REVIEW OF THE HOME OFFICE STATEMENT ON THE HEALTH CONSEQUENCES OF EXPOSURE TO DEPLETED URANIUM IN KOSOVO Chris Busby PhD

Report 2002/2; April 2002 Aberystwyth: Green Audit

1. Home Office Statement The issue of the health effects of exposure to military Depleted Uranium left in Kosovo and other areas where refugees may originate has been of interest to the Immigration Appeals Tribunal (IAT). The Home Office (HO), in their memorandum on the issue, have relied on what they call the 'latest available objective research' and they depend for the summary of this research on the document Depleted Uranium Environmental Surveillance in the Balkans published on 25th October 2001 by the US Department of Defence (DoD). In referring the IAT to this document, the HO give their own conclusions which include two main items: The studies undertaken on DU in Kosovo have not detected any significant levels of DU Studies have not shown any significant risk to the health of the population of the province from the presence of DU In this paper, I will demonstrate that both of these statements are incorrect and that the DoD document and its conclusions are unsafe. I will argue that this is because of bias, over interpretation of research and omission of relevant evidence. I will direct attention to evidence which shows that there is a significant health risk associated with living in areas contaminated by DU including recent evidence not available to the authors of the DoD report or the HO memorandum. 2. The health effects of low dose internal exposure Before turning to a critique of DoD, I need to draw attention to the existence of a debate in the scientific community over the health effects of internal exposure to ingested or inhaled radioactive material, since this debate is pivotal to the understanding of the DU exposure situation. This debate has been in existence since the first large scale releases of man-made radioactive elements (called radionuclides) to the environment, when the atmospheric nuclear tests of the 1960s caused contamination of water, milk and food by novel isotopes like Plutonium-239, Strontium-90 and many other substances which had not existed on earth throughout evolution. Late realisation of the health consequences of these exposures by the authorities in the US and USSR led to the test ban treaty of 1963 but the reasons for the ban were never publicly articulated. The official position, upon which both the nuclear industry and military nuclear security depends, is located now in the advice of the International Commission on Radiological Protection (ICRP). It is that internal radiation (i.e.doses from point sources of radiation inside the body) could be averaged over the whole body or organ and their health effects (modelled as cancer) could be assessed by comparison with the health of the survivors of the A-bombs Hiroshima. [ICRP90]. These survivors had been irradiated with an acute, large, external dose in which the effects were uniform over the whole body. The view that this approach was wrong was developed independently by scientists from different countries, and is now located, among other places, in the model of the European Committee on Radiation Risk (ECRR) whose report on the issue is due to be published next month. These scientists pointed to increases in cancer and leukemia near nuclear sites like Sellafield and to the trends in cancer in those exposed to isotopes from global fallout and Chernobyl contamination and argued that scientific induction demanded that such evidence falsified the essentially deductive models of the ICRP. As it applies to DU exposure, which is internal and follows inhalation of Uranium Oxide particles, these arguments are reviewed in my paper to the Royal Society which I attach. [Busby 2001a]. For although Uranium is a natural element and exists in nature, the concentrated pure micron diameter particulate form of Uranium Oxide which is created when DU weapons are used is entirely novel. This is a new situation, as far as public health is concerned, and no previous experimental evidence exists which can inform our understanding of risk.

