

effects from chemical toxicity. Two recent expert reviews have concluded 

that current evidence suggests that it is unlikely that inhaled or ingested 

depleted uranium poses a radiation health hazard, namely cancer. In 

assessing health effects associated with chemical toxicity, both reviews 

cited the kidney as the organ that would show the first adverse health 

effects, and they noted that animal studies show that very high doses of 

uranium may cause kidney failure. However, both reviews observed that 

studies of uranium miners and mill workers have not shown increased 

kidney disease even though they were occupationally exposed to elevated 

levels of natural uranium. The Department of Veterans Affairs is currently 

evaluating 51 Gulf War veterans who are considered to have had the highest 

exposure to depleted uranium. Evaluations in 1997 of 29 of these veterans, 

many of whom have embedded fragments, indicate that, to date, none of 

these veterans show any evidence of adverse kidney effects associated 

with exposure to depleted uranium. However, most depleted uraniumexposed veterans with embedded fragments continue to have elevated 

uranium levels in urine, which were related, in some cases, to lowered 

performance on computerized tests assessing problem-solving efficiency1

and to high levels of the prolactin hormone associated with reproductive 

health. The clinical significance and long-term health consequences of 

these findings are undetermined. Additional research is underway to more 

fully understand depleted uranium health effects and to better estimate the 

amount of depleted uranium exposure received by Gulf War veterans.

1

Program clinical investigators cautioned that the number of veterans with elevated 

uranium levels was small and that a few veterans with complex histories may have 

contributed appreciably to the observed variance.
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Some Gulf War veterans experienced problems in fully participating in the 

medical screening program established to ensure that veterans with higher 

than normal uranium levels are identified for appropriate monitoring and 

treatment. More specifically, the problems encountered by 19 (14.8%) of the 

128 veterans we interviewed included not being contacted by the 

Department of Defense or the Department of Veterans Affairs to arrange an 

appointment at a medical facility, not receiving the required urine test 

designed to detect elevated uranium levels, and not being able to 

understand the test results. The Departments of Defense and Veterans 

Affairs subsequently corrected or planned to correct each administrative 

problem we identified.

The military services have developed depleted uranium safety training, 

which instructs servicemembers on how to identify and safely deal with 

depleted uranium contamination. The services have integrated the depleted 

uranium safety training into training courses for personnel in military 

occupations, such as Army tank gunners, where the exposure potential to 

depleted uranium is highest. In addition, the services have begun efforts to 

provide general awareness depleted uranium training to servicemembers 

on a more widespread basis, regardless of their military occupation. 

However, our review of general awareness depleted uranium training at 17 

Army units, while not projectable to the Army as a whole, showed that the 

required training was not provided to all troops for various reasons, such as 

training materials not being available or servicemembers being away from 

their unit during the training. Furthermore, because neither the Army nor 

Marine Corps monitor depleted uranium training for deployments, they 

were unable to tell us whether troops who recently deployed to Kosovo, 

where depleted uranium munitions were used, had received depleted 

uranium training. 

We are recommending that the Secretary of Defense ensure, by appropriate 

monitoring and periodic review of training records, that all 

servicemembers, including those deployed to Kosovo, receive required 

depleted uranium safety training. 

Background Depleted uranium (DU), a low-level radioactive heavy metal, is a byproduct of the process used to enrich uranium. The United States uses DU 

in several of its armor-piercing munitions because its extreme density and 

its ability to penetrate targets make it an effective weapon; these same 

properties also enhance the protection of U.S. tanks when DU is 

incorporated into tank armor. Several other countries—including the 
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United Kingdom, Russia, Turkey, Saudi Arabia, Pakistan, Thailand, Israel, 

and France—are also reportedly developing or already possess weapon 

systems incorporating DU. A cross-section of a common armor piercing 

munition incorporating DU is displayed in figure 1.

Figure 1: 120-mm Armor Piercing Round With DU Penetrator

Source: U.S. Army.

When a DU munition penetrates a hard target, it breaks into fragments and 

fine particles that ignite easily, and it produces uranium dust particles that 

can be inhaled or ingested. During the Persian Gulf War, several situations 

occurred in which potentially hundreds of U.S. servicemembers could have 

been exposed to DU. These included incidents in which U.S. tanks 

mistakenly fired DU armor-piercing munitions into other U.S. combat 

vehicles. These friendly fire incidents exposed 102 surviving 
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servicemembers who were in or on the affected vehicles at the time they 

were struck to embedded DU fragments and/or inhalation and ingestion of 

DU particles as well as wound contamination. About 60 servicemembers 

who went into these vehicles to evacuate and rescue servicemembers may 

also have been exposed to DU by inhalation and ingestion. After the 

combat operations, about 191 other servicemembers may have been 

exposed, by inhalation and ingestion, when they entered DU-contaminated 

vehicles to remove unexploded munitions and to work in or on damaged or 

destroyed vehicles as they were prepared for repair or disposal. Personnel 

may also have been exposed to DU, by inhalation, during and following a 

fire at Camp Doha, Kuwait, in which DU munitions detonated and burned. 

Other personnel may have been exposed to DU as they passed through and 

inhaled smoke from burning DU, handled spent DU munitions, or entered 

DU-contaminated vehicles on the battlefield or in salvage yards. More 

recently, U.S. aircraft used DU munitions in Kosovo; troops currently 

deployed there may be exposed to DU particles as part of their 

peacekeeping operations.

Following their service in the Persian Gulf War, many veterans experienced 

health problems such as fatigue, muscle and joint pain, gastrointestinal 

complaints, headaches, memory loss, and sleep disturbances. The causes 

of these illnesses have been the source of much controversy over the past

8 years. In November 1996, the Deputy Secretary of Defense established the 

Office of the Special Assistant for Gulf War Illnesses to ensure, among 

other things, that DOD does everything possible to understand and explain 

illnesses in Gulf War veterans. The Office of the Special Assistant has 

completed several investigations, with several still ongoing, into possible 

causes for the illnesses, including possible exposure to DU, chemical or 

biological agents, oil well fires, and pesticides.

