of the Press Briefing
Major General Roger Van Hoof,
Colonel David Lam and Mr Mark Laity
at NATO Brussels
Mr. Mark Laity : Good Afternoon Ladies and Gentlemen. What we
have today is a briefing on the outcome of a meeting yesterday of the
Chiefs of Military MedicalServices in NATO. Now we have two briefers.
On my left we have Major General Roger Van Hoof, now he is Chairman of
this Committee and he will brief first. Secondly we have Colonel David
Lam, he works for the international military staff of NATO. He will
afterwards give a briefing which contains the same information as was
given to the medical staffs yesterday and has also been presented to NATO's
Military Committee. So once again you are getting the same briefing material
that has been presented to NATO internally. Then afterwards we will take
questions, which will be directed through me.
Major General Van Hoof : Ladies and Gentlemen. COMEDS is the senior
military medical advisory committee of NATO. It is composed of the Surgeons
General of each NATO nation, the medical advisers of the Strategic Commands
and the Medical Staff Officer of the international military staff.
COMEDS held an extraordinary meeting yesterday to discuss the health
concerns aired among the military personnel and veterans of member
nations in recent months. COMEDS takes these health concerns
seriously. Obviously it is our duty as medical officers to ensure that
each of our Service members receive the medical care to which they are
entitled, no matter what the cause of their problems. As an
organisation, COMEDS is dedicated to ensure that our Service personnel
do not face unnecessary health risks during operations and the meeting
of yesterday was held to address whether or not such health risks are
causing medical problems following the operations in the Balkans.
Accordingly, we first exchanged all the available information on the
actual health concerns among our military personnel, on the collected
data about illness reports, on local risk assessments and on preventive
measures that have been taken by the different nations. After analysis
of the available data and of the available peer reviewed medical
scientific literature, a common NATO medical policy for the handling of
the actual situation was discussed. Conclusions were drawn and
recommendations were put forward to the Military Committee.
From the available data COMEDS believes that :
- Based on the presented national preliminary data on deaths and diseases
and on the number of personnel deployed in theatre, we cannot identify
any increase in blood cancers or deaths in soldiers we have deployed
to the Balkans as compared to those soldiers who have not deployed.
- On the evidence available, a causal link cannot be identified between
depleted uranium and the complaints or the pathologies.
- Based on the available peer reviewed medical scientific studies,
from both governmental and independent sources, any danger related to
depleted uranium exposure is known to be quantity dependent and so far
there is no evidence of possible exposure beyond the safe levels. Available
medical scientific studies show no links between natural uranium or
depleted uranium exposure and cancer.
- However, there are a number of military personnel reporting symptoms.
While these symptoms are not linked to depleted uranium exposure, this
should warrant further peer reviewed scientific studies.
The following common NATO medical policy for the handling of the actual
situation has been agreed upon.
- Each nation should analyse its military personnel accrued mortality
rates and H-specific mortality rates. These rates should be calculated
separately for the deployed and the non-deployed military personnel
and should be compared. A comparison with the general population should
also be made.
- Each nation should analyse the overall and/or specific rate of malignancies
occurrence within its Balkan veterans and compare it to their national
- Each nation should also correlate the collection of morbidity data
with known local health hazards in theatre.
COMEDS insists that any investigation and measurements ought only to
undertaken where they are scientifically validated.
COMEDS also made proposals for the future.
Within NATO in the past the military medical support was a pure national
responsibility. With the increase in military national deployments, common
principles and policies specific for the medical support where and are
still being developed, common agreements and policies form the basis of
NATO working procedures as each nation's own legislative framework may
determine which measures will be additionally implemented for its own
A work group for military preventive medicine will develop a coherent
strategy, process and standardised procedures that will enable known and
future health hazards to be identified and addressed.
The conclusions of COMEDS were as follows.
- COMEDS recognises the imperative to listen to the health concerns
of the military personnel.
- These health concerns and problems are best served by scientific
peer reviewed analysis, including independent studies.
- Third, based on such peer reviewed medical scientific data and on
the available national information, a link between depleted uranium
and the reported cancers cannot be established.
- Although presently there is no indication of any atypical illness
linked to the Balkans, the timely investigation of all reports of an
increased incidence of symptoms or pathologies is necessary. Again,
this ought to be performed in an open scientific an peer reviewed manner.
