Daily Press 12/14/04

HAMPTON ROADS, VA. December 14, 2004

After $247 Million, What Is There to Show?

CHAPTER 4: THE BATTLEFIELD AT HOME

After winning the 1991 Persian Gulf War in a few days, veterans have spent more than a decade fighting to get relevant research done to determine why they're so ill.

BY BOB EVANS
247-4758

December 14, 2004

Photo Gallery

Exploring the dangers of depleted uranium.

VIDEO

Watch a training video about depleted uranium.

CHAPTER 4 IN BRIEF

The GAO: Congress' investigative arm
The Government Accountability Office issued a number of reports critical of how the Pentagon, Department of Veterans Affairs and other agencies have handled $247 million in research to find the cause of veterans' problems. In 1996, it told Congress that the military knowingly exposed troops to investigational drugs without their consent, continuing a pattern of deception that spanned decades. Earlier this year, it said a total reassessment of the process and priorities to investigate Gulf War illnesses was needed.

Robert Haley: noted epidemiologist
Haley, formerly with the Centers for Disease Control and Prevention, has poked holes in the Pentagon's efforts to dismiss the illnesses as ordinary results of warfare or simply stress-related. He says no one has done a proper epidemiological study of the problems, which should have been the first step once the problem was recognized. As a result, he says, millions of dollars were wasted. Now Haley sits on a Department of Veterans Affairs advisory panel on the problem.

A top Pentagon health official
The Pentagon has been decreasing spending on research into Gulf War illnesses despite important findings that promise a breakthrough. So far, the military has spent three-fourths of all government money used to investigate the illnesses, but Pentagon officials say they're not willing to finance new work -- just finish what's been started. Michael Kilpatrick, deputy director of the Pentagon's health program for deployed troops, says it decided to use its resources on issues tied to active-duty personnel.

An expert in cancer research
Richard Albertini found a link between exposure to depleted uranium and genetic mutations thought to be indicative of cancers. Obtaining the money to continue that work has proved difficult, he says, but there are other barriers to making progress in determining the possible health effects of these weapons. A larger, more recent set of blood samples would help him determine whether troops are at risk from use of depleted uranium. So far, the Pentagon hasn't been willing to make them available.

Former head of Army munitions
James Naughton, now retired, was a leading Pentagon briefer on the safety and benefits of depleted uranium weapons for a decade after the 1991 Persian Gulf War. He says depleted uranium gives U.S. and allied forces a decided advantage on the battlefield. People who criticize or question the use of the weapons are enemies of the United States and are trying to remove this weapon from the U.S. arsenal, he says.

Advocate for Gulf War veterans
Steve Robinson, an Army Ranger, ended his military career at the Pentagon, in the office that handled response to Gulf War illnesses. He says the military was often more worried about its image than soldiers' health. Now he lobbies Congress and government agencies for better treatment for veterans and better research efforts into the cause of Gulf War illnesses.

ABOUT DU

What is it?
It's a byproduct of making "enriched uranium" for nuclear weapons and fuel. "Enriched uranium" is somewhat misleading because processors take uranium with natural levels of radioactive isotopes, primarily Uranium 238 and Uranium 235, and remove as much of the U-235 as possible. Weapons makers and nuclear plant owners want almost-pure, highly radioactive U-235. What's left behind is primarily U-238 (other isotopes remain, in very small quantities). That substance has about 40 percent less radioactivity than natural uranium and is "depleted uranium."

What makes it so important?
It's proven to be the most effective tank-killing weapon ever. A round of depleted uranium no bigger than your little finger can stop a top-of-the line tank without depleted uranium armor. The weapons get sharper as they hit and plow through thick steel. They also create fireballs of thousands of degrees, a potent combination.

What is the controversy?
As they strike, the weapons get sharper by peeling off millions of shards of burning depleted uranium. Those burning pieces become microscopic dust that can be inhaled. Depleted uranium is a mildly radioactive, toxic substance that can cause damage to live tissue and cells once inside the body.

THE SERIES

Part One: Looking for a cause, looking for a cure

Part Two: From the nose to the brain
Part Three: The silver bullet

For 20 years and two days, Steve Robinson was a soldier. He jumped from airplanes, trained to fight and prepared to die for his country. He was tough and resourceful enough to win the beret of an Army Ranger.

Now he fights in Washington, D.C.

Often against the same outfit that trained him.

For the past few years, Robinson has been executive director of the Gulf War Resource Center Inc., a small-budget nonprofit group devoted to working on issues important to veterans of the 1991 war and active-duty troops in the ongoing wars in Iraq and Afghanistan. The center operates out of the offices of the Vietnam Veterans of America organization near Washington.

Robinson's last assignment in the Army was at the Pentagon, working for the officials in charge of looking out for the veterans of the 1991 war.

He says their willingness to put the Pentagon's public-relations ratings ahead of veterans' health prompted his career switch.

For the past few years, he's been one of the most public and persistent critics of the Pentagon's insistence that depleted uranium weapons are not a significant health risk to troops on the battlefield.