Although the arguments about radiation risk from internal point sources are technical, I can accurately illustrate them as follows. The ICRP model calculates radiation dose as energy per unit mass: this is an averaging procedure that does not distinguish between the same dose to the whole body of a person warming themselves by a fire or reaching into the fire and eating a red hot coal. In this analogy, the DU particle is the red hot coal, but the ICRP average its energy over the whole body and argue that this resulting dose is very low. But since it is the dose to the cell near the particle that causes cancer, the averaging method breaks down. The evidence of anomalous health effects of low dose internal irradiation has become so compelling in the last five years that the European Parliament has called (March 2001) for an independent reassessment of the ICRP model as it relates to such exposures and the UK government have set up (July 31st 2001) a new committee to investigate the ICRP model and report to ministers. I am a founder member of this Committee on Radiation Risk from Internal Emitters (CERRIE) which is an independent expert deliberative committee jointly funded by the Department of Health and DEFRA . In addition to this, the World Health Organisation conference on Chernobyl held in Kiev in June 2001, where I gave an invited plenary paper on radiogenic leukemia [Busby and Scott Cato, 2001] also concluded by calling for a reassessment of the risk models for internal irradiation. This is relevant background to the following critique and analysis. 3. Overview of the DoD report. On the basis of what is stated to be a comprehensive review of evidence on the health effects of DU exposure in the Balkans to October 25th 2001, the report provides the basis for the HO view and concludes that: There is no widespread DU contamination and No study has found a connection between DU exposure and leukemia or any other pathology. The sources for this conclusion are referred to and consist of a number of studies and position statements made by various organisations. The references to these studies are included in a list of 86 'end notes' consisting of 3 end-notes proper and 83 other referrals to a relatively small number of reports, memoranda and meeting summary documents. In order to make clear the source of the conclusions in DoD it is instructive to list the total number of references to the studies that are relied on (Table 1).

Report NATO website NATO report AHCDU-N(2001)38 April 3 2001 NATO Letter IMSM-164-01 March 5th 2001 Royal Society Report, May 22 2001 UNEP report Part I, Oct 1999 and Part II, March 13 2001 WHO DU report, April 2001 Italian MoD report, March 19 2001 EC Article 31 Group report, March 6, 2001 Available independent relevant studies or reports Peer-reviewed studies

End Note Numbers 1,2,3,4,9,11,15,27,38,43,44,45,48, 49,51,69,73,77 13,16,20,22,23,24,25,26,32,34,40, 50,52,53,54,56,57,58,59,61,62,63, 64,66,68,70,72,74,75,76 12,14,17,18,19,21,28,29,30,31,33, 35,36,37,39, 10,13,46,86 60,79,80 6,7,8,78,82,83 27 84 42 None

Total references 18 30

15 4 3 6 1

1 None

Table 1 Distribution of sources of conclusions of the DoD report It is clear that the document is not an even-handed review: it depends heavily on sources from within the military authorities: out of 83 references, 63 are to NATO documents and meetings. The other reports that are relied upon are those of official bodies like the United National Environment Programme (UNEP), the Royal Society, the World Health Organisation (WHO) and the European Commission (EC) Article 31 Group. None of the references are to reports or papers which have been peer reviewed. Many reports and studies of the health effects of DU are published which show significant health effects from DU exposure: none of these are cited. This is despite the fact that the US DoD, NATO, the European Commission, the WHO and others who are employed to be expert in this area have been sent these reports, and that they cannot be unaware of the research results which point to adverse effects from DU exposure, they are not included in the discussion nor are they cited in the DoD report. An example is the review by Dietz, 1996 of the use of DU in the Gulf War (Dietz, 1996). In addition, a number of US documents existed prior to the use of DU in the Gulf War which call attention to the possible adverse health effects of DU exposure following conflict. These also are not cited nor discussed. I conclude from this that the report is biased in its choice of sources. Whether the sources cited are themselves safe is also a question that I will deal with, and I will argue that in general, very few of the official expert committees and assemblies that have considered the matter of DU and health have examined available data. The reports of the WHO, the Royal Society and the Article 31 Group are 'armchair' reports of applications of the radiation risk models of the ICRP to the question. Where there have been measurements made either of DU concentrations in areas where it was used, or ill-health in populations living there or exposed, these have been marginalised or ignored. This is exactly parallel to the Sellafield child leukemia cluster, which was first dismissed as due to chance, then when it was confirmed, it was agreed by all

the expert committees that the radiation exposures from the nuclear site were too small for them to be the cause, and so other explanations were sought (without success). Finally, we should be cautious of any report produced by a group who would be ultimately responsible for the effect they are investigating.

