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MINISTRY OF DEFENCE Final
Page 1
Final
Gulf Veterans’ Illnesses Unit
MINISTRY OF DEFENCE
Zone A, Floor 7, St Georges Court,
2-12 Bloomsbury Way,
London, WC1A 2SH
Telephone
Direct dial
020 7305 4669
Helpline
0800
169
4495
Fax
020 7305 4166
Final
Our Reference:
D/GVIU/7/1/8/2
Date:
27 November 2003
MINUTES OF THE THIRTEENTH DEPLETED URANIUM SCREENING
PROGRAMME OVERSIGHT BOARD MEETING ON 20
TH
NOVEMBER 03
Present:
Board:
Observers:
Professor David Coggon
Surg. Cdre Nick Baldock
Mr Ron Brown
Mr Ivor Connolly
Maj Gen (Retd.) R P Craig
Dr George Etherington
Mr Jim Glennon
Professor Malcolm Hooper
Dr Gordon Paterson
Dr Margaret Spittle
Professor Brian Spratt
(Mr Charles Williams
Air Cdre Simon Dougherty
Wg Cdr Charlie Wilcock
Mr Alan Duncan
Miss Rosie Wane
MRC
INM
DRPS
NGV&FA
RBL
NRPB
NGV&FA
GVA
BRC
MH
RS
GVIU
DMSD
DMSD
HJA
GVIU
Chair
Secretary)
Apologies:
Dr Chris Busby
Dr Muir Gray
Dr Gideon Henderson
Mr Neville Higham
Dr Len Levy
Dr David Lewis
LLRC
NSC
Ox Uni
HSE
MRC IEH
INM

Page 2
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Final
2 of 13
Item Discussion
and
Decisions Actions
(Action date)
1.
Introduction
a) The chairman opened the meeting. He stated that the main items of business
would be the laboratory analysis contracts, arrangements for the healthcare
function, the normative values study, the advisory factsheets, and the test
questionnaire.
b) Mr Glennon had requested a closed session of the Board from which
observers would be excluded. The chairman said that public sector
committees of this kind usually conducted their business quite openly. He
asked permission for a closed session from the members present. It was
agreed that non-members would be asked to leave at the end of the
advertised agenda.
c) The chairman noted that Mr Brown had circulated an email about the results
to date of the Op TELIC biological monitoring, which might have
implications for DUOB business. Surg. Cdre. Baldock reminded the
meeting that Dr Busby had responded to Mr Brown’s message with the
request that the Board make no firm decisions on the subject until he was
able to attend. Professor Coggon ruled that the biological monitoring results
must nonetheless be discussed.
d) The chairman apologised to the Board for any delays on his part in
completing actions or replying to requests for information. He was dealing
with DUOB affairs in addition to his main employment, and thus having to
prioritise use of his time.
2.
Minutes of last meeting
The chairman asked for sub-headings to be numbered using Roman
numerals. Mr Brown requested the addition of some explanatory text to four
sections where he had been quoted.
Action 13.1 Secretary to finalise and circulate minutes of 12
th
DUOB
Secretary
(completed
21.11.03)
3.
Matters arising from last meeting
i. Discrepancy in pilot study reports
The secretary reported that he had been unable to identify any discrepancy.
It was agreed that this action had been overtaken by events and could be
closed.
ii. Meeting with the Under Secretary of State for Defence
The chairman reported that on November 17
th
he had met the Minister, who
was pleased with the work of the Oversight Board and keen for the main
retrospective testing programme to start. Professor Hooper asked whether
the chairman had raised Dr Busby’s point, namely that he thought it
unacceptable that the DUOB’s remit was not being extended to the second
Gulf war. Professor Coggon said he had, and the matter was to be kept
under review with an open mind. Mr Glennon pointed out that meant the
answer was still no. The chairman confirmed this.
iii. Post-TELIC urinary uranium study
Professor Coggon reported that a draft protocol for the study was now in
existence and had been circulated to the Board. Professor Hooper said he
was uneasy about three members of the DUOB collaborating with
P f
W
l
h
h d
ib d
lt t t th M D I
l

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Final
3 of 13
Professor Wessely, whom he described as a consultant to the MoD. In reply
to a query from Mr Brown, Professor Hooper said that Professor Wessely
had described himself as such in a television interview. Mr Brown and
General Craig said that MoD was funding some studies by Professor
Wessely, but that was not the same thing. The chairman said that the post-
TELIC study could be discussed in more detail later.