Robinson says he doesn't know whether depleted uranium weapons should be banned. But he says the Pentagon is so enamored with them and so concerned about its image, officials won't pay attention to the mounting evidence that they might be more harm than good.

The ultra-effective anti-tank weapons are crucial aspects of the U.S. arsenal, and Pentagon officials say it would be a huge loss if they were deemed too dangerous.

Every time that the weapons hit a hard target, they create thousands of particles of mildly radioactive toxic dust, small enough to be inhaled. A growing number of scientists are finding that the dust - even in small quantities - can cause genetic damage that they think might lead to cancer and other problems. Early research also indicates that the dust can migrate to the brain of rats forced to breathe small quantities of the dust, raising the possibility that some veterans' neurological problems are linked to the weapons.

Robinson says one of the most important ways that the Pentagon has tried to sweep the issue out of sight involves its handling of millions of dollars used to investigate the cause of the illnesses suffered by Gulf War vets. Instead of pursuing the cause of the veterans' health problems, he says, Pentagon officials have put the bulk of their efforts and money on studies that would discount the problem or show that the illnesses are mental, not physical.

Robinson isn't alone in that criticism.

AFTER $247 MILLION, A CAUSE HAS YET TO BE FOUND

According to Congress' Government Accountability Office, $247 million has been spent in the past 12 years to research the causes and possible cures of Gulf War vets' illnesses. Most was spent on work that would demonstrate or augment the Pentagon's original theory - that stress and people unable to handle it are the problem, not any of the weapons, pills or chemicals that the Pentagon produced, according to congressional testimony in June.

The Pentagon has controlled 74 percent of that $247 million, with the Department of Veterans Affairs and other federal agencies spending the rest, says the accountability office, commonly known as the GAO. The military and U.S. government also controls the availability of depleted uranium for use in experiments by outside researchers, though there are chemical substitutes that can be used.

Pentagon officials have rebuffed attempts to give experts at the federal Centers for Disease Control and Prevention, or CDC, and other agencies a bigger role in researching the possible effects of depleted uranium, even though those agencies are more experienced in that work, according to congressional testimony.

Several Nobel Prize winners have told Congress that researchers who might be interested in getting involved have been discouraged by the military's stranglehold over the money to finance the work and the way it controls other information about Gulf War veterans.

Some of the $247 million went to explore legitimate theories that proved invalid - a natural and unavoidable result of that kind of work, many researchers say. For instance, government officials in July ended years of research into whether a bacterial infection could be causing the neurological problems the veterans suffer.

Other expensive efforts were doomed from the beginning because they were poorly designed or set out to do the impossible, the GAO says.

POOR PLANNING, EXECUTION MEANS $13.7 MILLION WASTED

One recent example is an investigation into how many troops were possibly exposed to chemical weapons and other dangers as a result of a fire at an Iraqi munitions depot in Khamisiyah in 1991. According to the most recent official government account of the incident, the CIA warned the military before the war that chemical weapons were stored there, but the word never filtered to commanders in the field. Military officials ordered the depot destroyed, and a potentially lethal cloud of debilitating chemicals might have been launched into the air.

In 1993, the Pentagon and CIA said no one was exposed. In 1996, after news-media and congressional investigations, they acknowledged that there might be a problem, albeit a small one.

At first, the two government agencies said hundreds of troops might be affected and that the amount of chemical poison was so small as to be inconsequential. Then a copy of a classified document was leaked, and the government called a news conference and announced that it was really thousands of troops, congressional testimony said.

Finally, in 2000, the government's official estimate was upped to 101,752 troops, the GAO says.

But even that number was suspect. So to get a better handle on the facts, the Pentagon paid consultants $13.7 million to develop computer models and do other work. It also spent untold dollars and man-hours on the project with its own staff, so the true cost of this study can't be established, the GAO reported in June.

What resulted was a study so poorly conceived and done, it's worthless, the GAO says. Part of the problem is that some of the data necessary to do it right just isn't obtainable because no one was keeping reliable records on weather and wind conditions in Iraq at the time of the explosion. As a result, no one can say how far - or in what direction - the windborne chemicals might have gone. And there's no reliable information on exactly what was in the depot when it was blown up.

A similar incident occurred at the Blackhorse Army base in Doha, Kuwait, on July 11, 1991. In that case, more than 7,000 pounds of depleted uranium weapons were destroyed in smoke and flames, along with four Abrams tanks and millions of dollars of other equipment and armaments.

The heater for a munitions truck malfunctioned, caught fire and caused a series of explosions and fires in the base motor pool, the Pentagon's report on the incident says. As recently as last year, microscopic bits of depleted uranium could be found in the sand and debris there, other studies found.

TROOPS HAD NO WARNING OF DANGER AFTER 1991 FIRE

Pentagon records show that within hours of the fire, officers in the chain of command at Doha received the first of several notices about potential health hazards from the burning depleted uranium. The warnings contained specific directions about precautions that should be taken in the cleanup. None of those precautions were taken. The soldiers on the ground weren't told about the problem until 1998.