- It is in the interests of the veterans, the military and the medical
communities, and the local populations, that health risks related to
the operational environment be approached by medical services from a
multinational perspective in a transparent and independent manner.
- COMEDS will fully support the work of the Ad Hoc Committee of Depleted
Uranium established by the NAC.
- The issue of the health concerns will be discussed with our partner
medical community at the COMEDS plenary and PfP meeting in May.
- COMEDS will meet again to discuss this issue as more information becomes
Mr. Mark Laity : Just to help you out, when we mention the NAC,
that is the North Atlantic Council, which is the decision making body
at NATO which usually meets at Ambassadorial level. And the PfP is Partnership
Peace which is our organisation for liaising with the partners to NATO.
Colonel David Lam : I have been asked to present to you
today a synopsis of the currently known information on the health effects
of depleted uranium. I would like to point out that this is essentially
the same information that has
been dealt with by COMEDS, as you heard from General Van Hoof, and the
Military Committee in coming to the conclusions we have, it is simply
synopsis of the currently available peer reviewed medical and scientific
literature. This is an extremely complex physiological issue which is
unfortunately impacted more by political and emotional aspects than by
scientific ones in many cases. Entire books have been written on the
subject of toxicology, both heavy metals and radiation, and I do not
intend to simply regurgitate them to you today, I am trying to summarise
the current data.
The first thing I need to point out is that natural uranium is all
around us, it is in anything you eat, or drink, or breathe. You
currently have uranium in your body. When you are in bed at night with
your spouse you are getting radiation from that spouse. This is
something we can't get away from, it is present everywhere, and in fact
if you take approximately one foot of ground anywhere in the world and
scrape it off and analyse it, you will find between 2 - 40 tons of
naturally occurring uranium per square mile. It is all around us.
So what is depleted uranium? It is the uranium that is left after we
take out the highly radioactive U235 for use in nuclear weapons or
atomic fuel rods and things. Therefore it is inherently less
radioactive than the naturally occurring uranium which we are all
exposed to every day. It is approximately 40% less radioactive than
naturally occurring uranium. It is a heavy metal like lead, tungsten
and mercury. It is very mildly radioactive and theoretically at least
it can be potentially chemically toxic, as all the heavy metals are,
though it must be present in very large amounts in your body to have any
heavy metal toxicity. It burns very readily, especially upon impact
There are only two potential kinds of damage that your
body can receive from exposure to uranium, whether natural or depleted,
they fall into two categories: radiological or chemical. Unfortunately
there is very little scientific literature which directly addresses the
health effects of depleted uranium. However, there is a great
availability of studies over the past 100 years about the health effects
of natural, and more recently, enriched uranium and a review of that
literature is very relevant to our discussion. The toxicological, the
heavy metal effects of depleted uranium are exactly the same as those
As I have mentioned, the radiological effects, the
radiation part, always has to be less than natural uranium because we
have taken out so much of the highly radioactive isotopes. Generally
speaking, from a worker safety standpoint in all of the world, the
radiation aspects are not considered to be very significant when you are
dealing with depleted uranium, in fact in most countries it is not even
considered a radioactive waste product. The actual effects that you may
get in your body if you were exposed to sufficient quantities of
depleted uranium depend on several factors, whether it is internal, ie
did you breathe it or eat it, or external, does it come from outside
Internal effects theoretically can be either due to the
radiation or to the heavy metal poisoning, but external effects can only
be due to the radiation. The most extensive review of the world's
literature on the subject of the health effects of depleted uranium was
carried out by the Rand Corporation in 1999 as part of the United
States' investigation into the Gulf War illness problem.
Now up front I need to admit there is no doubt in anybody's mind that
radiation at very high levels can cause an increase in various cancers,
but this is at levels that you see when people are being treated for
cancer with radiation therapy, or after nuclear explosions. It has
never been demonstrated - and I repeat it has never been demonstrated
with low level radiation either in animals or people.
Although any increase in radiation can be calculated to perhaps be harmful
when you extrapolate from the higher levels, we don't have any studies
that show that this is in fact the case. This is very specifically due
to the fact that the human body is extremely efficient at excreting uranium.