iv. Autopsy information
The chairman said that enquiries had been made in the USA via the GVIU
liaison officer in Washington DC, Colonel White. There appeared to have
been no relevant American autopsies. There was however one published
paper reporting analysis for DU of a Canadian bone sample, which had
shown a negative result. Professor Hooper said that there had also been one
positive finding of DU from Canada. Mr Brown said that it was unclear
whether the study in question had included control data, and the finding was
at best speculative. Professor Hooper objected to what he felt was an
unwarranted attempt to belittle data from other researchers.
Professor Coggon observed that whatever the merits and limitations of the
Canadian data, it was clear that there were not enough results in this area for
useful conclusions to be drawn.
v. Draft advice on “negative” test results
Professor Coggon said that he had not yet completed the revised draft.
Action 13.2 Chairman to amend the draft advice on “negative” test results
vi. Kuwaiti cancer registry
The chairman said that he had received a reply to his enquiry, advising that
the best information available could be found in “Cancer Incidence in Five
Continents”, published by an agency of the World Health Organisation
(WHO). He had requested the latest volume from the British lending library,
but it would not be available for several months.
vii. Age data on Gulf war veterans
The secretary had just received the requested information from the Defence
Analytical Services Agency (DASA). He reported that the numbers of UK
Gulf 1 military personnel in the undermentioned age ranges on April 1
st
1991 were as follows:
40-44 1,968
45-49 752
50+ 262
viii.Healthcare provider
The chairman said that Dr Paterson had suggested a research group that
might take on this function, but he thought it was unlikely that an academic
group would be willing to provide the services required. Dr Paterson
explained that the group in question had carried out a study for the Scottish
Office involving the collection of urine samples. There had been no other
proposals from Board members. Professor Coggon felt that a group of NHS
Occupational Health (OH) departments might take on the work, in
conjunction with a central co-ordinating organisation. The DUOB itself
would probably have to nominate an advisory consultant.
ix. Main test isotope measurements
Professor Hooper asked whether the
236
U measurement would be retained.
Professor Coggon confirmed that it would, as agreed at the wash-up
meeting with the pilot study laboratories on September 22
nd
. Mr Brown
commented that only one lab had been able to make the measurement well.
Mr Glennon felt that was unimportant, as long as it could be done. The
Chairman

Page 4
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chairman said that the Board could decide exactly how to use the
236
U
aspect in the light of the pilot exercise findings.
x. Advisory consultant
Professor Hooper asked if two advisory experts could be considered:
Dr Busby and a medical specialist. The chairman said this could be
discussed later. Professor Spratt suggested that it would be wrong to offer
advice from a person not bound by medical ethics.
xi. Durakovic paper
The chairman noted that Dr Etherington had circulated a response to the
paper. It appeared that Dr Durakovic might have somewhat underestimated
the lung burden; though even allowing for this, the overall risk to health was
low according to conventional health physics. Dr Etherington added that
Dr Durakovic’s claims about the reliability of his method were consistent
with the findings of the extended pilot study overseen by the DUOB.
xii. NERC research
a) Professor Coggon asked if there were any messages from the DSTL DU
Workshop at Tidworth. Professor Spratt said there was nothing very
significant to the DUOB. Mr Connolly said there seemed to be a pool of
money available for research, and wondered whether the Board could tap
into it before it was all committed. Mr Brown explained that funds for the
MoD Corporate Research Programme (CRP) came from the budget of the
Chief Scientific Advisor, and were quite separate from the funds used by
GVIU. The chairman stressed that commitment of CRP funds would not
affect DUOB activities.
b) Dr Paterson expressed his appreciation for the Workshop, and especially for
what he considered an excellent summary presentation by Ron Brown.