On August 4, 1998, the Office of the Special Assistant issued its interim 

environmental exposure report on DU.2

 The Office of the Special 

Assistant’s methodology for its investigation of DU as a potential cause of 

Gulf War illnesses included (1) identifying who was exposed to DU and 

how, (2) identifying the known medical effects of human exposure to DU, 

(3) identifying how much DU personnel were exposed to, and (4) assessing 

the health risks of the DU exposures. As part of this investigation, RAND, 

under contract with DOD, conducted a review of medical and scientific 

2

Environmental Exposure Report: Depleted Uranium in the Gulf, Office of Special 

Assistant for Gulf War Illnesses (Washington, DC: Aug. 1998).
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literature on DU’s known medical and health effects. The scope of RAND’s 

review covered literature published or accepted for publication in peerreviewed journals, books, government publications, and conference 

proceedings. Also, the U.S. Army Center for Health Promotion and 

Preventive Medicine estimated the amount of DU that may have been taken 

into the body for personnel in, on, or near vehicles at the time they were 

struck by DU munitions.

In 1993, the DU Follow-up Program was established at the Baltimore 

Veterans Affairs Medical Center because of concerns about the possibility 

of long-term health effects from embedded DU fragments in 

servicemembers injured during Gulf War friendly fire incidents. In 1993 and 

1994, the program evaluated the health of 33 Gulf War veterans who were 

known to have been exposed to aerosolized DU and, in about half the 

cases, who obtained embedded fragments during friendly fire incidents and 

may have received some of the highest doses. Twenty-nine of the originally 

evaluated 33 veterans were reevaluated between March and June 1997. The 

program, which is still underway, collected information on medical, social, 

family, reproductive, and occupational exposure histories. In addition, 

participating veterans received physical examinations and 

neuropsychological, radiological, reproductive, and kidney function tests 

during 3-day hospital stays. 

In July 1998, DOD and VA established an expanded medical screening 

program to evaluate servicemembers potentially exposed to DU. Although 

the screening program is available for any Gulf War veteran, the Office of 

the Special Assistant attempted to notify and offer the screening to Gulf 

War veterans who were likely to have experienced the highest DU 

exposures, which included those who were in or on vehicles that were 

struck by DU munitions and those who worked around DU-contaminated 

vehicles. The program includes a urine test designed to identify elevated 

uranium levels, a DU-exposure questionnaire, and a medical examination. 

Thirty servicemembers, who had been involved in the friendly fire 

incidents, were identified through this new expanded screening program 

and accepted invitations to participate in the Baltimore VA Depleted 

Uranium Follow-up Program, which seeks to include all servicemembers 

involved in friendly fire incidents. The program evaluated these 30 new 

participants and 21 of the original participants between March and July 

1999.

Because DU is a low-level radioactive heavy metal, DOD believes that 

servicemembers’ exposures to it should be kept as low as reasonably 
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achievable. Consequently, in 1993 DOD required the Army to provide 

training on how to identify and safely operate in a DU-contaminated 

environment and required the other services to assess their DU training 

needs as well. 

Known Health Effects 

Related to DU 

Exposure

Reviews of the scientific literature conducted by RAND and the Agency for 

Toxic Substances and Disease Registry (an agency within the Department 

of Health and Human Services) concluded that current evidence suggests 

that radiation from inhaled or ingested depleted uranium is an unlikely 

health hazard. RAND also concluded that the occurrence of radiationrelated effects (such as cancer) from embedded depleted uranium 

fragments would depend on the size of the fragment and its proximity to 

vital organs. 

Both reviews observed that the kidney is the organ that shows the first 

effects from depleted uranium’s chemical toxicity as a heavy metal. 

Although laboratory tests on animals indicate adverse kidney effects at 

high doses, epidemiological studies of humans occupationally exposed to 

uranium have not found an increase in kidney disease. Similarly, a VA study 

of 29 Gulf War veterans believed to have been exposed to the highest levels 

of depleted uranium has found, to date, no evidence of adverse effects on 

the kidney, but it has found that most DU-exposed veterans with embedded 

fragments continue to excrete elevated levels of urinary uranium. These 

elevated levels were related, in some cases, to “subtle perturbations” in the 

reproductive and central nervous systems.3

 The clinical significance and 

long-term health consequences of these findings are undetermined. 

Additional research is underway to more fully understand DU’s health 

effects and to better estimate the amount of depleted uranium exposure 

received by Gulf War veterans.

3

Melissa A. McDiarmid, et al., “Health Effects of Depleted Uranium on Exposed Gulf War 

Veterans,” Environmental Research, Vol. 82 (2) (Feb. 2000), pp. 168-180.
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RAND and the Agency for 

Toxic Substances and 

Disease Registry Analyses 

of DU Health Effects 

Both RAND and the Agency for Toxic Substances and Disease Registry 

have recently reviewed the scientific literature on possible health effects 

from uranium.4

 RAND found that little published scientific information 

exists on the health effects of depleted uranium, but a wide body of 

relevant literature exists on natural and enriched uranium. Studies of the 

latter forms of uranium are considered relevant to depleted uranium health 

effects because DU is less radioactive than natural or enriched uranium, 

and it is identical to them in chemical toxicity. RAND and the Agency 

reviews examined the literature in regard to both radiation and chemical 

toxicity health effects. 

Regarding radiation health effects, some types of cancer have been 

associated with radiation exposure in humans. Both RAND and Agency 

reviews found that no human cancer attributable to radiation from natural 

uranium is documented in the literature. Since natural uranium is more 

radioactive than DU, these results indicate that DU represents an even 

lesser risk of causing cancer. According to the Agency, radiation from 

inhaled uranium is associated with a low risk of cancer, with the main risk 

occurring with co-inhalation of other toxic and/or carcinogenic agents, 

such as radon. Similarly, RAND reported that no peer-reviewed published 

reports show detectable increases of cancer or other negative health 

effects from radiation exposure to inhaled or ingested natural uranium 

even at levels far exceeding those likely in the Gulf War. RAND concluded 

that it would be virtually impossible to obtain enough inhaled or ingested 

depleted uranium to present a significant internal exposure. For embedded 

depleted uranium fragments, RAND concluded that radiation-related 

effects depend on the size of the fragment and its proximity to vital organs.