The Army says the commanding officer didn't recall getting the warnings. The Pentagon offered no explanation for why soldiers involved in the four-month cleanup after the fire were allowed to handle materials with their bare hands and no precautions.

After 1998, a government-maintained laboratory studied the situation. Despite the lack of adequate data and that "large uncertainties exist," it concluded none of the troops incurred a significant health problem by inhaling the depleted uranium dust created by the fire. That lab used many of the same techniques employed in the Khamisiyah analysis. No GAO examination of Doha has been requested.

The Doha base is still used by U.S. troops today, though the site of the fire is a restricted area. Troops from Fort Eustis deployed to the region visit there frequently. Doha is one of the major embarkation points for U.S. troops entering the Iraqi theater of war. It also has an amusement park and post exchange, making it a popular spot for off-duty troops to visit when they have a day off. The Army says the site, which is near a refinery, is safe.

BASIC FACT-FINDING WASN'T DONE, EPIDEMIOLOGIST SAYS

Critics of the government's efforts to find the cause of Persian Gulf War veterans' health problems say these examples aren't the most important oversights or missteps.

Despite all the research spending, the military and government have yet to do a responsible epidemiological study that includes some of the fundamental data necessary to unravel the problem, says Robert Haley, a former CDC official. Haley is now chief of the department of epidemiology at the University of Texas Southwestern Medical Center in Dallas and author of important studies on Gulf War veterans' health problems.

A good epidemiological study would give researchers a handle on how many veterans are ill with undiagnosed problems, where they were during the war, what vaccinations they were given, what they did while deployed and other data, Haley says.

It should have been done more than a decade ago as one of the first steps after they realized a problem existed, he says.

Haley's criticisms are echoed by a number of scientists, but his background in tracking down the causes of high-profile illnesses sets him apart. At the CDC, he helped lead the investigation into toxic shock syndrome in the late 1970s, showing how women were getting critically ill because of the new generation of tampons they were using.

He got involved in looking at Gulf War veterans' illnesses in the mid-1990s, after Texas businessman Ross Perot asked the dean of the Dallas medical center how much money it would take to start looking at reasons for the maladies that so many veterans were suffering. Perot said he'd been hiring former military personnel for years and just wasn't buying the Pentagon's line that these men and women were merely weak of body, will or mind, Haley recalls.

The first thing that Haley did was look at the available data on the disease. He says he was surprised to find out that the basics of figuring out an epidemiological puzzle hadn't been done, despite all the money and time the government had spent.

Instead of starting by spending a lot of money to prove one or two possible theories for the cause, he says, a good epidemiologist will start gathering some basic facts. Those facts would include who's involved (the sick people and people just like them who aren't sick), what they did during the war, where they were and other factors. That way, the epidemiologist can see what's common among the people who are sick and the people who aren't.

Usually, he says, there will be only one or two things that the sick people have in common that turn out to be statistically significant and worth pursuing with research money.

EPIDEMIOLOGY 101: THE CASE OF SUSPICIOUS POTATO SALAD

A classic example is figuring out why some people got sick at a church picnic, he says. A good epidemiologist would interview the people who went to the picnic (those who got sick and those who didn't). She'd find out what games they played, what food they ate and where they were at the picnic. Then all that data would be compared, and you'd typically find a common thread - for instance, all the sick people ate potato salad and none of the well people ate it. Only then would you spend the money to take the potato salad to the lab to examine it, he says.

But the government didn't do that - and still hasn't done it - Haley says.

Instead, it did three studies that said the vets weren't really sick or, at least, they were no worse off than most people their age. The only difference it found was a slight increase in accidental deaths among the Gulf War vets. "They were so convinced that they would find nothing that they found nothing and published the data," he says.

Haley took the numbers the government-sponsored epidemiologists used in those studies to demonstrate just the opposite. He showed where researchers made questionable assumptions and how the same data could point in the opposite direction if other, more logical assumptions were used.

A big mistake here, he says, is the government studies assumed that military personnel deployed for the war were just as healthy as anyone else in the military or the general public. So after the war, when they were found to be just as likely to die or get sick as other people, the government concluded that there was no problem.

But the deployed soldiers were probably much healthier than those other groups to start with because they had to pass a rigorous physical exam to be considered for deployment overseas, Haley says. In that war, many troops were deemed not deployable because they were HIV-positive, were injured or otherwise in questionable health.

Well before the Gulf War, epidemiologists had a stock phrase to describe this phenomenon: the "healthy warrior effect." The government's researchers should have been familiar with it, Haley says.

There were other problems, too. Haley and others noted that the data the government used in claiming only normal rates of death, cancer, infant deformities and other problems among Gulf War veterans came solely from military and VA hospitals. That left out most of the people who'd served in the war, Haley says - people who were reservists or got out of the military and weren't eligible for treatment in government hospitals. It wasn't surprising that data collected about active-duty military personnel using military hospitals showed they weren't sick; the sick ones had been forced out of uniform, Haley says.