4. Review of the DoD report The report makes three points: no widespread DU contamination, no impact on the health of the population, no impact on the health of peacekeepers, stating: At least 13 countries have sent teams to the Balkans to collect, analyze soil, air, water, vegetation and food samples. These surveys consistently report no widespread DU contamination and no current impact on the health of the general population or deployed personnel. . . [no studies] have found a connection between DU exposure and leukemia or any other pathology. The three assertions and their basis in evidence may be addressed in turn. In addition DoD presents a picture of DU and how it has come to be considered as a hazard: When DU strikes a hard surface, small pieces can fracture off and ignite, producing Uranium Oxides in the form of a fine dust. Most of this material settles close to the impact site and the remainder is rapidly diluted and dispersed by the effects of wind and weather. The very fine DU oxide dust can be inhaled by anyone nearby at the time of impact or resuspended and inhaled later. We all breathe in and consume in food and water small quantities of more radioactive natural uranium every day. In this statement, DoD approaches the key problem. The rapid dilution and dispersion of the DU dust, and its resuspension, are not denied: but dispersion does not make the dust safe, it merely makes it more available for inhalation by more people. Furthermore, DU particles are essentially pure Uranium Oxide, millions of times more radioactive than dust particles containing impurity quantities of Uranium contamination from the weathering of rocks. 4.1 Is there widespread DU contamination in the Balkans? The DoD report Part IV relates to environmental assessment. The studies that it depends on for assessment of contamination are listed in TabC. These reports, are mostly cited within the NATO document AHCDU-N(2001)38 of April 3 2001 (which I have been unable to obtain and have asked my contacts in the MoD to try and find) and as the original studies are reported, fall into three categories of finding, no DU, no health hazard or some DU but localised to a few metres from the target. I collect these together in Table 2 below. Finding No DU contamination No health hazard Some DU near target References 47, 48,49,50,55,57,66,67 51,54,56,62,63,64,68,69,70 52,58,59,60,61,65 Number of references 8 9 6

Table 2 Distribution of references findings on environmental contamination from DU in Balkans cited in DoD report I have personally visited two countries where DU has been used, Iraq and Kosovo with scientific measuring equipment and I collected samples for analysis. I found elevated levels of radioactivity in both countries without great difficulty and also took samples which were subsequently analysed in the UK by two independent laboratories. Both found DU in the samples from Kosovo so I find it hard to believe that all these groups found no evidence of DU, or at minimum, only DU near the target. However, there are a number of technical