Professor Spratt agreed that there had been some good talks, albeit mainly
of little relevance to the Board. Surg. Cdre. Baldock informed the meeting
that the classified second day of the Workshop had not involved DU health
issues. Mr Glennon thanked him for the report.
xiii. Biological
monitoring
update
a) Mr Brown reported that 181 tests had now been carried out. A small group
with shrapnel injuries were the only personnel whose urine showed
detectable levels of DU. The rest, even those claiming “level 1” exposure,
exhibited nothing abnormal. Around 800 bottles had been sent out, so more
tests were likely. Mr Glennon asked whether the samples were 24-hour
collections. Mr Brown said no, they were all spot (single void) samples.
b) Mr Connolly asked about Mr Brown’s aim in making the report: was he
seeking approval or guidance from the DUOB? The chairman said that the
update was for information only. The results could be borne in mind when
advising participants in the retrospective test; and they would also inform
the normative values study. The Board might usefully consider whether a
full normative values study should be pursued if the results were likely to be
all negative. However, no decision was needed until the outcome of the
preliminary study was known.
c) Professor Spratt said that it was not possible reliably to extrapolate back
from 2003 to 1991. The two wars were different. Test firings of DU
munitions, because they are designed to be “worst case”, tend to cause
greater aerosolisation than occurs under real battlefield conditions. During
Op TELIC the targets were relatively soft and there appears to have been
little dispersion of DU dust.
d) Mr Glennon asked exactly how many tests had so far been positive for DU.
Mr Brown replied that he was not at liberty to say, other than “a small
number”. The chairman said he would expect that to mean fewer than ten.

Page 5
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Since there had been so few DU shrapnel injuries, it might be possible to
identify individuals if the precise number were announced. Mr Glennon
enquired whether details of the biological monitoring tests would be given
to the Board. Mr Brown said that the data would certainly be published in
due course. The question was when, as the monitoring had no set end-date.
Mr Glennon said he would like to see all the available information straight
away.
e) Professor Hooper said that he wanted to have full details, such as the time of
day when the urine samples were taken and the volume collected.
Mr Brown questioned the relevance of this information, saying that only the
isotopic ratio was important. Professor Hooper said it had a bearing on the
kinetics. Mr Brown said that none of the personnel tested so far had shown a
urinary uranium concentration exceeding the “action level” defined by the
Royal Society.
f) Professor Hooper claimed there were indications of the use of munitions
made from natural, as opposed to depleted, uranium. Mr Brown stated
categorically that the UK did not use natural uranium weapons.
Mr Connolly wondered if the DUOB should review its previous advice on
biological monitoring. Mr Brown felt that a review was appropriate, since
new information was becoming available. The chairman said the Board
would take all information into account, noting its limitations; however, he
did not think the previous recommendations should be reviewed at this
stage. Professor Hooper asked whether any air monitoring had been done
during Op TELIC. Professor Spratt replied that air monitoring was carried
out at a few DU strike sites several weeks after the conflict.
xiv.
Inter-Parliamentary Gulf War Group (IPGWG)
a) Professor Hooper requested clarification of the chairman’s ‘disturbance’
reported in the minutes of the 12
th
meeting. Professor Coggon said it had not
been correct to state that no research into DU medical effects was planned.
Professor Hooper said he had not attended the IPGWP meeting in question.
The remarks attributed to him were based on his comments about the MRC
report. He had said the Board had “no plans for a coherent research
programme”. This was true, since nothing was yet in place.
b) Professor Coggon said there were plans for case-control studies and cross-
sectional surveys. No research was yet ongoing, but it was certainly
intended. Professor Hooper said he thought the significance of cytogenetic
tests was being played down by the Board. The chairman replied that
genetic damage was not a reliable marker of DU exposure, since it could
also be caused by other types of radiation such as x-rays; Dr Spittle
concurred. Professor Spratt said there might be a case for more research in
this area if the Doyle study on the reproductive health of Gulf war veterans
showed abnormalities. Professor Hooper felt that this UK study was flawed,
but strongly supported a critique by Doyle of the Cowan paper on birth
defects in US veterans and mentioned several other relevant papers.
4.