Members of Congress and others have latched onto that work and similar studies to force changes in the way the Defense Department, VA and other government agencies handle research, Haley and others say.

SOME NEW FACES, SOME OLD PROBLEMS

In 2002, Haley, Robinson and other critics of the government's handling of the research were appointed to a new panel of experts that advises the head of the VA on the research that should be conducted to find the cause of the vets' illnesses. Haley says he's encouraged that the government is slowly turning around to face the problem. In the past couple of years, he says, meaningful research has begun to trickle in, and the research is becoming better focused.

A proper epidemiological study is scheduled to begin in January, he notes.

There are still problems from within government agencies that have fought an honest approach to the problem, Haley, Robinson and others on the advisory panel say. Some of the bureaucrats who have thwarted progress are gone or shunted aside, they say, but others remain.

The GAO reported in June that the advisory panel was having problems getting reliable information from the Pentagon and even from officials within the VA. Panel members aren't consistently being told about research being considered for financing, so they can help ensure that money is directed to the greatest needs, the GAO said. The panel also wasn't even being told about research when it was finished, the agency said.

As of Sept. 23, 2003, about 80 percent of the 240 federally financed medical research projects for Gulf War illnesses had been completed, the GAO said in June. Yet the last time the VA reviewed this research to determine whether there were gaps and where there were opportunities that needed to be pursued was in 2001, the report said. The VA's inaction is important because it's responsible for coordinating the government's Gulf War illness research, even though it's not been given the bulk of the money to do that work.

The VA has also been slow to act in other ways.

In June, VA officials admitted to Congress that they had allocated only $450,000 of the $20 million budgeted for Gulf War illness research for the year. By then, three-fourths of the budget year was over. VA officials acknowledge that they need to do a better job.

The government's Gulf War research coordinating group (a separate panel from the advisory committee) hadn't met since August 2003, the GAO said in its June report. The GAO said that when it checked with the coordinating group in April 2004, it found that there were no plans to meet again.

Jim Binns, chairman of the VA secretary's Gulf War advisory committee, told Congress in June that he was concerned that the Defense Department had no plans to spend money on new Gulf War illness research in coming years. He said that meant total government research spending on Gulf War illnesses would drop from $35 million a year to $11 million, just as promising developments in research needed to be followed up. Most of the $11 million will have limited scope, too, because VA administrators can't spend money for research that isn't directly related to VA patients. The work on depleted uranium research that many scientists say is necessary thus isn't eligible.

Michael E. Kilpatrick, the Pentagon's deputy director for health issues involving deployed forces, says that doesn't mean the Pentagon is putting a halt to all this research. He says the military will continue to pursue the studies that are underway until they're concluded. With money tight, he says, the Pentagon must use more of its healthcare budget to benefit soldiers fighting current and future wars, not those of the past.

RESEARCH MONEY BECOMING HARDER TO FIND THESE DAYS

That decision was made in 2002, Kilpatrick says, when only one in six vets of the 1991 war was still in uniform. None of the active-duty troops from the 1991 war have the health problems targeted by Gulf War illness research.

With a war on, members of Congress pushing veterans' issues say it will be hard to beef up money for research in the VA or other budgets. VA medical centers are starting to feel the effects of caring for troops from the continued fighting overseas.

Binns notes that the VA, even in recent years, hasn't been very good about making sure that the money it has for research in this area is well spent.

"As recently as 2003, the VA budget in that year - according to the most recent report to Congress - provided for about $4.1 million in Gulf War illness research. Of that amount, 57 percent went to study stress and other psychological causes, 17 percent went to study things like Web-based training for VA physicians and bioterrorism events," he says.

Only 17 percent of the money went to things that the advisory committee thinks are directly linked to the soldiers' suffering, Binns says.

Alexandra Miller is a government scientist who's carried out some of the most important research into the health effects of depleted uranium.

She says Pentagon money for pursuing the results of that work has started to dry up in recent years. "There's not enough money to complete the research," she says, just as science is close to closing the loop on whether depleted uranium is dangerous.

She and Vernon Walker - a cancer biologist in New Mexico who's conducted experiments linking inhaled uranium to cellular mutations in rats - say completing the research would take only $5 million if the right projects were financed.

That could truly determine whether, once and for all, inhaled depleted uranium is a hazard on the battlefield, they say.

"We could be answering these questions, and we wouldn't have to have these kinds of conversations four years from now," Miller says.

Richard Albertini, one of the nation's leading cancer researchers, says access to money isn't the only thing that hampers research.

He's one of more than a dozen doctors and scientists involved in a continuing medical study assessing the effect of depleted uranium shrapnel in veterans of the 1991 war.

The Pentagon has called this study "the gold standard" of whether adverse health can result from exposure to depleted uranium on the battlefield and frequently points to its findings as support for its arguments that the weapons are safe.