problems associated with surveying for DU contamination, and it may be that these problems have been responsible for the failure of some missions to find DU. The most significant problem is that DU is an alpha and beta emitter, the latter because of its radioactive decay product isotopes, Thorium-234 and Protoactinium-234, which are not mentioned in the DoD report. The range in air of alpha particles is a few centimetres, and they are easily stopped by a film of water. Beta particles have a range of up to a metre but will not penetrate a Geiger counter window. This means that a normal Geiger Counter will not register the radioactivity from DU. The GM tube of a Geiger counter will mainly register gamma rays. Because Uranium is a very weak gamma emitter, it is only within a metre or so of pure DU fragments that any gamma signal will register, and this is probably why some of the reports mentioned activity near the target, or near the impact hole. To look for DU it is necessary to use a device called a Thin Window Scintillation Counter, such as the Nuclear Instruments Type Electra 1A that I took to Iraq and Kosovo. These instruments are expensive, and not used for measuring radiation except by the nuclear industry who use them to check contamination by Plutonium. There are, however, two independent reports from the United Nations Environment programme (UNEP) that enable us to examine the assertion that there was no widespread contamination in the Balkans. The first visit of UNEP to Kosovo was in October 1999 and later, under the early direction of Pekka Haavisto and following the release by NATO of details of the positions in Kosovo where DU had been used. There was a major survey of DU contamination published in March 2001. This study is Ref [79] in the DoD report and is summarised in Tab D. The summary maintains that there was no widespread DU contamination of the ground surface, detectable DU contamination was limited to areas 'within a few meters' of penetrators and penetrator impact points and there was no contamination of water, milk, objects or buildings. They also stated that there was no significant risk due to contamination of air, water or plants. This was the summary position given in the UNEP report but it was far from an accurate representation of their results. The main survey report and its conclusions were released to the Press in Geneva. However, the Tables of Results were missing from the report and were only made available as a website file. Consequently, no one could see if their conclusions were valid, and indeed, when the results files were downloaded, it became clear that they showed the existence of widespread contamination. I was asked by the Green Group in the European Parliament to assess this report and meet with the scientific leader of the UNEP team in Strasbourg at a meeting in 2001. My analysis of the UNEP data showed that they demonstrated there was widespread contamination by DU in Kosovo and this included the contamination of rainwater by particles larger than 0.2 microns. Out of 143 sample results tabulated, 46 percent showed presence of more than 5% DU. This is a simple matter of examining the tables, and I conclude from this, that contrary to their summary, UNEP did find widespread contamination by DU. I attach this report [Busby 2001b]. These findings were in agreement with my own measurements made at ten sites in Kosovo and the analyses of samples which I collected and had analysed in the UK [Busby 2001c]. These samples showed anomalous isotopic ratios in DU dust collected from beneath melting snow in Djakove, Kosovo, which was consistent with Uranium resuspension in dry and sunny weather and which I reported to the Royal Society as part of my evidence [Busby 2001c]. I pointed out to Dr Snihs, the UNEP scientific director, that there was evidence of DU in the air and that as this was the concern, I asked why they had not measured it. He replied that there would be no DU in the air after such a long time. I also pointed out that the Tables of results were difficult to read and asked why the highest readings were buried in the centre of the tables. These tables have now disappeared from the UNEP website although the

substantive report (without the tables) is now available in colour. For the technical appraisal of the findings, I refer you to Busby 2001b. Very recently, UNEP have published an account of a new study of DU in Bosnia and Montenegro. This also is on their website:www. balkans.unep.ch/du In this new study, perhaps because of the criticism, the team deployed air monitoring equipment. They found significant DU concentration in the air at two of the five sites they examined, and also found widespread contamination by DU in the soil and on plants. But they stated that even so, the concentrations were very low and of no radiological or health significance. As each piece of real evidence shows the previous statements to be false, the area of argument shifts. First there was no contamination at all (shown by monitoring with gamma detectors which cannot detect DU). Then when they find DU, it is only near the target. Then when it is found remote from the target, or widely dispersed, the argument becomes, 'there is no widespread contamination capable of causing health problems.' First it is said to be impossible for it to be in the air, then when it is found in the air, the concentration is too low for any health effects. 4.2 Is there any current impact on the health of the population? There is evidence of widespread contamination by DU in the form of particles. I have some of these particles in dust samples from Gjakove, Kosovo collected more than a year after the shells were fired. They are in my laboratory, so for me, there is no argument on this matter. I can show you them. The dust had collected on a road beneath where a snowdrift had collected and melted, and the isotopic ratio of daughter Thorium-234 to parent Uranium-238 showed that the Uranium was being resuspended in the air. Children were playing nearby: there were no wrecked tanks or bullet holes in the road. Beta radiation levels were about 11 times background, and the concentration of Uranium in the dust about 4000Bq/kg 200 times the background level of about 20Bq/kg. Was this material ending up inside the people who live nearby? To make this question more immediate, I could bring my radioactive DU particle to where you sit reading this report and blow it at you. Would you take the position of the DoD and the other learned bodies that there was no danger, or would you dive for cover, holding your breath? When I visited Iraq and Kosovo, I wore full respiratory protection and so did the TV camera crews who accompanied me. The DoD report implies that DU does not end up inside people, although curiously, they cite the findings of Nick Priest who measured DU in urine samples from 20 residents of Bosnia and Kosovo for BBC Scotland The BBC asked me to review and comment on these results. Prof. Priest, who I would class as a respectable pro-nuclear scientist, uses the most sophisticated measuring equipment available in the world for estimating DU. He and Prof. Thirlwell, his colleague in this study, have wide experience in doing such work: they found significant quantities of DU in the urine of all 17 of the samples tested, including that of Mr Macleod, the TV cameraman who accompanied them and who had been in Kosovo for a few days. His subjects were from Bratunac in Bosnia-Herzegovina, and from Gjakove and Klina in Kosovo. All were contaminated and he concluded that DU was present in the food chain. I would add that presence in the air would also give the same result. In referring to this report (their reference 42) DoD remark, 'there is no evidence that the study has been peer reviewed', a criticism that they entirely fail to level against any of the studies they cite, including their own. In fact, none of the studies cited in the DoD document have been peer reviewed, including the UNEP, WHO and Royal Society reports. There are measurements (not cited by DoD) which show the presence of DU in the urine of those veterans who were exposed in the Gulf War, both UK and US veterans, tested in the USA and Canada by independent laboratories. These are the results of tests made by Dr