If it gets into your body it will be excreted through the kidneys and
in your urine very rapidly. We do this extremely well and that means that
it is very, very difficult for you to get enough depleted uranium in your
body to cause any health effects, you tend to excrete it more than you
As only one example of this, even people with depleted uranium embedded
in their bodies, with chunks of this medal in their body due to war wounds
from the Gulf war, do not show any increased evidence of any health hazards
due to it, and we have now been following a cohort of these troops who
were struck by US weapons during the Desert Storm situation in the Gulf
now for almost 10 years and there has been no increase in health risks,
health hazards or cancers that we have found in any of these people.
Talking about radiation, radiation does pose the external health hazard
of DU, but it is comprised primarily of alpha beta and gamma particles.
95% of the radiation of depleted uranium is alpha particles which cannot
go more than two inches through the air and which cannot penetrate the
external layer of your skin. Therefore, as an external health threat this
simply does not cause health problems, they bounce off your skin basically.
The beta and gamma have a little bit more penetration but they are present
in such small quantities that we cannot find any scientific evidence that
in fact there is a health hazard at the levels that you get them in DU.
Especially in intact munitions, the ones that are uploaded in the tanks,
the radiation levels are far below those which are considered and proven
to be safe in radiation workers who have to deal with this stuff for an
8 hour day over an entire working life. The exposure levels are very low.
Studies of workers exposed to uranium in the work environment show no
skin cancers resulting from this exposure and no animal studies have found
skin cancers resulting from this cause.
As a point of perspective, to reach the safe occupational radiation dose
level for beta and gamma radiation, a soldier would have to hold an unshielded
tank sized round depleted uranium penetrator held tightly to his skin
for more than 250 hours, and that is in order to achieve something that
we can prove is a safe level.
This next chart is a little over-simplified, but it does give a
comparison with some other sources of radiation. A 30 mm depleted
uranium penetrator such as in that round over there will give you less
than 0.1 milirem (phon) per hour after it is expended if it is sitting
on the ground, that is a whole body exposure at 6 inches. The
background radiation that every one of us gets normally, naturally, just
by living in the world, is over 350 milirem per year, and in fact if you
smoke 2 cigarettes per day this year you will get more radiation from
that exposure than you would by holding that penetrator in your hand for
an hour. You get radiation when you fly, you get radiation when you
eat, it is out there. All I can tell you is that all of our evidence
shows that these things do not put it out at a high enough level to
The main routes of natural or depleted uranium into the human body are
by inhalation and ingestion, either you breath it or you eat it and
drink it. But when a DU weapon impacts a target, ie an enemy tank, the
fragments can penetrate the body and any dusts that are produced can be
inhaled, ingested or deposited on wounds. DU, like any uranium, as I
said does burn easily and when a penetrator strikes armour or burns it
produces uranium oxides, dusts or aerosols which can be inhaled. Once
it is into your body through inhalation, a small percentage of the
inhaled uranium is retained in the body. Most, however, is solubalised
and enters the bloodstream where it is then excreted through the
kidneys. A very small amount is deposited in the tissues.
As I have alluded to before, there are in fact documented adverse effects
from heavy metal aspects of DU if it is present in high enough quantities.
In all reality you can't eat enough to get a toxic effect, you can't breathe
enough to get a toxic effect and we have shown this in that the people
with the known highest exposure to inhaled uranium oxide dust from depleted
uranium are those soldiers who were in a tank which was struck by a DU
round. We have followed these gentlemen. They do not in fact have any
health effects due to this extremely high exposure level over a short
period of time. Long term low level exposures in animals can cause some
kidney damage, as does an acute high level exposure in man.
Again, we have never seen this with depleted uranium, only with naturally
occurring uranium or enriched uranium in a factory setting. No studies
which have been done on uranium miners, who chronically have a long term
low level exposure, show any increase in cancers due to chronic exposure
to uranium. A few do show an increase in lung cancer, but further evaluation
has shown that that is the result of the fact that those particular individuals
smoke and that they are highly exposed to radon gas which is present in
some uranium mines, there is not any good evidence that uranium per se
Extensive information is available about the health of workers in the
uranium industry, as you have heard me refer to a few times. No increase
in overall deaths has ever been observed in these workers as a result
of exposure to uranium. No evidence exists showing an association between
uranium oxide inhalation, exposure and adverse effects on the nervous
system, the immune system, in these workers. The kidney, as I have said,
is the target organ for uranium and experiences the most dramatic effects
if sufficient uranium is present.