In the most recently published version of the study, Albertini says, three veterans showed an increased rate of mutations in a gene that doctors think is a "marker" for cancer.

A marker for cancer isn't cancer itself but a warning signal that something might be wrong.

In this case, the genes were in the white blood cells of the soldiers.

Based on that finding, Walker exposed rats to air with very small particles of depleted uranium, to see whether the same kind of mutations would develop.

The rats did develop these mutations, which supports the idea that inhaling depleted uranium dust can cause cancer, Albertini and Walker say.

The mutations in the marker become less pronounced over time, Albertini says, so it's important to have blood samples from veterans of the more recent war to see whether these mutations continue and to do more research.

So far, he says, the military and VA say samples aren't available, even though obtaining them isn't difficult and costs less than $100 apiece, he says.

This isn't an idle academic exercise, Albertini says: Researchers might be close to finding a chemical that can halt the mutations, which might mean development of a pill or drug soldiers could take on the battlefield to reverse or arrest the mutations soon after their exposure.

Experiments using chickens have been successful in halting the mutations in a test tube, Albertini says.

He and Walker say that work could lead to antidotes to "dirty bombs," - explosives made of low-grade nuclear materials such as depleted uranium.

Government officials have repeatedly said the nation's urban areas are vulnerable to such attacks if terrorists can obtain a sufficient quantity of the right radioactive materials.

A LEGACY OF MISTRUST FROM PREVIOUS WARS

Robinson and other veterans' advocates say they're afraid that the Pentagon's attitude toward soldiers' health and the failure to properly address illnesses from the 1991 Gulf War will be equaled in the new war.

They say a pattern has developed that will make it difficult for any veteran to believe what the government says.

Soldiers, sailors and civilians were often used as guinea pigs in experiments of how nuclear blasts might affect human beings in the years after World War II.

The government never told them what was happening, then denied it - then denied that they were at risk until recently.

"It took 40 years for them to get treatment and care, " Robinson says.

Then came the Vietnam War and Agent Orange, a chemical used to kill acres and acres of jungle foliage, to make it easier for U.S. troops to find and kill the enemy. The government insisted for years that the chemical wasn't a problem, then finally admitted it was.

Documents show that U.S. leaders knew the truth in 1972 - maybe earlier - but continued using it anyway, Robinson says.

He says the same thing might be happening with depleted uranium and other possible causes of the Gulf War vets' ill health.

Part of the problem of getting to the truth of Gulf War veterans' illnesses is that too many people use the issue for ideological purposes, he says.

Critics of the weapon on the left use the radiological properties of depleted uranium "to scare people: Depleted uranium is the holocaust," Robinson says.

"Then you have the Department of Defense on the right," saying there's no problem and questioning the motives and patriotism of critics, he says.

A week before launching Operation Iraqi Freedom in 2003, the Pentagon briefed reporters to reiterate the safety of depleted uranium weapons and note the failure of anyone to conclusively link them to any of the health problems from the Persian Gulf War.

Col. James Naughton, then the Army's director of munitions, was brought out to speak.

According to a transcript issued by the Pentagon, he talked about how much of a battlefield advantage the weapon is.

"So we don't want to give that up," he said, "and that's why we use it."

One of the reporters asked him why giving up the weapon was even being raised, if the weapon was so safe.

"Well, you need to look at the environment of the context where people are asking us questions - who's asking the question?" Naughton replied.

"The Iraqis tell us, 'Terrible things happened to our people because you used it last time.'

"Why do they want it to go away? They want it to go away because we kicked the crap out of them - OK?"

Later in the briefing, Naughton made it clear he thought that Iraq "and other countries that are not friendly to the United States" were behind criticism of the weapon.

With those kinds of extremes, not much has happened in the middle, Robinson says.

"In the middle," he says, "is the science that has not been conducted."

Scientists might be able to tell, for example, whether veterans who definitely have depleted uranium inside them also have a type of brain abnormality thought to be characteristic of the neurological symptoms among Gulf War veterans, he says.

But until now, no one has had a test considered reliable enough to detect small enough quantities to determine who was probably exposed and who wasn't.

Scientists don't know what causes the brain abnormalities in those vets, Abou-Donia says. But unlike other chemicals and causes under suspicion, the depleted uranium in urine is measurable and might still be in the body.

The level of exposure to chemical weapons, bug spray and other suggested causes of the veterans' illnesses isn't detectable at this late date because those toxins are long gone from the body and no one kept accurate records of doses and other information on the 1991 battlefield, Abou-Donia says. Those toxins have done their damage and are gone. That's one reason that finding the cause of the veterans' complaints has been so difficult.

ACTUAL BENEFITS OF NEW TESTS NOT DETERMINED YET

Gerdes, an environmental geochemist, says he questions whether there's a link between depleted uranium exposure and the illnesses suffered by veterans. But doing the science and the testing is an important step toward understanding the problem. "There is simply a need to do further research in this topic," he says.