Durakovic in Saudi Arabia and Prof. Sharma in Canada and because of the long period of time that has elapsed between exposure and testing, they indicate the presence in the bodies of the veterans of a depot of DU which is still dissolving and causing elevated levels in the urine. This depot is probably the tracheobronchial lymph nodes, part of the lymphatic system that drains the lung. The UK Ministry of Defence is aware of this situation and has followed the recommendations of the Royal Society over uncertainty in the health risks following lymphatic contamination. MoD is currently engaged in developing a testing protocol for urine in all of the Gulf War and Balkan troops. I am a member of the MoD committee developing this protocol and overseeing the testing (DU Oversight Board). Measurement of DU in exposed populations is, in fact, not easy. This is because it is not enough just to measure Uranium in the urine. It is necessary to measure the individual isotopes of Uranium, in order to establish the quantity of DU present. The isotope test distinguishes between the normal Uranium U238-235 ratio of 137:1 and that of pure DU which is between 450 and 500:1. Why is this important? Because the presence in the urine of DU signals contamination of the body by particles of pure DU, which can cause very high doses to local cells, unlike natural Uranium where the dose is averaged over a large volume and no cells get more than a single 'hit'. Technically, measurement of small quantities of U235 in urine is quite difficult, and requires special instruments. However, a number of laboratories can do this work and the MoD committee is presently assessing these laboratories before engaging in examination of the Gulf and Kosovo veterans. Evidence of ill health in exposed populations is assessed in the DoD report by reference to evidence given to the Adhoc Committee meeting between NATO forces medical experts in Brussels and cited as AHCDU-N(2001) of 38 April 3 2001. A table summarising the results of studies presented at this meeting is given in DoD and none showed any sign of apparent elevation of illness or uranium in urine. However, the numbers of troops tested was very small, ranging from 39 troops from Bulgaria to 3580 Belgians and there was no uniformity of approach. No epidemiologist would expect to be able to find abnormal health indicators in such small numbers. Tests for total uranium in urine, however sensitive, would be unable to distinguish the DU and thus would not be able to detect contamination of the lymphatics with particulate DU. With regard to the population of the Balkans, the only evidence cited by DoD that there is no increase in illness in areas contaminated by DU is that the WHO reported after a single visit to Kosovo that it found no firm medical evidence to link medical cases in Kosovo to DU exposure. The head of WHO in Pristina stated in January 2001 that there was no rise in leukemia in the Kosovar population. In addition the DoD cite the WHO report on the theoretical risk from DU which was based on the ICRP risk models. When I visited Kosovo in January 2001 I interviewed a doctor in Pristina hospital for Nippon TV and asked whether there were increases in cancer or leukemia. He said that no one knew, but that they (the doctors) had been told not to speak to anyone about cancer by the medical director. He felt that the population changes after the war had been so great, that no one had any idea what the population was in Pristina or anywhere else, and therefore cancer epidemiology was not possible. As an epidemiologist, I can say that this seems very likely, and that it would be quite wrong to state that there was no increase in leukemia because no one would know what the expected value should be since the population figures were unavailable. I can say that the statement by the WHO in Pristina referred to in DoD is therefore placatory and has no basis in any fact or study. This doctor did draw my attention to increases in congenital