Regarding DU’s chemical toxicity, RAND and the Agency cited the kidney 

as the organ that would show the first adverse health effects from DU. Both 

indicated that animal studies have shown that uranium can cause changes 

in kidney function and at very high doses result in kidney failure. The 

4

A Review of the Scientific Literature as It Pertains to Gulf War Illnesses, Vol. 7, Depleted 

Uranium, prepared by RAND’s National Defense Research Institute for the Office of the 

Secretary of Defense (Santa Monica, Calif.: 1999), and Toxicological Profile for Uranium 

(Update), prepared by Research Triangle Institute for Agency for Toxic Substances and 

Disease Registry, U.S. Department of Health and Human Services, Public Health Service 

(Atlanta, Ga.: Sept. 1999). The Agency’s toxicological profile was prepared pursuant to 

section 104(i) of the Comprehensive Environmental Response, Compensation, and Liability 

Act of 1980, 42 U.S.C. § 9604(i) (1994), for hazardous substances found at Department of 

Energy waste sites, including the toxicologic and adverse health effects for uranium.
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Agency reported that the kidney effects observed in animals can also occur 

in humans if the uranium dose is high enough. However, both reviews 

reported that epidemiological studies of uranium miners and mill workers 

occupationally exposed to elevated concentrations of natural uranium have 

shown no increased kidney disease. Moreover, the Agency reported that 

the available data on uranium compounds are sufficient to conclude that 

uranium has a low order of chemical toxicity in humans in view of the high 

exposures to which humans and animals in studies were exposed without 

adverse effects in many cases. 

Both RAND and the Agency also reported that there are few studies 

addressing the human reproductive effects of uranium. The Agency 

reported that uranium may have adverse effects on fetal development 

because animal studies have observed reproductive effects from ingestion 

of uranium. However, RAND reported that the concentrations of uranium 

used to elicit the effects observed in the animal studies were much greater 

than the highest exposure that would occur in military or industrial 

settings. RAND concluded “to the extent that reproductive health issues 

related to uranium have been investigated to date, there have not been 

findings that would suggest a relationship between levels of exposures that 

could have occurred in the Persian Gulf and those that are associated with 

adverse outcomes in animal experiments.”

Based on their reviews of the scientific literature, both RAND and the 

Agency outlined additional research efforts that could more fully assess the 

health effects of DU. The Agency suggested several areas for further 

research, including the health effects on reproductive functioning. RAND 

also suggested additional research, including long-term epidemiological 

studies on Gulf War veterans and continuation of the Baltimore VA 

Depleted Uranium Follow-up Program.
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VA Evaluation of Gulf War 

Veterans

Even though most of the DU-exposed veterans with embedded fragments 

in the Baltimore VA Depleted Uranium Follow-up Program are continuing 

to excrete elevated levels of urinary uranium, to date the data show no 

evidence of adverse effects on the kidney—the organ presumed to show 

the first effects from exposure to DU.5

 Program clinical investigators also 

found uranium in the semen of some, but not all, program participants. The 

clinical investigators found a relationship between elevated urinary 

uranium levels and high levels of the prolactin hormone associated with 

reproductive health—many of the prolactin hormone levels were within the 

upper bounds of the normal range. The clinical investigators also noted, 

however, that as of January 2000, about 20 infants fathered by DU-exposed 

participants display no observable birth defects. Finally, the clinical 

investigators found a statistical relationship between elevated uranium 

levels and lowered performance on computerized tests assessing problemsolving efficiency. The clinical investigators urged caution about drawing 

conclusions about these test results because of the small number of 

veterans with elevated uranium levels in the study group; also, it appeared 

that a few veterans with complex histories may have contributed 

appreciably to the observed variance. The program director told us that the 

clinical significance of these findings is currently unknown; however, the 

director described these “subtle perturbations” as not normal. 

5

Information reported to date on the health effects of DU from this program are based on 

findings from 29 of the original 33 participants who have been monitored since the program 

began in 1993. More recent results should be available during the summer of 2000. These 

results will be based on medical evaluations conducted between March and July 1999 of 51 

participants, including 21 of the original participants.
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Studies in Progress Studies are underway that include analyses of the health effects from 

exposure to DU. The National Academy of Science’s Institute of Medicine, 

under contract with VA, is conducting a review of the scientific literature 

regarding adverse health effects associated with various Gulf War 

exposures. This review will assess whether exposures, or combinations of 

different types of exposures, are associated with illnesses experienced by 

Gulf War veterans. The first phase of the review focuses on health effects to 

several exposures, including DU, nerve agents, vaccines, and 

pyridostigmine bromide. The review is scheduled for completion in August 

2000.6

In response to the complaints of many servicemembers who returned from 

the Gulf War with health problems they believed were associated with their 

deployment, DOD and VA established two programs to monitor their 

health—DOD’s Comprehensive Clinical Evaluation Program in 1994 and 

the VA’s Persian Gulf Registry in 1992. Both programs include databases 

that contain health and potential exposure information on servicemembers 

who had received clinical evaluations as a part of the program. DOD and 

VA are currently engaged in a joint study to analyze the health conditions 

and possible hazard exposures in the combined databases which, as of 

December 1999, included information for over 100,000 U.S. Gulf War 

veterans. This study will examine the relationship between health effects 

and possible exposure to a variety of hazards, including pesticides, insect 

repellants, oil well fire smoke, anthrax vaccinations, and DU. The results of 

this study are expected to be published by December 2000.

The Armed Forces Radiobiology Research Institute is also conducting a 

series of animal studies to assess the health effects of embedded DU 

pellets. The studies are examining the redistribution and toxicity of DU 

fragments, the carcinogenic potential of DU, and the effect of DU on 

reproduction and fetal development. According to an Institute official, 

these studies are expected to be completed within 2 to 3 years. The 

Lovelace Respiratory Research Institute is also conducting an animal study 

examining the carcinogenic potential of embedded DU pellets as well as 

various cellular, biophysical, and biochemical effects. This study is 

expected to be completed in April 2000. 

6

Persian Gulf War Veterans Act of 1998, P. L. 105-277, §1603, 112 Stat. 2681, 2681-745 (Oct. 21, 

1998) and Veterans Programs Enhancement Act of 1998, P. L. 105-368, § 101, 112 Stat. 3315, 

3317 (Nov. 11, 1998), each of which mandates a review regarding the associations between 

illnesses and Gulf War service.
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Unreliable Dose Estimates 

for Servicemembers in, on, 

or near Vehicles When 

Struck by DU Munitions

DOD estimates describing the extent of DU inhalation exposure of about 

162 servicemembers who were in or on vehicles when they were struck by 

DU munitions in friendly fire incidents and for those entering the vehicles 

immediately after impact in the Gulf War are unreliable because of 

questionable assumptions used in the analysis. Reliable DU exposure 

estimates are important for assessing the potential for adverse health 

effects from exposure to DU and will augment the medical outcome data 

available from the clinical monitoring of servicemembers involved in the 

friendly fire incidents.

