HR 207 IH

To provide for identification of members of the Armed Forces exposed during military service to depleted uranium , to provide for health testing of such members, and for other purposes.

January 4, 2007

Mr. SERRANO introduced the following bill; which was referred to the Committee on Armed Services

To provide for identification of members of the Armed Forces exposed during military service to depleted uranium , to provide for health testing of such members, and for other purposes.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Depleted Uranium Screening and Testing Act'.

SEC. 2. DEPLETED URANIUM RISK NOTIFICATION FOR DEPLOYING FORCES.

(a) Notification- The Secretary of Defense shall establish procedures to require, as part of the procedures for preparing members of the Armed Forces for deployment to a theater of operations, that such members be notified of--

(1) any known or likely use of depleted uranium in that theater of operations (whether by forces of the United States and its allies or by any opposing forces); and

(2) any health risks associated with exposure to depleted uranium .

(b) Training- The Secretary shall provide for training deploying members of the Armed Forces on the safe handling of depleted uranium contamination before such members are deployed to a theater in which depleted uranium is used.

SEC. 3. DEPLETED URANIUM SCREENING AND TESTING.

(a) Identification and Testing Required- The Secretary of Defense shall carry out a program to identify individuals who, during active service in the Armed Forces, are or have been exposed to depleted uranium and to provide those individuals with bioassay testing and notification of the results of such testing.

(b) Depleted Uranium -Exposed Personnel Identification Methods-

(1) PROCEDURES FOR IDENTIFICATION OF EXPOSED MEMBERS- The Secretary of each military department shall establish procedures to identify members of the Armed Forces under the Secretary's jurisdiction who are, or may have been, exposed to depleted uranium . For such purpose, the Secretary shall identify units and members under paragraph (2) and shall accept self-identification reports by members under paragraph (3).

(2) IDENTIFICATION OF UNITS AND PERSONNEL- The Secretary of each military department shall identify units, and personnel assigned to units, that have been, or could have been, exposed to depleted uranium , based upon information about known exposure events (as determined under subsection (c)).

(3) SELF REPORTING- The Secretary of each military department shall accept a report by an individual, or a primary care provider for an individual, that the individual, while a member of the Armed Forces under the Secretary's jurisdiction, was, or may have been, exposed to depleted uranium based upon service on active duty (or training duty or funeral honors duty) in a theater of operations where depleted uranium was used, including travel through such an area. The Secretary shall prescribe procedures for receiving such reports. Such a self-identification report submitted to the Secretary under this paragraph shall be treated by the Secretary as identification of the individual for purposes of this subsection.

(4) TREATMENT OF INDIVIDUALS NO LONGER ON ACTIVE DUTY- In carrying out this subsection, the Secretary of each military department shall ensure that individuals no longer on active duty (including members of the reserve components who have been released from active duty, members who have been retired, and members who have been separated from service) are treated, for identification purposes, in the same manner as individuals remaining on active duty.

(c) Exposure Events-

(1) TYPES OF EVENTS- The Secretary of Defense shall identify depleted uranium exposure events for purposes of this section. The exposure events identified shall include the following:

(A) DIRECT EXPOSURES- An event in which an individual--

(i) is struck by depleted uranium munitions or depleted uranium armor fragments;

(ii) enters, or is present within 50 meters of, a vehicle or structure with possible depleted uranium residues; or

(iii) breathes smoke from fires involving depleted uranium materials.

(B) EQUIPMENT HANDLING EXPOSURES- An event in which an individual may inhale depleted uranium compound particulates as a result of the handling of equipment or wreckage that has been, or could have been, contaminated with depleted uranium .

(C) OTHER EXPOSURES- Other significant or incidental exposure events identified by the Secretary, including the performance of activities in the area of depleted uranium damaged vehicles or structures or the traveling through or residing in any such area.

(2) LIMITED RETROACTIVITY- In addition to exposure events described in paragraph (1) occurring on or after the date of the enactment of this Act, such events during the period between January 1, 2003, and the date of the enactment of this Act may be considered for purposes of this section, if reported during the 60-day period beginning on the date of the enactment of this Act.