A study of uranium mill workers occupationally exposed to a solubly uranium
compound reported that they had some reduced kidney function. However,
we have never seen this again in workers who are working around or who
are exposed to depleted uranium. When exposure is less than the approved
occupational safety limits, scientific literature does not indicate any
negative health effects. Negative effects from exposure to ionising radiation
from either depleted or natural uranium have not been seen in humans.
Cancer is the only radiation associated disease that has been shown to
be related to inhalation of radioactive particulates in humans, but there
is no evidence I can find in the literature of cancer or any other adverse
health effect related to the radiation received from exposure even to
natural uranium ores which is much more radioactive than depleted uranium.
No cancer, which of course includes leukaemia, has been demonstrated to
be due to either natural or depleted uranium exposure.
Some cancer rates have been studied in almost 19,000
highly exposed uranium industry workers who worked at
Oak Ridge Laboratories between 1943 - 1947, when we had
very limited health protection capability. We have looked
at these people now for almost 50 years and no excess
cancers have been found, even though they had major exposures.
Other epidemiological studies have been done and again
have either found no excess cancers or have attributed
them to other carcinogens than uranium, such as radon.
There have been no human studies which have shown association
between bone cancer and radiation exposure from natural
Now if you eat the stuff or drink it, the chemical toxicity of ingested
uranium is determined largely by the amount ingested, how much you take
in. This is controlled by the water solubility of the compound and therefore
the ease in which it gets into your bloodstream. Compared with industrial
compounds, uranium oxides are very insoluble and are very hard to get
absorbed. Most of it just gets excreted out through your gut in your stool.
In fact if you take a spoonful of depleted uranium right now, within 36
hours 90% of it will be out of your body and never will have been absorbed.
There are no studies which report either human deaths or other human
health effects from oral exposures to uranium oxides. Mortality, usually
from kidney failure, can be induced in animals at extremely high levels,
like if they are eating twice their entire body weight of uranium every
day. In the literature that I have reviewed, no increased illness or fatal
kidney disease has been observed in relatively large occupational populations
who are chronically exposed to natural or DU at concentrations very far
above those which we can document occurring at DU sites in the Balkans.
In summary, just to roll all this back together, I would like to point
out there is no evidence in any of the medical literature which I can
find of any increased health risks from exposure to depleted uranium,
specifically including cancer in leukaemia. Uranium and depleted uranium
have been extensively studied over a very long period of time and we have
studied them in people who have very high exposures and we cannot find
any relationship to cancer or leukaemias. I have found no scientific evidence
as of yet to support the current claims that DU is causing any health
damage to our soldiers in the Balkans.
While DU is considered potentially a hazard to our soldiers, it is only
a very low level one which would arise under only very select and extenuating
circumstances, it also would be ameliorated by the normal preventive medicine
and environmental health measures which we routinely take any time we
deploy troops, such as those which are taken to protect our people against
any kind of heavy metal exposures. Therefore, both as a clinician and
as an epidemiologist, I think the health risk from DU is minimal at worst.
If we determine after further evaluation that there is in fact a health
issue resulting from service in the Balkans, I think we need to look at
all the possible causes, such as other pollutants and other health hazards,
and not focus only on DU.
Question (Patricia Kelly, CNN): If soldiers get more radioactivity
sleeping with their wives or husbands, why then are they asked to take
precautions such as wearing masks when they are in the field dealing with
areas where depleted uranium ammunition has gone off in target areas?
My second question is that in your meeting yesterday and the reports on
the people that have died of leukaemia, are all the blood cancers the
same or are they different blood cancers? And thirdly, we have media reports
coming from Italy that the soldiers that died there had in fact not been
exposed to depleted uranium but to benzine and could you tell us if that
is what the conclusion of the Italian delegation was at your meeting yesterday?
Colonel David Lam : The first question has a very simple
answer, whenever we put troops into an area where there is any kind of
potential hazard we have them take normal protection measures. The issue
in areas where tanks have been
blown up by depleted uranium munitions is not necessarily depleted
uranium, there are a lot of other health hazards in a blown up tank,
ranging from petroleum, oil and lubricants to unexploded ammunition, to
for instance radon gas which does occur in the dials of some Soviet
built tanks. So this is simply the normal way we operate when you are
exposed to any potential hazards, we don't require any special training
or special protection measures simply because they are going to an area
where there may be DU.