In August 1998, the U.S. Army Center for Health Promotion and Preventive 

Medicine issued its interim DU exposure assessment for servicemembers 

who were in or on vehicles when they were struck by DU munitions in 

friendly fire incidents and for those entering the vehicles immediately after 

impact. It is believed that these individuals received the highest exposures 

to DU during the Gulf War. We reviewed the methodology used by the 

Center in preparing its estimates and found that it had relied extensively on 

a single test conducted in 1987, which involved DU munitions striking an 

Abrams M1A1 tank equipped with DU armor. 7

 We found that the conditions 

present during the 1987 test and those present during the Gulf War for the 

friendly fire incidents differed significantly, which could result in higher or 

lower dose estimates than the Center’s 1998 dose assessment. For example, 

the 1987 test measured the DU dose resulting from less than a minute of 

exposure, while the 1998 assessment assumes that servicemembers were 

exposed in the vehicles for 15 minutes during the Gulf War. Similarly, the 

1987 test results may have underestimated the amount of DU exposure 

because the test assumed a less intense breathing rate than believed to be 

experienced by Gulf War veterans. While these differences suggest that the 

1998 assessment on Gulf War veterans’ DU exposure level may be 

understated, other differences suggest that they could be overstated. For 

example, in the 1987 test DU munitions penetrated the DU armor of a tank, 

which may produce more aerosolized DU than would be the case had it 

struck a non-DU armor portion of the vehicle. In the Gulf War, DU 

munitions did not penetrate DU armor. Also, in the Gulf War many friendly 

fire incidents involved Bradley Fighting vehicles, which are not DU 

armored and therefore should not have produced levels as high as in the 

1987 test. 

7

Richard L. Fliszar, Edward F. Wilsey, and Ernest W. Bloore, Radiological Contamination 

From Impacted Abrams Heavy Armor, U.S. Army Laboratory Command, Ballistic Research 

Laboratory, Technical Report BRL-TR-3068 (Maryland: Dec. 1989).
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In response to our and congressional concerns about the accuracy of the 

Center’s dose estimates,8

 the Special Assistant for Gulf War Illnesses (who 

also serves as the Under Secretary of the Army) in October 1999 directed 

that the Army conduct further testing as soon as possible. The new test will 

be designed to develop more reliable estimates on how much DU 

servicemembers were exposed to during the Gulf War and to provide as 

much information as possible on the implications of similar exposures in 

future engagements. According to an Army official, the new live-fire test 

design and plan are currently being developed, and they will make 

extensive use of subject area experts in designing, conducting, and 

reporting the test results. Army officials estimate that it will take about 

17 months to complete and interpret the results of the new tests.

The Center is also developing exposure estimates for those Gulf War 

veterans who experienced lower-level exposures to DU. The Special 

Assistant for Gulf War Illnesses noted that these estimates are not based on 

the same test data used in developing the exposure estimates for those 

individuals in or on the vehicles involved in the friendly fire incidents and, 

therefore, are not subject to scientific disagreement. The Center’s 

preliminary exposure estimates for other lower-level exposure categories 

were not available for our review as of December 1999, but were being 

reviewed within DOD.

Administrative 

Problems Hinder Full 

Participation in 

Screening Program for 

Some Veterans

To ensure that those Gulf War veterans with higher than normal uranium 

levels are identified for appropriate monitoring and treatment, DOD and VA 

established an expanded medical screening program in 1998. Our survey of 

128 servicemembers found that 109 veterans we interviewed did not 

experience administrative problems, but 19 (14.8%) veterans did 

experience problems (such as in arranging an appointment at a DOD or VA 

hospital) that hindered their full participation.

Although the medical screening program is available to any Gulf War 

veteran, the Office of the Special Assistant directly contacted only those 

veterans suspected of receiving the highest levels of exposure to DU. These 

included veterans (1) who were in or on U.S. vehicles when they were 

struck by DU munitions in friendly fire incidents, (2) who entered these 

8

On September 24, 1999, Representative Lane Evans, Representative Bob Filner, and Senator 

Russell Feingold cosigned a letter to the Secretary of Defense requesting the Secretary to 

immediately investigate the issue and to direct a new dose reconstruction, if appropriate.
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vehicles to perform rescue operations, or (3) whose duties required them 

to make numerous trips into DU-contaminated vehicles. The process of 

identifying veterans in these groups has continued since the program 

started in July 1998. As of August 1999, when we began our survey, the 

Office of the Special Assistant had contacted 210 veterans who they 

believed were exposed to the highest levels of DU and asked them to 

participate in the screening program. 

We attempted to interview 194 of the 210 veterans who had been contacted 

by the Office of the Special Assistant to ask them about their experiences 

with the program.9

 We were able to interview 128 (66%) of the 194 veterans. 

Sixty (47%) of those we contacted were participating in the program. Six 

(10%) of these veterans had experienced problems related to the 24-hour 

urine test; more specifically, three had not been given the required 24-hour 

urine test, and three had difficulty in interpreting the urine test results.10

We asked the 55 veterans who said that they were not participating but 

planned to at a later time about their reasons for not yet participating. We 

found that 13 (23.6%) were not participating because they were waiting for 

an appointment—6 at DOD medical facilities and 7 at VA medical centers. 

When these veterans were notified by the Office of the Special Assistant 

about the screening program and indicated their desire to participate, they 

were told that someone would call them to arrange an appointment. 

However, no one had contacted them about an appointment. Nine of these 

13 veterans had been waiting at least 11 months for an appointment. The 

administrative problems found in our survey occurred because DOD and 

VA did not adequately monitor the status of individuals who had indicated a 

desire to participate in the program to ensure all phases of the screening 

were complete. We discussed the problems we identified with DOD and VA 

officials, who either corrected or developed plans to correct them.

Thirteen veterans who were notified for participation were not 

participating and had no plans to do so. When we asked these veterans for 

their reasons for not participating, none claimed that administrative 

problems deterred them. In addition, they did not claim that DOD had not 

informed them of their possible exposure, and they did not cite a lack of 

9

We did not attempt to interview 16 veterans because they were located outside the 

contiguous United States when we were doing our survey.

10The 24-hour urine test identifies the uranium level in a urine sample collected over a

24-hour period.
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trust in DOD or VA as a reason for not participating. Many of the veterans 

reported more than one reason for not participating. The most frequently 

cited reasons are as follows:

• Their health had not been affected from exposure to DU (11 

respondents).

• They did not believe that they were exposed to DU (7 respondents).

• Job demands or a lack of money or time had prevented them from 

participating (7 respondents).