Parrish says he's not sure what the testing is going to find. He notes that though the British government agreed to finance use of the new tests for veterans of the Persian Gulf War and peacekeeping missions in Bosnia and Kosovo, veterans of the continuing war in Iraq are tested with the less precise measurement.

A British Ministry of Defense spokesman says the new testing is considered important for veterans of the other wars because of the long period that's elapsed since the exposure and therefore the need to identify what might be smaller quantities.

He says the military is satisfied with the less-exact testing for veterans of the current fighting in Iraq and Afghanistan, though some will be given the more sophisticated tests as an expedience.

The new testing program for the British veterans is just starting. Advertisements and notices directed at veterans started in late September, and about 300 people have signed up so far, Coggon says. About 1,500 are expected to sign up, says Charles Williams, a spokesman for the Ministry of Defense.

Williams and Parrish say it will probably take six months to a year before enough tests are concluded to get an accurate picture of how many vets have been exposed and at what level.

Parrish says that as long as Britain and the United States refuse to let outside independent laboratories handle the testing, there will be suspicions that the truth about exposures and possible problems are being concealed.

The two labs in Britain performing the tests are considered independent.

He says he and other lab workers do the testing and analysis, but they don't know whether they're working on "dummy" samples or actual veterans' urine. That's one of the many levels of exactitude they've built into the process to help ensure accuracy. Some dummy samples might be "spiked" with known quantities of uranium and depleted uranium in another lab and sent out with the vets' samples, but others are taken from people known to have no depleted uranium in their urine. That keeps the labs on their toes, Parrish says.

In the United States, the most precise testing that the Pentagon does is handled at a national Centers for Disease Control and Prevention laboratory, Melanson says.

When that federal agency does testing for the military, it won't release any information about the tests conducted there and won't even answer questions about the procedures, error rates or scientific standards for the tests, says Kathy Harben of the disease control agency.

She referred all questions about the agency's testing for the military to the Pentagon.

VETS SAY U.S. DOESN'T WANT TO PAY FOR BETTER TESTING

Steve Robinson, executive director of the Gulf War Resource Center Inc., a veterans rights group, says he suspects there are two reasons that the United States uses the less sophisticated testing method.

First, he says, is the cost.

Pentagon officials say their tests cost $200 to $400 a sample, depending on whether there's enough total uranium in the urine sample for the government to attempt to determine whether it contains depleted uranium.

Melanson initially refused to divulge the cost of this testing, saying it wasn't a factor in his decision-making.

Parrish says his test costs about $1,000 each.

Robinson and other veterans advocates say the second reason that the U.S. government doesn't want to use the more sophisticated tests is they're afraid the tests might help show possible links between the highly valued depleted uranium weapons and veterans' health problems.

"These are very effective weapons, and they want to keep them," says Steve Smithson, assistant director of the American Legion's Veterans Affairs and Rehabilitation Division.

Kilpatrick says the critics are wrong.

He and Melanson say there's no need to identify the low levels of depleted uranium that the British can find because the tests that the United States uses can detect depleted uranium 1,000 times less than what's dangerous to health.

They cite World Health Organization, or WHO, and U.S. Institute of Medicine reports as authorities, based on 50 years of health research involving uranium miners, millers and processors. The Institute of Medicine is part of the National Science Foundation and is considered the country's best impartial health research organization. Kilpatrick and Melanson also cite the recently completed Capstone study. It involved measurements of inhalable-sized particles of depleted uranium that resulted from test-range firing of the weapons into a real tank, the hulls and turrets of tanks, and other combat vehicles.

Kilpatrick and Melanson say the Capstone research got its title because officials think that it provides the last pieces of data necessary to determine the health effects of depleted uranium.

Scientists who have been working outside the Pentagon to answer that question say there are still some important pieces missing before drawing such final conclusions.

Carolyn Fulco is one of the authors of the Institute of Medicine's reports on Gulf War illnesses. She says it would not be accurate to say her organization was as conclusive as the Pentagon officials when it comes to how much depleted uranium can harm someone.

"There was almost no literature on depleted uranium," she says. Nearly all of it was on uranium before it became depleted and in circumstances very different from the possible exposure resulting from use of the weapons, she says.

As a result, the institute recommended additional study into nearly all the health questions raised by the use of depleted uranium in warfare. The WHO report says the same.

Beate Ritz is an epidemiologist at the University of California, Los Angeles, who specializes in how internal radiation sources cause cancer. She's also the primary author of several of the most recent studies of the health effects of working with uranium.

SCIENTISTS SAY SAFE LEVEL OF EXPOSURE ISN'T REALLY KNOWN

When the Institute of Medicine needed an expert to review the report that Melanson cited to support his view that the U.S. testing program is adequate, it turned to her for approval. That's because she's one of the few people in the world qualified to pass judgments of that type, Fulco says.

Ritz now sits on an advisory panel for the institute's continuing review of possible causes of the illnesses suffered by Gulf War vets.

She says no one knows what the safe level of depleted uranium is inside someone's body when it comes to cancer and risk from radiation.