(d) Health-Care Services Required-

(1) BIOASSAY PROCEDURE- Any individual identified under subsection (b) shall be provided a health screening test by the Secretary of Defense. Such test shall be carried out using a bioassay procedure developed by the Secretary of Defense in consultation with the Centers for Disease Control and Prevention. The same bioassay procedure shall be used for all individuals identified under subsection (b) and for all types of exposure or possible exposure identified under subsection (c).

(2) TIME FOR TEST-

(A) EXPOSURES AFTER ENACTMENT- In the case of an exposure event described in subsection (c) that occurs on or after the date of the enactment of this Act, the bioassay under paragraph (1) shall be administered not later than 180 days after the date of the event, except that in the case of an individual with an exposure event described in subsection (c)(3), the bioassay under paragraph (1) shall be administered not later than 30 days after the end of the individual's deployment in the theater of operations, but such individual may be provided the bioassay earlier upon the individual's request.

(B) EXPOSURES BEFORE ENACTMENT- In the case of an exposure event described in subsection (c) that occurs before the date of the enactment of this Act, the bioassay under paragraph (1) shall be administered not later than 180 days after the date of the reporting of the event under subsection (c)(2).

(3) FURNISHING OF RESULTS- The Secretary of Defense shall provide the results of any bioassay procedure under this subsection to the individual tested, and the primary care manager or primary care provider of that individual, not later than 30 days after the Secretary receives those results.

(e) Personnel Tracking- The Secretary of each military department shall establish procedures for collecting, tracking, and maintaining information on the health status of individuals tested under subsection (d) for the purpose of assessing any long-term health consequences of exposure to depleted uranium .

(f) Independent Review of Bioassay Types and Contamination Thresholds- The Director of the Centers for Disease Control and Prevention shall conduct an independent review of bioassay types and contamination thresholds for purposes of the testing under subsection (d).

(g) Treatment- Based on the results of the bioassay tests, the Secretary of the military department concerned shall provide appropriate treatment for any illness of an individual resulting from a depleted uranium contamination or exposure.

SEC. 4. COMPTROLLER GENERAL SURVEY AND REPORT ON RADIOISOTOPE IDENTIFICATION EQUIPMENT USED BY DEPARTMENT OF DEFENSE.

(a) Survey- The Comptroller General shall conduct a survey of radioisotope identification equipment used by the Department of Defense in order to assess the capability of Department of Defense facilities to identify concentrations of different radioisotopes in naturally occurring levels of uranium .

(b) Report- The Comptroller General shall submit to Congress a report on the results of the survey under subsection (a) not later than 180 days after the date of the enactment of this Act.

1: Toxicol Appl Pharmacol. 1997 Sep;146(1):156-61.  Links

New method for retrospective detection of exposure to organophosphorus anticholinesterases: application to alleged sarin victims of Japanese terrorists.

• Polhuijs M,
• Langenberg JP,
• Benschop HP.

Department of Chemical Toxicology, TNO Prins Maurits Laboratory, Rijswijk, 2280 AA, The Netherlands. poljuijs@...

With regard to detection of exposure to anticholinesterase, the presently used methods have the disadvantage that they cannot detect either low-level exposures with certainty or the structure of the agent and the extent of poisoning. In principle, organophosphate-inhibited butyrylcholinesterase in human plasma is the most persistent and abundant source for biomonitoring of exposure to organophosphate anticholinesterases. Fluoride ions reactivate the inhibited enzyme readily at pH 4, converting the organophosphate moiety into the corresponding phosphofluoridate. Subsequent quantitation of the latter product provides a reliable, highly sensitive and retrospective method for detection of exposure to, or handling of, organophosphates such as nerve agents and organophosphorus pesticides. We applied the new procedure to serum samples from victims of the Tokyo subway attack by the AUM Shinriyko sect and from an earlier incident at Matsumoto. In serum of 10 of 11 victims from the Tokyo incident and of 2 of the 7 samples from the Matsumoto incident, reactivation with fluoride ions yielded sarin concentrations in the range of 0.2-4.1 ng/ml serum. Evidently, these victims had been exposed to an organophosphate with the structure PriO(CH3)P(O)X, presumably with X = F (sarin). Several applications of the new procedure to establish nerve agent and/or organophosphate (OP) pesticide exposure can be envisaged, e.g., (i) in biomonitoring of exposure for health surveillance of those handling organophosphates, (ii) in cases of alleged exposure to nerve agents and/or OP pesticides in armed conflict situations or terrorist attacks, (iii) in medical treatment of intoxication, and (iv) in forensic cases against suspected terrorists that may have handled anticholinesterases. Copyright 1997 Academic Press.