DU Training Programs 

Established but Not 

Fully Implemented 

The lack of DU training and delays in providing it have been long-standing 

issues for the services. In January 1993, we reported that the Army had not 

effectively educated its Gulf War personnel about the hazards of DU 

contamination and proper safety measures, and we recommended that the 

services provide appropriate training to those servicemembers who may be 

exposed to DU.11 In June 1993, the Deputy Secretary of Defense directed 

the Army to ensure that DU training was provided to servicemembers and 

required the other services to also assess their DU training needs. In April 

1998, the Special Assistant for Gulf War Illnesses reported that the services 

had not made sufficient progress in implementing DU training and that 

servicemembers were only marginally better prepared to contend with DU 

hazards than they had been during the Gulf War. 

To review the status of DU training provided by the services, we visited 

each of the service headquarters and several Army schools where DU 

training is conducted. We found that each service provides DU training for 

military occupations considered to have the greatest likelihood for DU 

exposure, such as Army chemical unit personnel, Army tank gunners who 

would fire DU rounds in combat, Navy personnel who operate the Phalanx 

weapons system (which also fires DU rounds), and Air Force explosive 

ordnance disposal personnel. Since the beginning of fiscal year 1995, DU 

training modules have been included in 21 military skill specialty and 

noncommissioned officer and officer leadership courses taught to over 

26,000 personnel. Each service has also provided DU training to medical 

personnel who are responsible for treating troops who may be wounded by 

DU munitions. 

11Operation Desert Storm: Army Not Adequately Prepared to Deal With Depleted Uranium 

Contamination (GAO/NSIAD-93-90, Jan. 29, 1993).
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Page 18 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Beginning in 1998, the services initiated efforts to provide DU training to 

the general population of troops on a more widespread basis, regardless of 

their military occupations, either as part of basic training, unit readiness 

training, or predeployment training for personnel subject to duty in areas 

where they may encounter DU. The services vary in their approaches to 

providing this general awareness DU training. For example, 

• the Air Force requires general awareness DU training for all personnel 

subject to mobilization and deployment and as part of basic training;

• the Navy targets its general awareness training to specific types of 

shipboard personnel it believes most likely to encounter DU in a 

conflict, such as corpsmen, damage control personnel, and ammunition 

handlers;

• the Marine Corps plans to make DU general awareness training a 

requirement for enlisted personnel in all units during fiscal year 2000 

and to include DU training in several officer-level courses; and

• the Army incorporated DU tasks into the required unit level common 

task test12 for 5 consecutive years (fiscal years 1999 through 2003). 

Appendix II provides more detailed information on the numerous training 

modes each service has taken or plans to take to implement DU training. 

To determine if soldiers are receiving the required DU awareness training, 

we reviewed training records at selected Army sites. We chose the Army for 

our review because, as the service with the largest numbers of ground 

troops, it is the service with the greatest likelihood of having large numbers 

of troops exposed to DU on the battlefield. Also, the Army formally 

required the general awareness DU training and stressed the importance of 

common task training as its mechanism for providing it. The Army, 

however, does not centrally track the extent to which servicemembers are 

provided the required common task test training components; that 

information is kept at the individual unit level. Because no central records 

were available, we selected several Army units to test the implementation 

of DU general awareness training. 

We reviewed fiscal year 1999 common task training and testing records at 

16 Army units at Fort Bragg, North Carolina, and 1 unit at Fort Knox, 

12Common task training includes a number of critical combat and survival skills in which the 

Army requires all soldiers to be routinely trained and tested—every year for active soldiers 

and every 2 years for reserve soldiers.
B-284646

Page 19 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Kentucky. The review, which included over 1,600 personnel, indicated that 

only 65 percent received the required DU training. We also found a great 

deal of disparity among units in that three units had not conducted the 

required DU training at all, while four units had provided the training to 

almost everyone (over 90%) in the unit. Appendix III shows in more detail 

the results of our review.

Reasons given for not providing the required DU training to all units and 

personnel included the following:

• Another common task was substituted for the DU task because the unit 

did not have the DU training materials available or lacked the expertise 

to conduct the training.

• Scheduled DU training was superseded by a larger scale training 

deployment requirement.

• Common task training and testing was interrupted by a hurricane.

• Some individuals were on leave, sick, or away at other training during 

the conduct of common task training.

All the above reasons for not providing DU training to unit personnel could 

have been overcome or avoided if the common task training had been 

scheduled early in the year so that (1) needed equipment could have been 

obtained, (2) the training could have been rescheduled if other priorities or 

conflicts arose, and (3) personnel away from the unit at the time of the 

training could have been trained when they transferred into or returned to 

the unit. 

Because DOD and the services do not monitor DU training for 

deployments, Army and Marine Corps officials in Washington, D.C., and 

Europe were unable to tell us whether Army and Marine Corps troops who 

recently deployed to Kosovo had received DU training prior to or during 

the deployment. This lack of information is potentially significant because 

our forces in Kosovo used DU munitions. Army officials said that since DU 

is a common task training item, the units in Kosovo should have received 

the training at some time during fiscal year 1999, but they could not 

confirm that the training had occurred. Marine Corps officials said that the 

Marine Corps had no policy or directive to provide DU training to deploying 

troops and would do so only if directed by the responsible commander in 

chief.
B-284646

Page 20 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Conclusions We believe that the Under Secretary of the Army acted appropriately in 

directing the Army to conduct new live-fire DU tests. Proper analyses of the 

test results should provide more reliable estimates of the level of DU 

exposure experienced by servicemembers who were in or on the vehicles 

involved in friendly fire incidents during the Gulf War or who may be 

exposed to DU in future engagements. Because of the Army’s apparent 

commitment on this issue, we are not making any recommendations but we 

plan to monitor the Army’s conduct of this testing.

U.S. servicemembers continue to use DU munitions and may be exposed to 

them from other sources as a growing number of other countries 

incorporate DU into their weapon systems. Because depleted uranium is a 

low-level radioactive heavy metal, servicemembers’ exposure to it should 

be kept as low as reasonably achievable. The services, therefore, need to 

do more to ensure that servicemembers receive safety training on how to 

properly operate in a DU-contaminated battlefield. Proper implementation 

of the training programs is essential to achieving a necessary level of 

protection. While our review of training records was limited to the Army, 

the importance of training implementation is applicable to the other 

services because they also employ DU in their combat systems and could 

encounter damage from enemy DU munitions. Given that DU munitions 

were used in Kosovo and U.S. servicemembers are deployed to the region, 

we believe that it is especially important to know whether they have 

received DU safety training.

