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DU Medical Follow-Up Program

DoD has established policies and procedures to ensure that Service members are evaluated for possible depleted uranium (DU) exposures. The Army first adopted a "Policy for the Treatment of Personnel Wounded by Depleted Uranium" in 1999, to address DU combat casualty care, and this was incorporated into a DoD Health Affairs policy in 2003. DoD Health Affairs published the "Policy for the Operation Iraqi Freedom Depleted Uranium (DU) Medical Management", HA Policy: 03-012, which recognized three levels of possible exposure to DU:

  • Level I contained individuals who were in, on, or near combat vehicles at the time they were struck by DU rounds, or who attempted to rescue personnel from inside such a combat vehicle, and included those persons who potentially inhaled DU or were wounded by DU fragments;
  • Level II included individuals who routinely entered DU-damaged vehicles as part of their military occupation, or who fought fires involving DU munitions;
  • Level III included personnel involved in all other potential exposures, generally incidental, such as driving by a vehicle struck by DU munitions. 

Handling intact DU munitions or spending time in undamaged DU armored vehicles, such as an Abrams tank, is not considered an exposure in which DU could become internalized in the body. Service members do not ordinarily come into contact with DU in undamaged munitions and equipment.

On April 9, 2004, DoD Health Affairs published a supplemental memorandum on "Operation Iraqi Freedom Depleted Uranium Medical Management", requesting the semiannual reporting of DU Urine Bioassay results by the Services. DoD also described the procedure for assessing the level of possible exposure using a DU questionnaire, and the archival of all DoD patient information related to DU exposure, at the Psychological Health Center of Excellence.

Personnel Who Are Tested for DU Exposure

DU exposure evaluations of personnel serving in Operation Iraqi Freedom are initiated based on positive responses to the Post-Deployment Health Assessment (DD 2796), or participation in an event or with a unit that would have placed the individuals at risk of DU exposure. The Military Services are identifying all Operation Iraqi Freedom Service members who have had Level I and Level II exposures. Other personnel are identified through their responses to specific questions about possible DU exposure on the DD 2796. The identified personnel are asked to complete a DU Exposure Questionnaire (DD Form 2872), which a medical provider reviews to assess the exposure level. Those who are determined to possibly have had a significant exposure (Level I or II), submit 24-hour urine specimens. Based on the concerns of the provider or patient, health care providers may also order DU testing for personnel in low exposure groups, such as those with incidental exposures. This gives every Service member the opportunity to verify possible exposure to DU. 

Procedures for Testing for DU Exposure

DU bioassays are required for all personnel with Level I and II exposures as soon as possible and within 180 days of their most recent exposure incident. 24-hour urine collections are analyzed for total uranium, depleted uranium, and creatinine to determine the total amount of uranium (natural and depleted) that the individual is passing in the urine per day. For Level III, DU bioassays are not required, although medical providers may order a bioassay for medical management or to address concerns of the individual. These procedures are summarized in the fact sheet on "Urine Testing for Depleted Uranium". Any embedded fragments removed from injured personnel with suspected Level I exposures are sent to a DoD-approved laboratory for analysis of the metal composition of the fragment. The Services ensure that the results of these analyses are entered into the individual’s medical record. Further details on the personnel included in each level are contained in the Guidance for Depleted Uranium (DU) Bioassay Urinalysis, Attachment I to Policy for the Operation Iraqi Freedom Depleted Uranium (DU) Medical Management, HA Policy: 03-012, and Guidance and Procedures for Depleted Uranium (DU) Bioassay DU Urine Analysis, Attachment 3 to "Department of Defense Deployment Biomonitoring Policy and Approved Bioassays for Depleted Uranium and Lead", HA Policy: 04-004

Those who have confirmed results indicating the presence of DU in their urine are offered referral to the Veterans Affairs (VA) DU Follow-Up Program after consultation with the Psychological Health Center of Excellence

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DD Form 2796: Post-Deployment Health Assessment

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10/1/2015

This form is completed at the end of a deployment. All forms are submitted electronically.

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This memo directs the Services to report their DU urine bioassay results

Department of Defense Deployment Biomonitoring Policy and Approved Bioassays for Depleted Uranium and Lead

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The Department has developed criteria for the approval of bioassays to support deployment operations (Attachment 2). Bioassays for Depleted Uranium and lead (Attachments 3 and 4) are approved for use at this time to assess human exposures during or after deployment and combat operations.

Depleted Uranium Questionnaire

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This form is used to assess your state of health after deployment or for any deployment related concern and to assist military health care providers in identifying and providing present and future medical care.

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This policy outlines the military Services responsibilities for the DU Medical Management program.

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