PMID: 9299607 [PubMed - indexed for MEDLINE]

1: J Enzyme Inhib Med Chem. 2006 Oct;21(5):509-14. Links

Detection of sarin in plasma of rats after inhalation intoxication.

• Bartosova L,
• Bielavska M,
• Bajgar J.

Department of Toxicology, Faculty of Military Health Sciences, Trebesska 1575, Hradec Kralove, Czech Republic. bartosova@...

Presently used methods for detection and diagnosis of the severity of intoxication with organophosphorus (OP) compounds are mostly those that quantify inhibition of blood cholinesterases. It was found that when plasma inhibited with OP compounds is incubated in the presence of a high concentration of fluoride ions, the organophosphate is released from the enzyme thus yielding a phosphofluoridate, which can be analyzed by gas chromatography and NP detection. In our study, the concentration of sarin released after fluoride ions were added to the plasma of sarin-poisoned rats was determined. Sarin amounts in plasma measured after refluoridation and plasma butyrylcholinesterase activity in ten rats, that were exposed to sarin vapors at concentration of 1.25 microg/L (E1 group) and 2.5 microg/L (E2 group) respectively, for 60 min. In the E2 group the concentration of sarin in plasma was nearly 2-fold higher than in the E1 group. These results correspond well with the concentrations of sarin vapors to which the animals were exposed. Both experimental groups of animals showed significant decreases in butyrylcholinesterase activity by more than 30%-36.4% (E1 group) and 47.0% (E2 group). The method of fluoride-induced reactivation provides a very good marker for monitoring sarin intoxication in laboratory animals determined previously mostly by ChE determination which does not allow any information on sarin amounts in plasma.

PMID: 17194019 [PubMed - indexed for MEDLINE]

1: Arch Toxicol. 2004 Sep;78(9):508-24. Epub 2004 May 29.  Links

Retrospective detection of exposure to nerve agents: analysis of phosphofluoridates originating from fluoride-induced reactivation of phosphylated BuChE.

• van der Schans MJ,
• Polhuijs M,
• van Dijk C,
• Degenhardt CE,
• Pleijsier K,
• Langenberg JP,
• Benschop HP.

Department of Medical Countermeasures, TNO Prins Maurits Laboratory, P.O. Box 45, 2280 AA Rijswijk, The Netherlands. schansm@...