Recommendations To provide that both active and reserve component servicemembers 

receive depleted uranium safety training, we recommend that the Secretary 

of Defense 

• direct the secretary of each military department to ensure, by 

appropriate monitoring and periodic reviews of training records, that 

active and reserve component servicemembers receive required annual 

or biennial depleted uranium safety training and

• identify whether servicemembers currently deployed to Kosovo have 

received depleted uranium safety training, and if not, provide it 

promptly.
B-284646

Page 21 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Agency Comments and 

Our Evaluation

In commenting on a draft of this report, DOD concurred with our 

recommendations that the Secretary of Defense ensure that all 

servicemembers, including those deployed to Kosovo, receive required 

depleted uranium safety training. DOD further described actions it has 

already taken to emphasize the importance of this training.

DOD also stated that we accurately reported the findings from two recently 

published reviews of medical literature related to depleted uranium health 

effects. DOD took exception, however, to our presentation of the Baltimore 

Depleted Uranium Follow-up Program findings in the Results in Brief. DOD 

stated that we did not include key caveats related to those veterans with 

embedded fragments, a small number of veterans with complex histories, 

and the clinical significance of the findings. We revised the Results in Brief 

to more completely reflect these caveats. 

In follow-up to VA’s written comments, the VA’s Chief Officer, Public Health 

and Environmental Hazards, Veterans Health Administration, agreed with 

the findings and conclusions in the draft report and stated that they have 

taken action to correct the problems that we identified during our audit 

work.

DOD and VA comments are presented in their entirety in appendixes IV and 

V, respectively. DOD and VA also provided oral and technical comments, 

which we have incorporated as appropriate.

We conducted our review from March 1999 through January 2000 in 

accordance with generally accepted government auditing standards.

As agreed with your office, unless you publicly announce the contents of 

this report earlier, we plan no further distribution of this report until

30 days after its issue date. At that time, we will send copies of this report 

to appropriate congressional committees. We will also send copies to the 

Honorable William S. Cohen, Secretary of Defense; the Honorable Togo D. 

West, Jr., Secretary of Veterans Affairs; and the Honorable Bernard Rostker, 

Special Assistant to the Deputy Secretary of Defense for Gulf War Illnesses. 

Copies will also be sent to other interested parties upon request.
B-284646

Page 22 GAO/NSIAD-00-70 Depleted Uranium Health Effects

If you have any questions about this report, please call me at (202) 512-3610 

or the contacts listed in appendix VI. 

Norman J. Rabkin

Director, National Security

Preparedness Issues
Page 23 GAO/NSIAD-00-70 Depleted Uranium Health Effects
Page 24 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Appendix I

Scope and Methodology ApApenednxidexiIs

To perform our review, we obtained relevant documents and reports about 

potential depleted uranium (DU) health effects from various sources, 

including the Department of Defense’s (DOD) Office of the Special 

Assistant for Gulf War Illnesses; RAND; the U.S. Army Center for Health 

Promotion and Preventive Medicine; the Baltimore Veterans Affairs (VA) 

Depleted Uranium Follow-up Program; the Persian Gulf Veterans 

Coordinating Board; the Department of Veterans Affairs; the Offices of the 

Surgeons General at the Army, the Navy, and the Air Force; the Institute of 

Medicine; and the National Gulf War Resource Center, Inc. We analyzed this 

documentation and discussed in detail issues related to potential DU health 

effects with representatives of these organizations.

To identify what is generally known about health effects from exposure to 

DU, we analyzed RAND’s report, published in 1999, on its review of the 

scientific literature about the health effects of depleted uranium. We met 

with RAND representatives and discussed the methodology used for its 

review and the process used for quality assurance. In addition, we reviewed 

the Toxicological Profile for Uranium prepared by the Agency for Toxic 

Substances and Disease Registry, a federal agency within the Public Health 

Service of the U.S. Department of Health and Human Services, which was 

issued in September 1999 after a public comment period. We met with 

representatives of the Persian Gulf Veterans Coordinating Board and 

discussed federally funded research projects on depleted uranium health 

effects. In addition, we met with Institute of Medicine representatives and 

discussed the methodology and status of their review of the scientific and 

medical literature regarding adverse health effects associated with various 

exposures experienced during the Gulf War.

To identify evidence regarding possible negative health effects experienced 

by servicemembers as a result of DU exposure during the Gulf War, we 

discussed the findings of the Baltimore VA Depleted Uranium Follow-up 

Program with program officials and reviewed program documentation. We 

discussed with representatives of DOD’s Comprehensive Clinical 

Evaluation Program and the VA’s Persian Gulf Registry completed and 

planned analyses of program data related to possible health effects from 

exposure to DU. 

To assess the reasonableness of the DU exposure estimates for 

servicemembers involved in DU friendly fire incidents, we reviewed the 

methodology used by the U.S. Army Center for Health Promotion and 

Preventive Medicine at Aberdeen Proving Ground, Maryland. In analyzing 

the methodology, we discussed with Center officials the basis for various 
Appendix I

Scope and Methodology

Page 25 GAO/NSIAD-00-70 Depleted Uranium Health Effects

components of the methodology. In reviewing the dose estimation 

methodology, we also met with the principal author of a 1989 test report 

and other officials at the U.S. Army Picatinny Arsenal to discuss the 

reasonableness of the Center’s use of data from the earlier test.

To identify whether Gulf War veterans were experiencing administrative 

problems in participating in the current DOD/VA DU medical screening 

program, we surveyed by telephone servicemembers who had been 

contacted by the Office of the Special Assistant for Gulf War Illnesses. The 

Office of the Special Assistant contacted those Gulf War veterans believed 

to have received the highest levels of exposure to DU to encourage them to 

participate in the program. We developed and pretested a structured 

interview protocol that we subsequently used in surveying the 

servicemembers. As of August 11, 1999, the Office of the Special Assistant 

had contacted 210 individuals about the screening program.1

 Because of 

the difficulty in reaching servicemembers located outside the United 

States, we did not attempt to reach the 16 individuals who were located 

outside the contiguous United States. We subsequently attempted to 

contact 194 individuals who were believed to be in the United States at the 

time of our survey. We located and interviewed 128 individuals about their 

experiences with the medical screening program. We analyzed the survey 

results and subsequently communicated information about those instances 

in which program administrative problems were cited to DOD and VA 

officials. We provided DOD and VA officials an opportunity to investigate 

the problem cases and provide us with any documentation that refuted the 

allegations. In those instances where the DOD or VA officials provided 

evidence that effectively refuted the servicemembers’ allegations, we 

revised our summary results. Specifically, 10 veterans told us about 

administrative problems that were not substantiated by information or 

documentation provided by DOD or VA— such as not completing the urine 

tests, not receiving the test results, and not being notified to set up an 

appointment.