Update on screening programme contracts
i. Main testing contracts
a) The secretary said that the cost of placing contracts with the three analytical
laboratories recommended by the DUOB would have exceeded the available
budget by around 70%. To proceed on this basis would have required fresh
financial authorisation within MoD, inevitably causing delay. The secretary
had therefore arranged for contracts to be let to two laboratories, giving an
initial capacity of 800 samples in total. He would seek additional funds to
contract with the third organisation (whose tender price was approximately
four times that of the least expensive laboratory) if the Board so required.
b) Mr Glennon and Mr Connolly asked how such a restriction could occur

Page 6
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Final
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when the MoD was committed to supporting the DUOB. The secretary
explained that in its day to day management, the Ministry always operated
within defined budgets set at the beginning of the financial year. These had
to be based on forward estimates, and the actual requirements might prove
to be greater or less. If greater funding were needed, as in this case, it could
be requested; but firm contractual commitments could not be made until
budgetary authorisation was obtained.
c) Mr Williams said he had been anxious to ensure that at least some analytical
capacity would be available to the Board before the end of calendar year
2003. He was conscious that the start of the testing programme had already
slipped considerably. Mr Glennon said he felt it was premature to have
laboratories on standby when the rest of the practical arrangements were not
yet in place. Mr Connolly said that at a meeting of his organisation, veterans
had expressed concern about the laboratory that had tendered the lowest
price, because of its links with the nuclear industry.
d) The chairman said that the DUOB had two options. It could declare the
interim position unsatisfactory and demand contracts with three
laboratories, though this would be difficult to justify on scientific grounds
alone; or it could accept what had been done, begin the testing, and make a
case for a third lab only if a problem arose such as high demand. He felt that
the latter course was better since it minimised delay.
e) Mr Connolly said that it was hard on the third laboratory to be denied a
contract after its good work and co-operation in the pilot studies. The
chairman said the lab had put a very high price on its services. Mr Connolly
said he would be concerned if all samples were analysed by the lowest-
priced lab. Professor Coggon assured him that the initial samples (those
collected in the proposed pilot exercise) would all be split and tested by
both laboratories until the Board had gained confidence in the consistency
of the measurements. Mr Brown expressed concern on hearing that the third
laboratory intended to use new equipment and temporary staff for the main
study, as this meant the laboratory was not following the pilot study
procedures. Professor Spratt said that the labs had an incentive to work
diligently, as their reputations were at stake.
f) Mr Glennon was unhappy at what he saw as the selective nature of the pilot
testing being put forward. He said that a free and open test had been
promised. Dr Paterson said that the pilot exercise had been proposed only
because of the lack of contractors willing to take on the original healthcare
provider role. It was designed to ensure that something would be achieved,
rather than nothing; the Board had to start somewhere. A pilot exercise in a
single geographical area would allow other Occupational Health (OH)
departments to gain confidence in the practicality of the procedures.
g) The chairman said that the Board must decide whether to go ahead with two
laboratories, or not. The secretary reminded members that sample splitting
would be carried out routinely throughout the test programme as part of the
Quality Assurance. In reply to a query from Mr Connolly, the chairman said
that the samples would have to be split by the laboratories themselves in
order to maintain security and avoid the risk of contamination. Mr Glennon
said that the programme should not proceed without the third lab, since
otherwise analytical capacity would be too limited. Other Board members
raised no objection, however, and the chairman ruled that the majority
decision was to accept two laboratories for the time being.
ii. Heathcare provider
a) The chairman said that the main issue was the proposed pilot exercise. This
would involve approximately 30 veterans in a single region of the UK. They
would be supplied with containers, written guidance and questionnaires for
self-completion. They would be invited to a clinic to hand over a 24-hour
i
ll ti
d
id
t
i
l
At th
ti
th

Page 7
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7 of 13
urine collection and provide a spot urine sample. At the same time they
would hand in their questionnaires for review of completeness by clinic
staff, who would provide any further guidance required. By this means the
Board could get a feel for the workability or otherwise of the procedures,
the appropriateness of the questionnaire, and the quality of the courier
service; it would also discover how well the analytical laboratories agreed,
and get an indication of the prevalence of detectable DU (with implications
for the advice to be given) and of the reliability of data from spot as
compared with 24 hour samples. In short, the exercise would provide useful
information, and at least some of the waiting veterans would get their
results.
b) Mr Connolly expressed concern about the quality and accuracy of the
sample splitting. Professor Coggon said that this had been carried out
satisfactorily during the pilot studies. The Board could stipulate exactly how
it wanted the splitting done. Mr Glennon wondered if the pilot exercise
might entail compromise in relation to the security of the urine samples.
Professor Coggon said it would make no difference: tamper-evident seals
and coded labelling would still be used. If any problem arose, it would soon
be apparent as the split samples would give different results.
c) Professor Hooper said he supported a pilot exercise, but did not think
London would be the best location. In many respects the capital was unique.
