Weapons without fragments, long-term risks

The amount and identity of metals incorporated into “weapons without fragments” remain undisclosed to health personnel. This poses a long-term risk of assumption and contributes to additional hazards for victims because of increased difficulties with clinical management. We assessed if there was evidence that metals are embedded in “wounds without fragments” of victims of the Israeli military operations in Gaza in 2006 and 2009. Biopsies of “wounds without fragments” from clinically classified injuries, amputation (A), charred (C), burns (B), multiple piercing wounds by White Phosphorus (WP) (M), were analyzed by ICP/MS for content in 32 metals. Toxic and carcinogenic metals were detected in folds over control tissues in wound tissues from all injuries: in A and C wounds (Al, Ti, Cu, Sr, Ba, Co, Hg, V, Cs and Sn), in M wounds (Al, Ti, Cu, Sr, Ba, Co and Hg) and in B wounds (Co, Hg, Cs, and Sn); Pb and U in wounds of all classes; B, As, Mn, Rb, Cd, Cr, Zn in wounds of all classes, but M; Ni was in wounds of class A. The presence of toxic and carcinogenic metals in wound tissue is indicative of the presence in weapon inducing the injury. Kind and amounts of metals correlate with clinical classification of injuries, exposing a specific metal signature, similar for 2006 and 2009 samples. Metal contamination of wounds carries unknown long term risks for survivors, and can imply effects on populations from environmental contamination. We discuss remediation strategies, and believe that this knowledge can suggest epidemiological and environmental surveys.

This study was conducted by:

Sobhi Skaik, Nafiz Abu-Shaban, Nasser Abu-Shaban, Mario Barbieri, Maurizio Barbieri, Umberto Giani, Paola Manduca

Sobhi Skaik: Shifa Hospital, Gaza, Palestine

Nafiz Abu-Shaban: Plastic surgery Dept. and Burn Unit, Shifa Hospital, Gaza, Palestine

Nasser Abu-Shaban: FRCSI, Gaza, Palestine

Mario Barbieri: Istituto di Geologia Ambientale e Geoingegneria, C.N.R., Rome, Italy

Maurizio Barbieri: Dept. Scienze della Terra, University of Rome, Rome, Italy

Umberto Giani: Dept. of Preventive Medical Sciences, Faculty of Medicine, University Federico II, Naples, Italy

Paola Manduca: Dept Biology, University of Genoa, Genoa, Italy