To assess whether the services have implemented programs to train 

servicemembers on how to operate safely in a DU-contaminated 

1

The Office of the Special Assistant has continued to notify veterans about the program. 

From August 1999 to January 2000, the Office of the Special Assistant contacted 12 

additional veterans. As discussed in the report, DOD and VA have made this program 

available to any Gulf War veteran who believes that he or she may have been exposed to DU. 

As of December 31, 1999, a total of 269 veterans have entered the screening program 

through this avenue as self-referrals.
Appendix I

Scope and Methodology

Page 26 GAO/NSIAD-00-70 Depleted Uranium Health Effects

environment, we interviewed officials and obtained relevant 

documentation by visiting or contacting the following locations:

• Department of Defense

• The Office of the Special Assistant for Gulf War Illnesses, Falls 

Church, Va.

• Department of the Army

• Office of the Deputy Chief of Staff for Operations, Army Training, 

Headquarters, Department of the Army, Pentagon, Washington, D.C.

• Headquarters, U.S. Army Training and Doctrine Command, Fort 

Monroe, Va.

• Headquarters, U.S. Army Medical Command, Fort Sam Houston, Tex.

• Headquarters, U.S. Army Europe, Heidelberg, Germany

• Headquarters, 7th Army Training Command, Grafenwoehr, Germany

• Headquarters, V Corps, Heidelberg, Germany

• U.S. Army Chemical School, Fort Leonard Wood, Mo.

• U.S. Army Ordnance Centers and Schools, Aberdeen Proving Ground, 

Md.

• Redstone Arsenal, Ala.

• Headquarters, U.S. Army Infantry Center and Fort Benning, Fort 

Benning, Ga.

• Continental U.S. Replacement Center, Fort Benning, Ga.

• U.S. Army Armor Center, Fort Knox, Ky.

• U.S. Army Combined Arms Center and Fort Leavenworth, Fort 

Leavenworth, Kans.

• Department of the Navy

• Radiological Controls & Health Branch, Office of the Chief of Naval 

Operations, Pentagon, Washington, D.C.

• U.S. Navy Bureau of Medicine and Surgery, Washington, D.C.

• Chief of Naval Education and Training, Pensacola, Fla.

• U.S. Navy Fleet Combat Training Center, Atlantic, Virginia Beach, Va.

• Department of the Air Force

• Office of the Deputy Assistant Secretary for Environmental Safety 

and Occupational Health, Office of the Secretary of the Air Force, 

Washington, D.C.

• Civil Engineering Directorate, Headquarters, U.S. Air Force, 

Washington, D.C.

• Office of the Air Force Surgeon General, Bolling Air Force Base, 

Washington, D.C.

• U.S. Marine Corps

• Radiation Safety Office, Marine Corps Safety Division, Headquarters, 

U.S. Marine Corps, Arlington, Va.
Appendix I

Scope and Methodology

Page 27 GAO/NSIAD-00-70 Depleted Uranium Health Effects

• Health Services, Headquarters, U.S. Marine Corps, Arlington, Va.

• Marine Corps Combat Development Center, Quantico Marine Corps 

Base, Quantico, Va.

To review the implementation of DU safety training, we focused on the 

Army because, as the service with the largest numbers of ground troops, it 

is the service with the greatest likelihood of having large numbers of troops 

exposed to DU on the battlefield. In reviewing the Army’s implementation 

of its broadscale DU general awareness training for soldiers, we visited 

selected active Army units and reviewed their common task training 

records for fiscal year 1999. In performing our review we compared the DU 

portion of the common task training records to the unit rosters to 

determine how many soldiers in each unit had been trained and tested on 

DU. Our review included visits to the 17 units listed below, some of which 

are rapid deployment units. 

• Fort Bragg, North Carolina

• A Company, 3rd Battalion, 505th Parachute Infantry Regiment

• C Company, 3rd Battalion, 505th Parachute Infantry Regiment

• D Company, 3rd Battalion, 505th Parachute Infantry Regiment

• Headquarters and Headquarters Company 3rd Battalion, 505th 

Parachute Infantry Regiment

• D Troop, First Squadron, 17th Cavalry Regiment

• C Company, 307th Engineer Battalion

• 82nd Military Police Company

• C Battery, 3rd Battalion, 4th Air Defense Artillery Regiment

• C Company, 82nd Signal Battalion

• Headquarters and Service Company, 313th Military Intelligence 

Battalion

• C Company, 27th Engineer Battalion, 20th Engineer Brigade

• B Company, 27th Engineer Battalion, 20th Engineer Brigade

• C Company, 37th Engineer Battalion, 20th Engineer Brigade

• B Battery, 1st Battalion, 377th Field Artillery Regiment, XVIII 

Airborne Corps Artillery

• C Battery, 1st Battalion, 321st Field Artillery Regiment, XVIII 

Airborne Corps Artillery

• A Battery, 3rd Battalion, 27th Regiment, XVIII Airborne Corps 

Artillery

• Fort Knox, Kentucky

• 233rd Combat Heavy Equipment Transport Company
Appendix I

Scope and Methodology

Page 28 GAO/NSIAD-00-70 Depleted Uranium Health Effects

DOD and VA provided written comments on a draft of this report. These 

comments are discussed on page 21 and are reprinted in appendixes IV 

and V.
Page 29 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Appendix II

Military Services’ Depleted Uranium Safety 

Training ApendxiI

This appendix describes, in detail, the depleted uranium safety training 

developed by each military service.

Army The Army included DU training for personnel in its M-1 tank Master Gunner 

Course in 1991 and in the Armor Officer Basic Course and Armor Captain 

Career Course in 1995. Depleted uranium training was introduced into the 

noncommissioned officer Ammunition Specialist Course in 1994, and into 

the Nuclear, Biological, and Chemical Course in 1995. In 1996, DU training 

was added to four different ordnance courses and to the Army’s 

Ammunition Technician Course. DU training was introduced into the 

Infantry Bradley Fighting Vehicle Course in 1997 and into two additional 

Bradley vehicle courses in 1999. In 1998, DU training was included in the 

Army’s Pre-Command Course for Lieutenant Colonels and Colonels prior to 

their first command assignment. Army officials could not give the actual 

date for when DU training was included in the Advanced Individual 

Training course for explosive ordnance disposal personnel or the core level 

Ammunition Specialist Course, but they said DU was not introduced into 

these two courses until after the Gulf War. 