Many of the veterans had misgivings about the big London hospitals. It
would also be useful to trial the test procedures provincially.
d) The chairman said he had suggested London for practical reasons. He had
had some contact with the OH department at St. Thomas’ hospital, which
was well established and experienced. Much of the population of southern
England could reach St. Thomas’ by public transport within one hour. The
chairman asked for alternative suggestions, but warned of delays if there
were a need to repeat the initial approach.
e) Dr Paterson noted that a great many veterans were resident in the west of
Scotland, and said he had a contact in an NHS OH service there. Professor
Coggon said the capacity existed to run two pilot exercises concurrently.
Dr Paterson said that in that case he proposed using London plus a second
region outside southeast England. Professor Hooper said this was a good
way forward and would address the anxieties of the veterans. Dr Paterson
felt there would be no problem in hospitals taking on the work at the level
proposed, because handling 30 or so samples would be a minimal addition
to what was part of their normal routine.
f) The chairman pointed out that a list of names and addresses was required so
that veterans in the chosen regions could be contacted. He said that the pilot
exercises would be run in the London and Glasgow areas, and asked for
assistance from the NGV&FA. In addition, the secretary should examine the
list of veterans who had already contacted GVIU to ask about the test.
General Craig said that the Royal British Legion would also like to put
forward nominations.
Action 13.3 NGV&FA members and General Craig to assist the secretary in
drawing up a list of potential test participants in the London and Glasgow
areas
g) The chairman said that a health advisory mechanism had to be set up for the
pilot exercises. Dr Spittle had offered her assistance and was willing to take
calls on a helpline if necessary, so long as the numbers were small.
Dr Spittle’s expertise lay in radiation medicine rather than heavy metal
toxicology. Mr Glennon said he would prefer the advisor not to be a
member of the DUOB. The chairman said such a restriction would create
considerable difficulty, as the UK had very few specialists in that field.
Secretary
Mr Connolly
Gen Craig
Mr Glennon

Page 8
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h) Professor Hooper asked how the suggested arrangement would work.
Professor Coggon replied that people whose test results were negative
would receive written advice from the Board, which he thought should
initially review all results. The DUOB would decide on the interpretation of
“questionable” cases, and participants would be offered follow-up via the
helpline if needed. The review process would probably make the feeding
back of results a little slower than in the main testing programme.
i) Professor Hooper said he was happy for Dr Spittle to take on the role. He
did not consider membership of the DUOB a relevant factor. Professor
Coggon pointed out that participants would be free to discuss their results
with Dr Busby or anyone else if they wished. Professor Hooper said that the
division of opinion on the Board with regard to the health risks of DU
exposure must be made clear to veterans. The chairman confirmed that this
would be done.
j) Mr Connolly asked if review of individual results by the Board might raise
legal issues. Professor Coggon said that no names would be seen – only
anonymous data.
k) Dr Paterson said that the advance information on the test should name Dr
Spittle in her full professional capacity. Dr Spittle said it was important to
have an agreed response for particular levels of DU. The Board must not
give mixed messages. The chairman said it would speak with one voice but
state that there were two opinions.
l) Mr Brown felt that one of the two analytical laboratories lacked experience
with urine samples and ought to be guided on what was ‘normal’. The
chairman thought that was not essential at this stage; results from the
normative values study were not a prerequisite. Professor Hooper agreed.
m) The chairman wondered whom the Board should approach for the central
healthcare role: overall co-ordination, handling of appointments, and the
transport of samples. He asked the secretary to make enquiries.
Action 13.4 Secretary to research potential co-ordination contractors with
assistance from the chairman
n) The chairman referred to the question of an “independent third party” that
had been raised by Dr Busby. He said that he saw no problem in lodging a
third copy of the test results with such a party, provided that individual
consent was obtained and all statistical analysis of results was carried out
through the Board. It was agreed that further discussion would be deferred
until Dr Busby was present.
iii. Civilian normative values study
a) The chairman recalled that the initial proposal received from the normative
values contractor had been complex and excessively expensive. The work
was now being approached in two stages. The first stage would be a
preliminary study based at a single hospital in Edinburgh, where each
participating patient would be asked to give both a combined 24-hour urine
sample and a series of individual spot samples collected over a second
24-hour period. The results obtained would define how well a spot sample
could serve as a proxy for a 24-hour sample and how much variation is
caused by the time of day of voids. With that information, the Board could
decide whether to proceed to the full civilian normative values study; and if
so, whether its logistics could be simplified.