malformations at birth of a particularly unusual type which I had also noticed had occurred in Iraq after the use of DU there. In any event, I have obtained a table of cancer incidence in Sarajevo, which shows significant increase in incidence in most types of cancer there after the use of DU. I attach this table as part of my report on the Italian veterans study which I shall now describe, since this is an important piece of evidence that there is a significant risk following exposure to DU and flatly contradicts the assessment made by DoD [Busby 2002] I also attach a paper I gave at the International Res Publica Conference on DU in Prague in 2001 since this refers to anecdotal evidence of ill health in the Italian and Portuguese veterans who were exposed to DU [Busby 2001d]. In Kosovo, it was the Italian and Portuguese sectors that were most contaminated as I9 can show with the NATO map of DU targets I obtained through Mr Kasuya of Nippon TV. The study by an expert medical group of 39,491 Italian peacekeepers and veterans was published in Italian in May 2001. I refer to Busby 2002 for a complete analysis of the results but will summarise them here. In the study group ,who were mostly aged 20-35, there were 17 cancers 16 lymphomas and 2 leukemias. In a normal population, lymphoma is rare. For example, in England and Wales in 1997, lymphomas represented 16 percent of the number of cancers in the equivalent age group. However, in the Italian study group, there were almost as many lymphomas as cancers. Lymphoma (cancer of the lymphatic system) increased rapidly in the study group after their tour of duty in areas contaminated by DU. The effect clearly peaked in the period of 1 to 2 years after the tour of duty, suggesting that the period in Bosnia or Kosovo was the cause or related to the cause. The effect is unlikely to have been due to chance. The Relative Risk Ratio for the all lymphomas was calculated on the basis of an England population was 1.87 ( p = 0.02) and calculated by the Italian authors for Hodgkin's lymphoma was 2.98 (p = 0.0015). The statement p = 0.0015 means that the probability of the occurrence being a chance finding was 1 in 666. The number of cases of all cancers combined for the study group was smaller than expected on the basis of the national averages, but this was certainly due to the fact that soldiers are more healthy than the normal population. Ill or unhealthy people do not get to be soldiers: this is the 'healthy worker effect' operating in the nuclear industry. It is possible to allow for this if there is sufficient data and I have done this in Busby 2002. If this factor is included in the calculation, the increase in lymphoma was just under 8 times the expected value (p = 0.0000) This p value shows that the probability of this being a chance finding was less than 1 in 10,000. The spectrum of cancer types is quite unusual demonstrated by the Italian veteran study is biologically consistent with exposure to inhaled or ingested particles of DU. There were solid cancers of the brain, pharynx and larynx, colon and lung: all sites where particulate DU could cause increased local exposure. Most significant were cancers of the lymphatic system, where the inhaled DU would be translocated from the lung. There were two leukemias ( 2-fold excess over the expected number): however, this finding does not agree with the reports of Mr Kasuya who investigated the issue independently and reported 5 deaths from leukemia in Italian peacekeepers, so we should keep an open mind. There was a statistically significant excess of thyroid cancer (3 cases in young people). The thyroid gland is known to be highly radiosensitive.