The field is rife with errors and misclassifications because actual testing to settle the matter with scientific assurance is almost impossible, she says.

"When you're looking at humans, you need large numbers of subjects," to make sure that you have accurate results, she says. "But you can't cage humans and feed them uranium and count the exposure for 20 years."

The next best thing is to pick an animal - and hope that you've picked the right one, she says.

Even then, rats, mice and monkeys often have genetic and other differences that can't tell you whether a human will react the same way, she says.

So to be sure, you have to try things out on humans. Or see what happens to them after exposure.

Lots of them.

Kilpatrick, Melanson and others say 50 years of experience watching the health and health problems of people who have worked as uranium miners, millers and processors during the Nuclear Age give them the number of people and the confidence to say that enough research has been done. They point out that they add in a large margin of error to make sure they're right.

They also dismiss the idea that depleted uranium exposures resulting from combat can be a serious radiation or cancer risk.

Ritz and Alexandra Miller, a researcher at the Armed Forces Radiobiological Research Institute, say that isn't a justified conclusion, as far as science goes.

"I don't see the data that supports that at all," Miller says.

The studies on people who worked in the uranium industry are often flawed and don't involve the same issues and exposures as soldiers on the battlefield, Miller says. The Institute of Medicine's report says the same thing, and so does the Department of Veterans Affairs' educational program for physicians and other health care workers.

Using uranium industry workers' health experiences as a benchmark might not be a good measure either, say critics of the military's dismissal of the health threat from depleted uranium.

Several studies by Congress' Government Accountability Office, or GAO, note that getting an accurate picture of nuclear workers' health is difficult. That's in part because for years, the government encouraged its contractors and managers to refuse to acknowledge work-related diseases and health problems. This helped mask the true death and illness rate to researchers.

As for whether the health standards are adequate, there's also a great deal of debate. The GAO says the government will probably need to spend more than $1 billion this decade to compensate nuclear workers for health problems - a higher cost than estimated because the number of workers with legitimate claims keeps rising.

In addition, the GAO says, there's little or no scientific agreement on what constitutes an acceptable radiation risk, even among U.S. government agencies.

SCIENTIFIC MODELS NEED TESTING TO PROVE ACCURACY

Kilpatrick and Melanson say the Capstone study's data-gathering enabled them to determine how much depleted uranium dust would be inhaled in the worst of battle circumstances. They say the calculations on that volume of dust, using mathematical and other models of human health adopted by government occupational and safety agencies, prove little or no adverse health effect from use of the weapons.

Those calculations create a new standard for discussing the issue, Kilpatrick says.

Ritz and Miller say the Capstone work doesn't change the fact that there has been insufficient experimentation on animals to prove or disprove the assertions of safety.

The calculations and models that the Pentagon points to are nothing more than theory waiting to be tested, they and other scientists say.

"You know the problem with models, don't you?" Ritz asks. "You get out of them what you put in."

The type of models that the Capstone study relies on for its conclusions are frequently shown to be flawed, she says. That's much of what health science is all about - testing the models and showing whether they work.

A recent example of how these models can be flawed occurred with the chemical paraquat, Ritz says.

For decades, the U.S. government had been using it - and giving it to other countries - to eradicate marijuana and other plants used to make drugs. Critics questioned the wisdom of those programs, noting that the possible effects of ingesting the drugs were not known.

Government officials dismissed the caution warnings.

For one thing, they noted that long-established scientific models said paraquat couldn't cause brain damage because its chemical composition kept it from penetrating through a layer of cells that protect the brain from impurities in the blood.

The layer of cells is called the "blood-brain" barrier.

"All that was true," Ritz says. But just a few years ago, one of her colleagues found that paraquat could get into the brain anyway.

Like other parts of the body, the brain needs amino acids to make proteins to keep going.

The brain has special nerves to directly transfer those acids to the brain, bypassing the brain-blood barrier. Paraquat is made of molecules that look like amino acids.

So the brain sucks up the paraquat molecules, thinking that they're amino acids, she says. "And it can cause brain damage when it happens."

That's one of many examples where the models aren't good enough.

And it's why sufficient research involving human cells and animals should be done to test the models thoroughly before declaring something safe, she and Miller say.

Vernon Walker, a cancer biologist at the Lovelace Respiratory Research Institute in New Mexico, conducted a study that found that when rats inhaled depleted uranium, they developed genetic mutations indicative of cancer.

He says the government exposure standards and scientific models used to determine workplace safety - the barometers of safety used in the Capstone study - don't include the potential for developing cancer in the way that his experiments showed is likely.

The military has drugs, developed in the World War II era for troops exposed to radiation, that can reduce those mutations to safer levels, he says.

Experiments are being conducted to see whether they have the same effect on depleted uranium inhaled from the battlefield, as well as from shrapnel.

He says that based on his experiments and what he's seen from other science on the subject, he'd be taking those drugs if he were a soldier in Iraq and was exposed - especially if he were hit by depleted uranium shrapnel.

