As the Bush administration prepares to make war on the Iraqi people -- and make no mistake, it is the civilian population of that country and not Saddam Hussein who will bear the brunt of the hostilities -- it is important that we recall the medical consequences of the last Gulf War. That conflict was, in effect, a nuclear war.

During the 1991 Gulf War, the United States deployed hundreds of tons of weapons, many of them anti-tank shells made of depleted uranium 238. This material is 1.7 times more dense than lead, and hence when incorporated into an anti-tank shell and fired, it achieves great momentum, cutting through tank armor like a hot knife through butter.

What other properties does uranium 238 possess? First, it is pyrophoric: When it hits a tank at high speed it bursts into flames, producing tiny aerosolized particles less than 5 microns in diameter that are easily inhalable into the terminal air passages of the lung. Second, it is a potent radioactive carcinogen, emitting a relatively heavy alpha particle composed of 2 protons and 2 neutrons. Once inside the body -- either in the lung if it has been inhaled, or in a wound if it penetrates flesh, or ingested since it concentrates in the food chain and contaminates water -- it can produce cancer in the lungs, bones, blood, or kidneys. Third, it has a half-life of 4.5 billion years, meaning the areas in which this ammunition was used in Iraq and Kuwait during Gulf War will remain effectively radioactive for the rest of time.

Children are 10 to 20 times more sensitive to the effects of radiation than adults. My fellow pediatricians in the Iraqi town of Basra, for example, are reporting an increase of 6 to 12 times in the incidence of childhood leukemia and cancer. Yet because of the sanctions imposed upon Iraq by the United States and United Nations, they have no access to drugs or effective radiation machines to treat their patients.

The incidence of congenital malformations has doubled in the exposed populations in Iraq where these weapons were used. Among them are babies born with only one eye or missing all or part of their brain.

The medical consequences of the use of uranium 238 almost certainly did not affect only Iraqis. Some U.S. veterans exposed to it are reported, by at least one medical researcher, to be excreting uranium in their urine a decade later. Other reports indicate it is being excreted in their semen. (The fact that almost one-third of the American tanks used in Desert Storm were themselves made of uranium 238 is another story, for their crews were thereby exposed to whole-body gamma radiation.)

Would these effects have surprised the U.S. authorities? No, for incredible as it may seem, the American military's own studies prior to Desert Storm warned that aerosol uranium exposure under battlefield conditions could lead to cancers of the lung and bone, kidney damage, non-malignant lung disease, neurocognitive disorders, chromosomal damage and birth defects.

Do George W. Bush, Dick Cheney, Paul Wolfowitz, Condoleezza Rice, and Donald Rumsfeld understand the medical consequences of the 1991 war and the likely health effects of the next one they are now planning? If they do not, their ignorance is breathtaking; even more incredible though -- and alas, much more likely -- is that they do understand, but do not care.

Helen Caldicott has devoted the last 25 years to an international campaign to educate the public about the medical hazards of the nuclear age. She spoke in San Francisco recently in a benefit for the Nuclear Policy Research Institute, which she founded.

©2002 San Francisco Chronicle

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