I conclude that the Italian study is the only in-depth and well researched study that has been undertaken in this area, and that it shows a significant association between tours of duty in areas known to be contaminated by DU and increase in lymphoma. The study has not been accurately assessed or reported by the DoD. 5. Other reports on the health risks which were cited by DoD I will briefly turn to the other reports on DU which have been cited by DoD and on which the HO rely. 5.1 The Royal Society (RS) The RS committee interviewed independent experts on the issue but ultimately decided to base their report on the ICRP risk model. On this basis, they reported that there would be unlikely to be any increase in ill health following exposure to all but the most unlikely large doses. They did, however, agree that these models may be unsafe when applied to lymph node contamination and they recommended that research be directed in this area. They also recommended that the MoD measure DU in the Gulf War veterans. My depositions to the Royal Society (attached) were largely omitted except for the Du and lymph node point. The RS intentionally omitted considerations of increases in ill health in Iraq or in the Gulf Veterans and based its findings on Uranium miners (where the exposure is to ore dust) and Uranium milling workers (who are not exposed to micron particulates of Uranium Oxide). They did not undertake any study, but their chairman, Brian Spratt, is on the MoD DU committee. 5.2 The EC Article 31 group This is a group of scientists who advise the European Commission. Their provenance (and until recently) identity is secret. They applied the ICRP model and found the same result as the RS. They have not undertaken any studies. 5.3 The WHO The World Health Organisation signed an agreement in 1958 with the International Atomic Energy Agency whereby WHO may not undertake research in the area of radiation and health: this is left to the IAEA. The IAEA was set up to develop nuclear power and this is its remit. This agreement is still in force but is being questioned by the European Parliament. The WHO is very close to the IAEA and they have consistently aimed to discount any possibility of links between low level radiation exposure and illness. Most recently, this has manifested itself in the WHO position on the after effects of Chernobyl. They also have sent a team to Iraq and discounted the possiblility of DU effects in that country. In 2001 I spoke in a Radio programme to Dr Rapacholi, the Director of WHO, and taxed him over the IAEA connection: he agreed that this was unfortunate and stated that steps were being taken to dissolve the link However nothing has been done. I conclude that WHO are biased in the area of radiation risk assessment. The WHO position on DU in the Balkans (referred to by DoD) is therefore predictable and based on the ICRP risk model. WHO have not undertaken any study. 6. Other evidence which bears on the issue and which is excluded from the DoD report. 6.1 Iraq The first pieces of evidence followed the first use of DU, in the Gulf War. In Iraq, 350 tonnes of DU was used, and there followed a rapid increase in cancer, leukemia, lymphoma and horrible new types of congenital birth malformation . These increases were recorded by the Iraqi cancer registries which are proper medical registries: the Iraqi public health system