"I'd be taking the pills for the rest of my life," Walker says.

Miller says her research has found that a single particle of depleted uranium can deform cells and DNA, the basic building block of life, in ways thought to lead to cancer.

Others have shown that uranium in the body and inhaled uranium can make its way to the brain.

Those findings haven't solved the riddle of Gulf War vets' illnesses, but they're far from comforting about how safe the black dust from the explosions must be, Miller says.

Someone practicing good science shouldn't be closing the book on the subject and declaring a particular level of exposure safe under those under-researched circumstances, she says.

TOO FEW PEOPLE HAVE BEEN STUDIED TO KNOW THE TRUTH

Ritz says the same thing about the possibility that cancer risks might increase after inhalation of depleted uranium.

"Our human research, as valuable as it is, has a lot of severe limitations," she says.

At most, she says, it proves that we've been unable to detect anything, not that there's no risk.

There might be 6,000 people involved in the studies that the government is relying on, she says.

Perhaps that's enough to figure out whether something's toxic, she says, but it's far from enough to determine whether it's carcinogenic.

For cancer, if you had a million people and followed them for 50 years, you might be able to determine a safe level of exposure with confidence, she says.

But no study has ever attempted to follow uranium workers on that large a scale, not to mention people exposed to depleted uranium, she says.

After the Pentagon tested the New York reservists and announced that the soldiers tested negative for depleted uranium, a news briefing was called.

William Winkenwerder Jr., a physician who is assistant secretary of defense for health affairs, told reporters that 10 years of health studies found that "low levels of depleted uranium that our troops would be exposed to are neither a radiological or chemical health threat to our service members."

He also said there was no evidence linking depleted uranium to radiation-induced illnesses such as leukemia and cancers.

But Ritz says the failure to find a link to cancer at this point isn't surprising at all.

It will take about 30 more years before soldiers from the Persian Gulf War could reasonably be expected to start showing evidence of most cancers spawned as recently as 1991, she says.

Lung cancer - which many researchers say is the most likely form that might result from inhaling depleted uranium - would take a few years longer to show up, she says.

Some forms of leukemia and lymphomas might have started showing up in the past year or two, she says.

Those forms of cancer have also been identified as possible problems because lymph nodes are vulnerable when particles are inhaled.

Even if an outbreak of leukemia and lymphomas has begun among veterans of the Gulf War, it's unlikely that the data to prove it would have been collected and that anyone would know about it, the GAO says.

No one is comparing a list of cancer deaths in the 50 states with the names or Social Security numbers of veterans from the Gulf War, the GAO says.

And no one is likely to begin doing it anytime soon because the money has not been made available, the agency says.

NO MONEY TO TRACK VETS' CANCER RATE ANYWAY

In the past 13 years, only two studies have been financed to determine cancer incidence among Gulf War veterans, the GAO says, and both of them had limited ability to study the problem.

The studies' access to data is being curtailed as a result of financial and legal issues, the report says. Veterans in only a few states were included.

VA officials say they're studying ways to fill this gap in the data.

In the meantime, Ritz says, the best that we can do is guess what a safe level of exposure to depleted uranium might be.

Depleted uranium isn't alone in this respect.

Of all known carcinogens, "none of those in the carcinogenic fields have accepted a threshold level," where safe and unsafe can be identified with a measurable number, Ritz says.

Threshold levels are set by government agencies, not scientists, Ritz says.

"These are all policy decisions about what is acceptable," not to be confused with scientific proof, she says.

There are many critics of the military's approach to establishing safety levels and standards, but there are also many scientists who agree with how Kilpatrick, Melanson and others have handled the problem that they're faced with.

Terry C. Pellmar - who works at the same lab as Miller - co-authored the first research paper citing that depleted uranium from pellets embedded in the bodies of rats might migrate to their brains.

Still, she says, she doubts that depleted uranium is responsible for the neurological problems suffered by veterans of the Persian Gulf War. And she doubts that the government is making a mistake in the policies it's established regarding the safety of depleted uranium on the battlefield.

"As a scientist, I'm not sure of anything" that could be deemed absolutely safe, she says.

"As an individual, I would have no personal concerns."

Knowing the science as well as she does, she thinks that a soldier can trust the Pentagon's assessment of the risks.

If she were a soldier on a battlefield, she says, she would feel safe, as far as the danger from inhaling depleted uranium dust.

"We all live in a world that's filled with things that increase the chances of getting cancer," Pellmar says.

Even if Miller's research shows that a single particle of inhaled depleted uranium might increase the risk of cancer, that degree of increased risk is accepted by people all the time in everyday life. There's an increased risk of cancer if you spend time in smoky bars, she says. "Yet, we all walk into smoky bars."

Similarly, she says, there's increased risk from living in Colorado, for instance, because there's more uranium in the environment there naturally, compared with most states.

Yet thousands of people have been moving to Colorado for years.

So given the battlefield advantages that depleted uranium gives soldiers, she says, taking that little extra risk might be a good bet.