b) Professor Hooper asked how many patients would be involved. The
secretary replied that the plan was for twenty five. Professor Hooper said he
was content for the work to proceed. The chairman pointed out that there
was provision in the study protocol for patients to be asked follow-up
questions if the need arose. Mr Glennon enquired about the isotopic ratio
measurements Professor Coggon said that the
238
U/
235
U ratio would be
Secretary
Chairman

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Final
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measurements. Professor Coggon said that the
238
U/
235
U ratio would be
recorded, but the
238
U/
236
U ratio could be added if required. Mr Glennon
wanted it included.
c) General Craig wondered about the risk of impaired renal function,
expressing concern that hospital in-patients on medication might have
altered levels of creatinine excretion. Professor Coggon said that such
variation should not affect the uranium isotope ratios, though it could alter
the overall uranium excretion. General Craig suggested the use of mental
health patients, but this was considered too difficult. He said that creatinine
levels were elevated for at least three days after surgery. Mr Brown advised
that patients fitted with catheters should be excluded from the study, as the
plastic tube material could influence the test result. The chairman undertook
to convey this instruction to the contractor. Dr Paterson asked for all
correspondence with the contractor on technical matters to be copied to the
Board. The secretary reported that placement of a contract for the normative
values preliminary study was underway.
Action 13.5 Chairman to warn contractor against use of catheters
Action 13.6 Secretary to copy any technical correspondence to the Board
Chairman
(completed
21.11.03)
Secretary
5.
Information to veterans and GPs
The chairman asked Dr Spittle, who had to leave the meeting early, for her
comments on the factsheets as redrafted by the contractor and the latest
draft of the test questionnaire. Dr Spittle felt that a question should be asked
specifically about pregnancy, since it was not an illness. Professor Coggon
thought this was not essential because there was an existing question on any
children’s health problems.
i. Depleted
Uranium
Factsheet
a) The chairman said that the contractor had apparently believed the aim of the
factsheets was to encourage the highest possible participation in the testing
programme, and this was not the case. Professor Hooper noted that the
statement DU is “40% less radioactive” than natural uranium is true only for
α-particle emissions. If all emissions were considered, DU had 88% of the
radioactivity of the natural material. Dr Etherington explained that the
phrase “40% less radioactive” referred only to the activity of uranium
isotopes present in DU. Mr Brown objected to use of the phrase “natural
uranium” in the factsheet on the grounds that it has a very specific meaning
which was not intended.
b) The secretary was asked to consult Dr Levy about the toxicity of tungsten.
Action 13.7 Secretary to enquire about the toxicity of tungsten
c) There was a discussion about the list of sources of further information on
the factsheet. Professor Hooper and Mr Glennon wanted Dr Busby’s Low
Level Radiation Campaign (LLRC) website included, but the chairman was
opposed to this because of some of the site’s non-scientific content.
Professor Hooper felt it was important to have a non-orthodox view
available to veterans. The chairman suggested a separate heading for “other
views”.
d) The Board agreed a number of changes to the factsheet, which were to be
implemented by the secretary.
Action 13.8 Secretary to modify the DU factsheet as agreed
ii. Information for those seeking a test for DU
a)
The Board discussed the question of “significant” exposure.
Secretary
(completed
28.11.03)
Secretary
(completed
25.11.03)

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Professor Hooper said he thought there was no effective threshold and that
all DU exposure was therefore significant for health. The chairman
disagreed, stating that there was a wealth of information on relevant health
outcomes. Professor Hooper insisted that a firm statement could not be
made. Mr Brown felt that the advice should be based on a consensus view,
but Professor Hooper pointed out that the majority opinion on the health
risks of low-level radioactive sources was in dispute.
b) There was some discussion of bone cancer. Professor Hooper claimed that
information on the subject was being suppressed, and said that statements
from the Board should not be categorical. Professor Spratt said that the
question of reassurance to participating veterans had to be considered.