was set up by the British in the early century. I emphasise this to communicate that as far as public health is concerned, within the constraints imposed by sanctions, Iraq has a highly civilised and modern system. Agatha Christie lived for a while in Basrah, in the south of the country, where the cancer rate in now highest and where most of the DU was used. The WHO sent a team to examine the claims of cancer increases. The team spent a few days in the country and decided that there was insufficient evidence for increases in cancer: their report made much of the fact that the Iraqi cancer registry had an obsolete computer system. I visited Iraq in September 2000 and examined the evidence, interviewing senior doctors in the Baghdad University hospital and oncologists and the cancer registry director. I also toured the battle sites in the south and made radiation measurements, including for alpha activity. I found evidence to support the claims of increased leukemia in children and also found higher levels of alpha activity in Basra and the south, than in Baghdad, in line with the cancer incidence increases. 6.2 The Gulf Veterans The Gulf War Syndrome is an area of considerable dispute but I have been convinced by the available evidence that this is a real effect and that DU exposure is the main if not first cause. Although the MoD have only just begun to set up a test for DU in the veterans, some results of urine tests made by independent groups under Prof. Hari Sharma and Dr Asaf Durakovic show consistently significant levels of DU in the urine if veterans ten years after their exposure. The most interesting and persuasive evidence I have seen that this is causing ill health is the set of chromosome aberration results obtained by Prof. Albrecht Schott of Berlin. I have referred to these results in my Prague paper (Busby 2001d). The increased percentage of chromosome damage in the 9 veterans tested is significantly higher than the expected rate in the normal population and may be compared with the rate in Chernobyl firemen whose external dose was measured at 550mSv (250 times the annual dose from natural background in the UK). This study was funded by Schott himself, who took out a mortgage on his house. The MoD have consistently refused to undertake chromosome damage tests, despite their ability to signal historic radiation exposure. 7. Summary and Conclusion The Home Office position on the health risks from DU is unsafe. The reliance they place on the US DoD summary of evidence is also unsafe because that document is itself biased and selective in its sources. Where it does refer to substantial evidence on the health effects of DU exposure, it is either dismissive or provides inaccurate interpretations. Sufficient evidence now exists to be able to demonstrate the following: There is widespread contamination of the environment of Kosovo by DU. There is evidence that the DU particles are in the air and rainwater and may be inhaled. There is evidence that the DU particles are routinely resuspended in dry weather and washed out by rainfall. There is widespread contamination of people living in Kosovo by DU as shown by urine testing for DU using sophisticated equipment. There is evidence of a significant 8-fold increase in lymphoma in Italian peacekeepers who were stationed in Sarajevo and Kosovo developing shortly after their tour. There is evidence of increase in many cancers including leukemia an lymphoma civilians in Sarajevo There is evidence of increases in cancer and leukemia in Iraq, where DU was used There is evidence of increases in congenital malformation in Iraq where DU was used There is evidence of increased chromosome aberrations in Gulf veterans exposed to DU, such aberrations follow ionizing radiation exposure.

There is evidence of DU in the urine of Gulf War veterans some 10 years after the war, suggesting a depot in their bodies of long lived DU contamination. There is evidence that the ICRP risk models used to assess risk from internal DU particle exposure are unsafe.

References Dietz L.A. (1996), Contamination of Persian Gulf war Veterans and Others by Depleted Uranium Amsterdam: WISE Busby, C. C. and Cato, M. S. (2000), Increases in leukemia in infants in Wales and Scotland following Chernobyl: evidence for errors in risk estimates Energy and Environment 11(2) 127-139 Busby C.C (2000a), Science on Trial: On the Biological Effects and Health Risks following exposure to aerosols produced by the use of Depleted Uranium weapons. Invited th presentation to the Royal Society, London July 19 2000 and also given at the International Conference against Depleted Uranium, Manchester 4th November 2000. Occasional paper 2000/11 (Aberystwyth: Green Audit) Busby C.C (2001b) Depleted Uranium in Kosovo: Review of UNEP Report of 13th March 2001 Occasional Paper 2001/3 (Aberystwyth: Green Audit) Busby C.C (2001c) Additional Evidence A1 To the paper: Science on Trial-On the Biological Effects and Health Risks following Exposure to Aerosols produced by the use of Depleted Uranium Weapons (Aberystwyth: Green Audit) Busby C.C (2001d) Health Risks following exposure to aerosols produced by the use of Depleted Uranium Weapons. Presentation to Res Publica International Conference Prague 24th Nov 2001. Occasional Paper 2001/12 (Aberystwyth Green Audit) Busby C and Scott Cato M (2001e) Increases in leukemia in infants in Wales and Scotland following Chernobyl: Evidence for errors in statutory risk estimates and dose response assumptions. Kiev WHO conference paper. Occasional Paper 2001/7. Aberystwyth: Green Audit Busby C.C. and Cato M.S. (2001f) Increases in leukemia in infants in Wales and Scotland following Chernobyl: Evidence for errors in statutory risk estimates and dose response assumptions. International Journal of Radiation Medicine 3 (1) 23 Busby C.C. (2002) 'Lymphoma Incidence in Italian Military personnel involved in Operations in Bosnia and Kosovo' Occasional Paper 2002/3 (Aberystwyth: Green Audit)