Mr. Mark Laity : I think also it is important to pick up a point
there. No-one in NATO has ever said, as was implied, that depleted uranium
is totally harmless, we have said it is a low level hazard under specific
limited circumstances, and I think that is important because I have seen
quite a lot of reporting saying NATO says DU is harmless. We don't say
DU is harmless, we say it is a low level risk under specific limited circumstances
and we take the appropriate measures to ensure that even that low level
risk is eliminated. So when people wear masks and take protective measures,
this does not in any way suggest that we think that it is anything more
than we have always said, a low level hazard under specific limited circumstances.
With regard to Italian studies I would refer you to the Italian government
to get their information. We are talking here, almost every article that
we have seen, the reason that you are here today is because of a link
that has been drawn up between depleted uranium and leukaemia and that
has been the focus of your attention until now and it has been the focus
of our attention, and I think what you are seeing here is the increasing
evidence that would suggest that there is no link between leukaemia and
depleted uranium, and that is the focus of what has caused this story
and why you have all come here today.
Colonel David Lam : Let me answer your second question briefly
if I could. There are different kinds of leukaemia, they are very different
and they have very
different causes. Most cases of leukaemia, we have no idea what causes
them, some seem to be genetically induced, some seem to be due to toxic
chemical exposure, some can be due to very high ionising radiation
loads, but most just sort of happen and we don't know what they are. We
investigate them all, we look at them, but you cannot say leukaemia, is
leukaemia, is leukaemia. Medically speaking they are very different and
you cannot tell what caused them by looking at the blood under a
Question: Colonel Lam, do you know which kind of uranium was used in
the depleted uranium munition, is it possible that that might be inclined
Colonel David Lam : The answer is I cannot answer the question.
There normally is 235, 238 and several other isotopes involved. I cannot
specifically address 236
because I just don't know.
Question: Did General Van Hoof possibly have some information yesterday
Major General Van Hoof : I cannot answer that detailed question.
Mr. Mark Laity : Congratulations, you have stumped the panel.
Question: Cadena Ser (question asked in French) (Voice of interpreter)
From the medical point of view, these principles that you mention, that
is preventing access to these sites where there were weapons with depleted
uranium, is this necessary to prevent access to the site and another question,
since you had said that lung cancer is more due to cigarette smoking,
do you have scientific evidence to prove this?
Colonel David Lam : Yes, Ma'am, there are numerous studies that
have been done, especially in the uranium miners, that clearly identify
that the risk is stratified
by whether or not the uranium miners, all of whom had essentially the
same exposure to the uranium, have a much higher level of cancer in
their lungs if they also smoke. This has been very well proven. The
relationship between cigarette smoking and lung cancer is not debatable
Mr. Mark Laity : I think your second question about the screening,
the Military Committee is looking at the issue of the sites and what further
necessary or practical now, so we will get more information on that and
I think they will be reporting to the North Atlantic Council soon.
Mr. Unteanu (Romanian journalist), (question asked in French) (Voice
of interpreter): A question for the chairman of the medical COMEDS
- you mentioned the possibility of a-typical symptoms in the Balkans,
now what would this a-typical pathology be for the Balkans just as a study
subject for example?
Gen. Van Hoof (French - voice of interpreter): I didn't actually
talk about an a-typical disease for the Balkans we said in the report
we don't find in the information that we have received, we don't find
any specific a-typical disease linked to the Balkans. But when you talk
about a-typical diseases or illnesses, I would have to look at my report
again, but I don't think we talk about the disease as such in English,
it would be complaints, general complaints which might not be typical
but these are just health complaints of different kinds, especially coming
from people who have come back from the Balkans, they have different types
of complaints. We have looked at the epidemiogical information yesterday
and we saw that the frequency of these a-typical complaints is not necessarily
greater in those that were sent to the Balkans than in the military personnel
that have never been deployed to the Balkans. Nevertheless we are seriously
concerned because for us each complaint each health complaint by any military
person must be taken very seriously and we want these patients to get
over their complaints. Now, as long as we have no specific diagnosis on
the individual level, it is very difficult to start treating these complaints.