Mr Glennon said that the factsheets should not be about reassurance, but
rather about telling the truth as it was understood.
c) Dr Paterson said that the key point of the test was to establish whether a
given individual’s urinary uranium concentration was significantly different
from that expected in the general population. Mr Brown pointed out that
relatively high urinary uranium levels can arise from drinking some mineral
waters, so that by itself is not a sufficient indicator. The chairman said that
DU content was the key factor.
d) Professor Coggon undertook to modify the draft factsheet in accordance
with the Board’s deliberations. The secretary was asked to ascertain the
exact starting dates of the UK Balkan operations. Dr Paterson requested a
definitive statement from the MoD about whose tests it would pay for; and
that other NGO personnel could access the testing programme on the
understanding that they or their organisation would bear the cost of the test.
Action 13.9 Chairman to rewrite the “seeking a test” factsheet
Action 13.10 Secretary to ascertain Balkan operation dates
Action 13.11 Secretary to provide a definition of the MoD payment policy
e) Mr Brown pointed out that the test participants must be asked for their
permission if the results were to be sent to a third party; this was agreed.
The likelihood of compliance with a 24-hour urine collection regime was
discussed. General Craig said that it would be difficult to guarantee. It was
agreed that the factsheet would stress the importance of completing the
collection, but all samples would be analysed even if they were not
complete.
f) The secretary reported that the individual chiefly responsible for the revised
factsheets was no longer employed by the contractor, but had expressed a
personal professional interest in learning the response of the Board to her
work. He asked for permission to give her this information. The Board
assented and asked the secretary to convey its thanks.
Action 13.12 Secretary to convey the thanks of the DUOB to the factsheet
author
Chairman
(completed
25.11.03)
Secretary
Secretary
Secretary
(completed
27.11.03)
6.
Questionnaire
a) The chairman said that he had designed the latest draft of the questionnaire
to be simple to complete; sections not relevant to an individual could simply
be passed over. The operation of the questionnaire could be tested in the
planned pilot exercise.
b) The Board considered the questionnaire under its existing page numbering
and agreed the following changes:
Page 1: Question on NHS number to be deleted.

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Page 2: Question on service start date to be deleted; dates to be recorded as
year and month only.
Page 3: Questions 6 and 7 to be deleted.
Pages 4 & 5: Question 8 to read “1990 or 1991”; question 13 to ask “to
which unit were you attached?” rather than “where were you based?”;
question 14 to include Doha and Thumrait in the list of military sites, and
to include Royal Marines; question 21 to read “assist or treat casualties”.
Page 6: The term “Balkans” to be used in place of “Bosnia/Kosovo”.
Page 7: “NGO” to be written in full (Non-Governmental Organisation).
Page 8: Question 45 to read “military or NGO”.
Page 9: Question 53 to be deleted; in question 54, the definition of “close”
to be “within 2 miles”.
c) General Craig said that most war pensioners suffered musculoskeletal
problems, so question 62 would provide no information about DU.
Mr Glennon felt the question was irrelevant. The chairman said it was
included for background understanding and awareness, which would be
useful when offering advice over the telephone.
d) Mr Glennon enquired about the purpose of question 64 (previous urine test
for DU). Professor Coggon said that too was background information that
would be useful to have in case of any discrepancy. Dr Paterson commented
that it would be of value only if the previous result were known as well.
Mr
Glennon expressed some concern about the security of copy
questionnaires. Dr Paterson said that a serial number must be printed on
each page to avoid the possibility of accidental mismatching during the
copying process.
e) Professor Coggon undertook to revise the draft questionnaire as agreed. He
said it would be piloted with the first groups of veterans tested and then
refined again if necessary before the main programme.
Action 13.13 Chairman to modify and reissue the draft questionnaire
Chairman
(completed
26.11.03)
7.
Timescales
The chairman said that discussions with the OH departments and the setting
up of contractual arrangements with them would take several weeks. A list
of veterans to be invited to participate in the pilot exercises could be drawn
up concurrently.
8.
DU background and scientific issues
There was no discussion of this agenda item.
9.
Dates of next meetings
The secretary reported that provisional venue bookings had been made for January
27
th
and March 23
rd
, as these were the dates on which the greatest number of
DUOB members had said they were available. It was agreed that the next two
meetings would be held on those days.
10.
Any other business
i. Post-TELIC
DU
study
Professor Coggon had circulated a draft study protocol, and asked for Board
members who wished to do so to send him comments on it by email.