The utility was explored of a new approach to detect retrospectively exposure to nerve agents by means of conversion of the inhibitor moiety bound to the active site of the enzyme BuChE in plasma with fluoride ions into a phosphofluoridate which is subsequently analyzed by means of gas chromatography (GC). This quantifies >or=0.01% inhibition of BuChE and identifies the structure of the inhibitor except for the original leaving group. A three-tiered approach was followed involving the five classical nerve agents GA, GB, GF, GD, and VX, as well as the active metabolite of parathion, i.e., paraoxon: in vivo experiments in rhesus monkeys after iv administration of a sign-free dose of agent and concomitant in vitro experiments in plasma of rhesus monkeys and humans should allow an assessment of in vivo retrospectivity in humans. A systematic investigation was performed in order to find a single set of reaction conditions which yields a maximum amount of phosphofluoridate for all nerve agents. Fluoride-induced reactivation at 25 degrees C at a final concentration of 250 mM KF during 15 min in a pH-range between 4 and 6 appears to be effective. The in vitro decrease with time in reactivatibility of inhibited BuChE in plasma from humans and rhesus monkeys was largely due to aging of the phosphyl moiety, except for VX where spontaneous reactivation was a major cause. The decrease followed first-order except for a biphasic course in the case of GF in human and rhesus monkey plasma as well as of GD in rhesus plasma. In vitro half-lifes in human plasma ranged between ca. 14 h for GB and ca. 63 h for GA. A comparison of the in vivo data from rhesus monkeys and the in vitro data is complicated by the observation that the in vivo decrease with time of fluoride-reactivated phosphofluoridate is biphasic for all nerve agents. The terminal in vivo phase pertains to a small fraction of the amount of initially regenerated phosphofluoridate but is responsible for a considerable degree of retrospectivity, ranging between 14 and 56 days for GF and GB, respectively. The new procedure can be used in a variety of practical applications, e.g., (i) biomonitoring in health surveillance at exposure levels that are several orders of magnitude lower than presently possible; (ii) diagnosis in case of alleged exposure to nerve agents in time of war or after terrorist attacks; (iii) in forensic cases against suspected terrorists that have handled organophosphate anticholinesterases; and (iv) in research applications such as investigations on lowest observable effect levels of exposure to nerve agents.

PMID: 15170525 [PubMed - indexed for MEDLINE]

Related Links

• Improvements of the fluoride reactivation method for the verification of nerve agent exposure. [J Anal Toxicol. 2004] PMID: 15239857
• New method for retrospective detection of exposure to organophosphorus anticholinesterases: application to alleged sarin victims of Japanese terrorists. [Toxicol Appl Pharmacol. 1997] PMID: 9299607
• The application of the fluoride reactivation process to the detection of sarin and soman nerve agent exposures in biological samples. [Drug Chem Toxicol. 2004] PMID: 15038250
• Capillary gas chromatographic analysis of nerve agents using large volume injections. [J Chromatogr A. 1996] PMID: 8819827
• Erythrocyte and plasma cholinesterase activity in male and female rhesus monkeys before and after exposure to sarin. [Fundam Appl Toxicol. 1994] PMID: 7835534
• See all Related Articles...

 

1: Chem Res Toxicol. 2002 Apr;15(4):582-90.  Links

Retrospective detection of exposure to organophosphorus anti-cholinesterases: mass spectrometric analysis of phosphylated human butyrylcholinesterase.

• Fidder A,
• Hulst AG,
• Noort D,
• de Ruiter R,
• van der Schans MJ,
• Benschop HP,
• Langenberg JP.

Division Chemical & Biological Protection, TNO Prins Maurits Laboratory, P.O. Box 45, 2280 AA Rijswijk, The Netherlands.

In this paper a novel and general procedure is presented for detection of organophosphate-inhibited human butyrylcholinesterase (HuBuChE), which is based on electrospray tandem mass spectrometric analysis of phosphylated nonapeptides obtained after pepsin digestion of the enzyme. The utility of this method is exemplified by the positive analysis of serum samples from Japanese victims of the terrorist attack with sarin in the Tokyo subway in 1995.

PMID: 11952345 [PubMed - indexed for MEDLINE]

Related Links

• New method for retrospective detection of exposure to organophosphorus anticholinesterases: application to alleged sarin victims of Japanese terrorists. [Toxicol Appl Pharmacol. 1997] PMID: 9299607
• Quantitative analysis of O-isopropyl methylphosphonic acid in serum samples of Japanese citizens allegedly exposed to sarin: estimation of internal dosage. [Arch Toxicol. 1998] PMID: 9851684
• Verification of exposure to organophosphates: Generic mass spectrometric method for detection of human butyrylcholinesterase adducts. [Anal Chem. 2006] PMID: 16970345
• Detection of human butyrylcholinesterase-nerve gas adducts by liquid chromatography-mass spectrometric analysis after in gel chymotryptic digestion. [J Chromatogr B Analyt Technol Biomed Life Sci. 2006] PMID: 16569519
• Improvements of the fluoride reactivation method for the verification of nerve agent exposure. [J Anal Toxicol. 2004] PMID: 15239857