In our report we said that for these complaints which are not linked to
Balkans mission, there must be further studies undertaken to help our
Mr Laity: I think the point here is that I think there was a slight
misunderstanding there. They have not found any increased frequency of
atypical diseases, but there is a concern about the health of our soldiers
in general terms. If soldiers of NATO are suffering from illness they
deserve treatment. If there is anything which is unusual it deserves investigation.
Again I would remind that the issue is depleted uranium leukaemia but
beyond there is a bigger issue and that is the health of soldiers, if
the soldiers are ill then they deserve treatment, if there are unexplained
things that deserves investigation, but we should not sort of leap to
conclusions between them. The depleted uranium issue is separate from
something which is a priority for the Chiefs of the Medical Services which
is to ensure their soldiers are healthy at all times and under all available
Question : A question about the health of civilians in Kosovo.
Is NATO or KFOR going to investigate the other toxical metals because
some reports from the ground suggest that in Mitrovica for example every
third child has an overdose of lead in the blood? And Mark, considering
that you are already having contacts with the Yugoslav Army, did you ask
them what did they use in Kosovo and Bosnia during those ten years, starting
from 1989 when Serbian forces used sarin poison in Kosovo?
Mr. Mark Laity : On the issue of general health, NATO is a military
alliance. We are in KFOR as part of an international alliance with as
many other organisations there. Environmental health is a concern to us
generally but it is of more specific concern to some of the other organisations
who deal with the civilian aspects of the international involvement in
I think that we do all know though that there are severe environmental
problems in Kosovo, they are related to things that have been going on
there for a very long time. KFOR shut down the smelter in the vicinity
of Mitrovica for precisely that reason, because it posed an extremely
severe health hazard and I think that we have to acknowledge the environmental
situation in Kosovo is not good, therefore people are falling ill because
of environmental hazards, we know that, but there are many organisations
involved in that and KFOR is not a prime mover in that particular area.
With reference to your second question, we have only just started the
kind of contacts with the Yugoslavs reflecting the improved cooperation
which has followed the election of President Kostunica and the new government
so we will be talking about all sorts of things, it is too early to get
down to specifics but I would like to mention that we want them involved
in this kind of thing as well, we will be talking to them about these
kind of issues in due course and they have already asked us, and they
have said publicly, that they want to cooperate with us over this particular
issue and we will be co-operating with them.
I don't know whether you want to make a particular point about the
number of environmental hazards there are in Kosovo?
Colonel David Lam : No, I think you have covered it well. The
fact is this is
environmentally a very dangerous area right now, as he said for things
that have gone on for many years, it has nothing to do with the war in
Kosovo. The Mitrovica lead factory is a primary example. We are
looking at all these potential threats, we try to ameliorate them when
possible, but as he also said, most of the responsibility for protecting
the civil populous against environmental threats is the role of other
agencies, not NATO.
Question: General Van Hoof, you said that there is not one pathology
but a number of different symptoms amongst soldiers who served in the
Balkans and if
I understood you well you said that there is not a higher incidence of
those different illnesses than between soldiers who have not served in
the Balkans. So two questions, do you first have already the necessary
data to be sure of that; and secondly, does that mean you are saying
there is no Balkans syndrome at all?
Major General Van Hoof : As to Kosovo and the fact that we are
certain or sure that this statement is true, I can refer you to what I
said in the report, based
on the available peer reviewed medical scientific data several countries
presented such epidemiological data so I think based on that evidence
can make that statement. As to the concern to the definition of Balkans
syndrome, it is written also in the final report that COMEDS suggest not
to speak about a syndrome, a syndrome is a complex of symptoms that
progress in one way for one pathology and we deal here with different
complaints and some symptoms, different complaints, so we cannot speak
about the syndrome and COMEDS prefer to speak about health concerns
among military personnel returned from the Balkans.
Question: But if you say that those complaints among the Balkan veterans
apparently are not more frequent than among other soldiers then
apparently there is not any issue at all then?
Major General Van Hoof : That finally what we believe, what will
come out of the epidemiologic studies that we will and that all nations
will start in future. What we
say now it is from the available data we reviewed yesterday.