At this point the observers left the meeting, which then continued in members-only
session. The secretary departed also, and subsequent minutes were recorded by

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the chairman.
ii. Closed session
a) Mr Glennon reported that he had a number of issues he had been asked to
raise by the National Gulf Veterans and Families Association (NGV&FA).
The first concerned the involvement of three members of the Board (the
chairman, Professor Spratt, and Dr Etherington) in the study to be carried
out in collaboration with Professor Simon Wessely on DU exposures among
Operation TELIC military personnel. Professor Wessely was perceived by
the Association as not being “on the side of veterans”; and members of the
Association felt that Board members should not be involved in the study,
particularly since it was not under the direct control of the DUOB.
b) In response the chairman pointed out that the DUOB did have involvement
in the study to the extent that it had been invited to comment on the draft
protocol, and any suggestions would be taken into account when the
protocol was finalised. The fact that three members of the Board were
taking the leading role in designing the study helped ensure that the thinking
of the DUOB was properly taken on board. However, the DUOB did not
have ultimate responsibility for the work, and it was recognised that the
Board could not be considered to have “authorised” the investigation.
c) Professor Spratt said that he had spent much of the previous two years
trying to persuade the MoD of the need to collect better information about
the patterns and determinants of exposure to DU when DU weapons are
used in military conflicts; and that it was important to capitalise on the
opportunity to obtain data in an appropriate time window.
Surg. Cdre. Baldock added that in his view the input from DUOB members
should improve the quality of the study and enhance its credibility.
General Craig agreed, asking who else had the expertise to conduct the
study. Dr Paterson noted that there was a perception that health problems
related to Gulf War 1 had not been taken seriously early enough. In his
view, it was to the credit of MoD that it now wanted to act quickly.
Professor Hooper said that there was nevertheless concern that members of
the Board would be “tainted by association”.
d) The chairman pointed out that unlike Gulf War 1, Operation TELIC was not
of immediate concern to the NGV&FA. Therefore there was no obvious
case for its being closely involved in the study. However, it was recognised
that the NGV&FA representatives on the DUOB did have a contribution to
make, along with other Board members, and the mechanism was in place to
achieve this. Professor Hooper agreed that it was important from a scientific
point of view to carry out the study at an early stage, but nonetheless
remained concerned about what some members of the Board considered
secrecy in its development. Dr Paterson said he was sure that relevant issues
would be brought to the attention of the DUOB, and the chairman
confirmed that this was the case.
e) Mr Glennon said that a second issue of concern was the chairman’s
apparent wish to push for the use of spot urine samples rather than 24 hour
collections. The chairman responded that if they were shown to provide
scientifically valid information, the use of spot samples would be to the
advantage of all concerned, including the veterans being tested. There was
no question of substituting spot samples for 24-hour collections unless there
was good scientific evidence that this was justified. In order that a properly
informed decision could be made, it was proposed to collect information on
the comparison of results from spot and 24-hour samples as part of the pilot
testing of veterans, and also in the civilian normative values study.
f) Mr Glennon said that a third issue for the veterans was the need to ensure
that measurements of
236
U were made. The chairman responded that whilst
he did not think there was a strong scientific rationale for measuring
236
U,

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the marginal cost of doing so was relatively small and it could be done if
that was what the veterans wished.
g) Mr Glennon then asked about the position of the DUOB in relation to
testing for chromosome aberrations. The chairman said he did not believe
that chromosome aberrations provided a specific index of exposure to DU;
but that if urine testing indicated a significant prevalence of exposure to DU
among veterans, a scientific study of the relationship between chromosome
aberrations and DU exposure would be useful and something the Board
could actively promote. Other members of the Board agreed, pointing out
that chromosome aberrations might also arise from exposure to diagnostic
x-rays. It was agreed that this topic would be an agenda item for the next
DUOB meeting.
h) Finally, Mr Glennon asked for clarification on the proposed paper reporting
the results of the pilot study of laboratory methods. Professor Spratt said the
pilot study had been a valuable piece of work, and it was important to share
its findings with the wider scientific community. The chairman added that
this was not only so that others could learn from the work, but also because
it was possible that someone might draw attention to previously
unrecognised limitations in it. The chairman assured Mr Glennon that the
paper would simply report what was done, and would not be used in support
of other aspects of the DU testing programme that were not addressed in the
study. He said it was unlikely that anything would appear in print for at least
a year.
Distribution:
All members
All observers