In October 1998, DU training was included as a common task in the Army’s 

list of required unit-level training tasks, and DU will be included in the 

common task test for a 5-year period from fiscal year 1999 to 2003. In 

addition, on three different occasions in 1999, the Army used its worldwide 

satellite broadcasting system to televise DU training information to Army 

units worldwide. The same system was used on two earlier occasions in 

1998 to broadcast DU-related medical treatment information to military 

medical personnel in all the services worldwide. In April 1999, the Army 

Medical Command established a requirement that all physicians and other 

applicable health care providers be trained on the Army’s policy for treating 

personnel wounded by depleted uranium munitions. Also, as of February 

2000, according to the Army’s Training and Doctrine Command, DU training 

is now a mandatory part of officer precommissioning training for all new 

officers, and warrant officers will receive mandatory DU training during 

preappointment training as well. 

During our visit to units at Fort Bragg, N.C., the XVIII Airborne Corps 

Chemical Officer told us that the Corps conducts a 2-week training course 

to train alternate nuclear, biological, and chemical officer and 

noncommissioned officer personnel from individual units at Fort Bragg, 

and that the course began including DU training informally in October 1998 

and formally in 1999. He also said that other corps and division size Army 
Appendix II

Military Services’ Depleted Uranium Safety 

Training

Page 30 GAO/NSIAD-00-70 Depleted Uranium Health Effects

units may have similar training courses. In addition, the 82nd Airborne 

Division’s Chemical Officer told us that, given the current emphasis on DU, 

the division is planning to incorporate DU training into its predeployment 

checklist of required items to accomplish before a unit deploys. This is 

being done as an additional assurance that deploying personnel will receive 

DU training, even if they miss it as part of common task training. 

Air Force The Air Force provided DU training as part of its nuclear radiation and 

hazardous materials training to bioenvironmental engineers and in the 

training curriculum for personnel with potential for exposure to DU as part 

of their military occupation (e.g., it has been provided for explosive 

ordnance personnel since before the Gulf War). In 1998, the Air Force 

began including DU training as a unit training requirement as part of its 

annual nuclear, biological, and chemical refresher training for all officer 

and enlisted personnel subject to deployment. In October 1999, DU training 

was added to Air Force basic recruit training. In addition, the Air Force 

Surgeon General made DU training a continuing medical education 

requirement by requiring that all Air Force medical personnel be trained 

annually in how to treat personnel wounded by DU munitions. 

Navy The only Navy weapons system that uses DU munitions is the Phalanx 

Close-in-Weapons System, a shipboard, rapid-firing 20 millimeter cannon 

designed to shoot down incoming missiles. The Navy is phasing out its use 

of DU rounds over the next 5 years because it has determined that the 

penetration capability of DU rounds is not necessary for shooting down 

missiles because they are lightly armored. Since the introduction of the 

Phalanx around 1980, the Navy has provided DU training to its fire control 

technicians who operate the system and who store and handle DU 

ammunition. Recognizing that other countries now have DU rounds and 

that its ships may be hit by DU rounds, the Navy made DU general 

awareness training a unit training requirement and a predeployment 

training requirement beginning in the fall of 1999 for all shipboard damage 

control personnel, firefighters, and medical personnel. In addition, 

explosive ordnance personnel, special operations personnel, and Seabees 

are now required to be provided DU training prior to each deployment or as 

part of annual refresher training. In addition to the general awareness 

training, deploying Navy medical personnel must also receive information 

on the treatment of personnel wounded by DU. 
Appendix II

Military Services’ Depleted Uranium Safety 

Training

Page 31 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Marine Corps The Marine Corps decided to wait until the Army had completed the DU 

training materials before providing DU training to its troops on a broad 

scale. In October 1998, the Marine Corps began providing DU training to 

personnel who have completed basic recruit training and are waiting to 

enter either the Marine Corps School of Infantry or a military occupational 

training program such as armor, ordnance, ammunition technician, or 

aircraft maintenance. In fiscal year 2000, Marine Corps officers are 

scheduled to begin receiving DU training as part of their entry-level officer 

training. DU training will also be introduced into advanced officer training 

courses and schools such as the Marine Corps War College, Marine Corps 

Commanders’ Course, Marine Corps Command and Staff College, and the 

Amphibious Warfare School. Marine Corps noncommissioned officers will 

receive DU training in their noncommissioned officer courses, also 

beginning in fiscal year 2000. In addition, the Marine Corps plans to provide 

DU training to every Marine beginning in fiscal year 2000 by including DU 

training as one of its critical combat and survival skills, which are taught, 

tested, and periodically retrained in individual Marine Corps units 

(battalion level or below). Marine Corps units have a 2-year cycle for 

accomplishing this training. The Navy provides the Marine Corps with 

medical support; Navy medical personnel receive DU training as discussed 

earlier in the section on Navy DU training efforts.
Page 32 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Appendix III

Army’s Implementation of Common Task 

Test—Depleted Uranium Training 

Requirement ApendxiI

This appendix presents in table 1 the results of our review of selected Army 

units’ compliance with the Army’s Common Task Test—Depleted Uranium 

Training for fiscal year 1999 at Fort Bragg, North Carolina, and Fort Knox, 

Kentucky.

Table 1: Number and Percentage of Unit Personnel Completing Army’s Required 

Common Task Test−Depleted Uranium for Fiscal Year 1999 for Selected Army Units

Source: GAO.

Unit

Number in unit

subject to Common

Task Test

Number

completing

DU training

Percentage

completing

DU training

Fort Bragg

A 133 109 82

B 122 111 91

C 69 56 81

D 176 175 99

E 10 7 70

F 108 65 60

G 82 37 45

H 101 74 73

I 99 95 96

J 59 44 75

K 79 55 70

L 89 78 88

M 100 0 0

N 104 95 91

O 89 0 0

P 89 70 79

Fort Knox

A 132 0 0

Total 1,641 1,071 65
Page 33 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Appendix IV

Comments From the Department of Defense ApendxiIV
Appendix IV

Comments From the Department of Defense

Page 34 GAO/NSIAD-00-70 Depleted Uranium Health Effects
Page 35 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Appendix V

Comments From the Department of Veterans 

Affairs ApendxiV
Page 36 GAO/NSIAD-00-70 Depleted Uranium Health Effects

Appendix VI

GAO Contacts and Staff Acknowledgments ApendxiVI

GAO Contacts Christine A. Fossett (202) 512-2956

Acknowledgments In addition to the name above, Derek Stewart, Steve Fox, Leo Jessup, Lynn 

Johnson, William Mathers, and Jack Edwards made key contributions to 

this report.

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