Mr. Mark Laity : Just to say that epidemiological studies take
a long time. Some of the available ones are particularly the United States
and the UK which are
related to the Gulf conflict and you can for instance go to their
websites and you can actually pick up information. The British for
instance have a control group which as it happens includes people who
went to Bosnia, people who served in the Gulf and people who served in
neither, and I think that the figures between them don't differ overly
much, though I would urge people to look at it and draw their own
conclusions because I am speaking from memory. But epidemiological
surveys are not quick, again it is another example of the fact that we
need calmness, science, time and patience to actually get at this rather
than leap to conclusions, but the assessment so far is nothing, but that
is why COMEDS have said they want to see more and that is why NATO has
its Ad Hoc Committee and wants to do more, to make sure that we
leave no stone unturned.
Question: France Soir: If I understood correctly, NATO is concerned about
the health of its military and if my memory serves me, the Balkan operations
didn't start yesterday and you must already have some results at least.
You had the leisure to do all that you were able to do with all the seriousness
that it merits, because it wasn't actually discussed in the media until
now, so there should be some results available. They did not come back
yesterday. They have already been back for some years now.
Colonel David Lam : I will answer that one, if I could. The answer
I believe is what
General Van Hoof stated. The results of studies that we currently have
available, ie the ones that have been done over the past 5 or 6 years
all of our nations, have not shown any increased incidence of illness
people who have deployed to the Balkans. So your point is correct, yes,
we have a lot of experience with this and so far we have no evidence of
any illness that came from this.
Question RTBF: three questions for General Van Hoof, if I may.
Are there any plans to publish a complete list of symptoms and illnesses
that might be linked to a Balkan syndrome? Because as you have said it
is not just a question of cancer, and would there be a complete list that
might be published, secondly are you going to delve into other tracks,
not just the depleted uranium, are you going to look into other areas
of interest and which are they? And thirdly, amongst all the nations have
you decided on a method to follow-up this epidemiological work , because
we have seen in Belgium that there was a study undertaken which has certain
problems because some questions were not actually given to the soldiers
who had been discharged for health reasons or for those who were actually
on long-term sick leave?
Mr. Mark Laity : I think some of the questions there are a little
bit too early. The
COMEDS yesterday decided on a course of action and how far ahead they
are going to move and that includes a variety of studies. But I think
also we are concerned about things that affect our soldiers and
specifically the issue that has been aroused which is the links between
depleted uranium and disease, and overwhelmingly leukaemia. We are not
in a position where we should be launching other things which go beyond
that. What nations themselves can do is if they are concerned they have
the absolute right and they feel the obligation to investigate
everything that they want to, and NATO with its Ad Hoc Committee, the
COMEDS as a group of senior military medical officers, can take this
information in and they can exchange it, they can work on it, they can
advise each other and disseminate it. But we have started this process
and you are asking us to give you our conclusions and I don't think that
is the case.
Major General Van Hoof :As regards Belgium, I don't think that
this is the appropriate forum to explain the ins and outs of the Belgian
position and what we are going to do, so I can always do that outside
of this meeting but there is a simple explanation for the accusations
that you just mentioned.
Question in French (Le Monde) to General Van Hoof: What you say
is quite striking but we have in mind the Gulf War and the Gulf syndrome
and it took some time for NATO to recognize that there was a problem with
the Gulf syndrome and tI have here statements from the US government on
the Gulf syndrome so I wonder whether there is a problem of credibility
and whether the public opinion really can trust what you are saying today?
Mr. Mark Laity : NATO wasn't involved in the Gulf War, so it isn't
a question, it was a
coalition of nations so we were not involved in the Gulf War. We are
prepared to learn lessons of the people. I believe the present controversy
started with a group of leukaemia victims amongst the Italians, which
came out late last year, with also some reported leukaemia incidents in
Portugal and Spain and since then in other countries. We are now in the
middle of January. We have set up ad hoc committees to liaise with other
organisations. We have provided a
massive body of work already. We have dipped into the scientific community
to provide material. We are acting as a clearing house for information.
So I think that the Gulf War happened 10 years ago. In NATO terms this
issue has become controversial to NATO rather than individual nations
for about three weeks. I think we are doing pretty well.
Question: You said before that the literature and the studies on depleted
uranium are very limited at this point. Can you be more specific about
limited they are, and can they be too limited to be reliable at this point?
Colonel David Lam : I would say no they are not too limited to
be reliable. The reason no-one has studied depleted uranium in any great
depth is because of the
wide-ranging studies that have already been done on natural uranium
which is more toxic. So if we have studies that clearly show that
natural uranium is not dangerous in most circumstances, there is no
reason to study depleted uranium which by its very nature is less
radioactive and therefore less toxic. So it is simply a matter of the
literature is comprehensive enough, and good enough for the uraniums as
a whole, but there is no scientific need to study depleted uranium per
Question: Colonel Lam, you made an analogy between depleted uranium and
smoking cigarettes. Your words were, I believe, a person smoking two cigarettes
a day for one year would get more radiation than if you were holding a
depleted uranium weapon penetrator close to his body, and I didn't get
for what period of time. The same year?
Colonel David Lam : No sir. I said specifically, number one it
was a 30 millimetre depleted uranium held at 6 inches, and that was a
one hour exposure. What you
get is less than 0.1 millirem per hour from a 30 mm depleted penetrator
at 6 inches, whole body exposure. From smoking you get approximately
125 millirem times the number of cigarettes you smoke per day for the
year. So if you smoke 2 cigarettes a day, you will receive
approximately 250 millirems equivalent whole body exposure, as compared
to less than 0.1 millirems from the D.U.
Mr. Mark Laity : So give up smoking.
Colonel David Lam : A good answer.
Question: Colonel Lam, is it possible that we can forget about this uranium
and eventually think about some other material that probably you are not
aware of, and that has been used and causing some problems? And
another question, the Portuguese Army Chief of Staff said last December
that he didn't believe in any problem of health but more some Serbian
propaganda. Can you imagine that this is what we have to look for?
Colonel David Lam : The first question is of course. As General
Van Hoof said we continue to be concerned about the health complaints
and concerns of our
soldiers. We are looking into them to see if there is any unifying
factor. If we can say, hey, there is an increased incidence of such and
such a complaint and we are looking into potential things that could
have caused it, certainly, we want to look at other environmental
hazards, exposures to chemicals, to lead and so forth. At the present
time, however, we have not found any such evidence, but we are looking
into it, and that is why we have our working group on military
preventive medicine developing a new programme that all the nations can
take a look at and decide whether or not to implement. The second
question was about Serbian disinformation. I cannot comment. I'm
sorry. That's outside my area.
Mr. Mark Laity : Let me answer that. The fact is that the reason
we are here is because the public have had concerns because soldiers have
fallen ill, because
there is an issue. We are dealing with that issue. We are not going to
get involved in individual nations, or individual comments, or
individuals and what they said. The fact is that you are concerned, the
public is concerned, our soldiers are concerned. We think there are a
lot of answers already and we have given you some of them today, but
there are other answers that we can find, and we are not complacent, so
we are still working on it. That is why we are here.
Question: It is possible there was some stuff being used in weapons that
you are not aware of, during this conflict?
Colonel David Lam : In all honesty, of course, there is a possibility
of many things being used by many people. I am not saying yes, I am saying
I don't know what
has been used in weapons by other nations and other people.
Mr. Mark Laity : What in fact you are saying is do you have 100
% knowledge of
everything? Well, does anyone have 100% knowledge of everything? The
answer is, if you want a philosophy tutorial, let's go down that road.
But that is an absurd question. The fact is that Colonel Lam is a
medical expert giving you the best available review of documentation.
What you are asking for him is to be God. Well, he ain't, and neither
am I, and neither are you.
Question (El Pais) - question in French: You said that depleted
uranium is found everywhere, but in what quantities? Have the exposure
to depleteted uranium increased for our soldiers in the Balkans and what
is the point of comparison between the sort of normal exposure and what
our soldiers have been exposed to?
Colonel David Lam : Basically, several nations have implemented
study protocols on their soldiers who are having various medical complaints.
In many countries,
part of this study is an evaluation of the amount of radiation, amount
of uranium, that is being put out in their urine. That is an accurate
reflection of the body load of uranium. None of these nations has found
any soldiers with uranium above the normal body background levels.
Therefore, we can pretty much with confidence say there have not been
any exposures above normal background radiation.
Mr. Mark Laity : I know there are more questions, but the ad hoc
committee on this issue is about to meet. I am a member of it, so I have
got to go, and you have had an hour, which I think is a fair crack. I
am sure we will be returning to this, and we are going to stay open on
it. Thank you very much indeed.