1 February 2001

WHO Expert Team Winds Up Kosovo Visit on DU PRISTINA-At the request of UNMIK, a four person team from WHO has been in Kosovo since 22 January, 2001, assessing any possible health consequences arising from the use of depleted uranium (DU) in the shell tips of bombs used by NATO during the war. The team was asked to present their conclusions and recommendations as quickly as possible so UNMIK can take any necessary action to deal with depleted uranium sites. The team extensively reviewed all available information, visited DU sites, and met with a wide range of organizations including health units and hospitals, KFOR contingents, medical and environmental NGOS and agencies, and various UN and other organizations with a direct interest in depleted uranium. On 31 January they presented a draft report to Tom Koenigs, DSRSG-Civil Administration. The final report will be released from WHO Headquarters in a week. But the general conclusions and recommendations are listed below. Conclusions of the WHO Experts Team: Depleted uranium is only weakly radioactive and emits about 40% less radioactivity than a similar mass of natural uranium. Scientific and medical studies have not proven a link between exposure to depleted uranium and the onset of cancers, congenital abnormalities or serious toxic chemical effects on organs. Caution has been expressed by scientists who would like to see larger body of independent (i.e. non-military) funded studies to confirm the current viewpoint. Soldiers, particularly those at the site of an attack, are the most likely to have inhaled uranium metal and oxides in dusts and smoke. Except possibly in isolated instances, the general population likely would have not have encountered DU in this manner. The presence of plutonium in the depleted uranium used in Kosovo has not been detected so far by laboratories analysing samples from DU sites. No firm medical evidence was found by the team to link individual medical cases in Kosovo to exposure to depleted uranium. The present health information system on non-communicable diseases in Kosovo is in a state of chaos in spite of the best efforts of many people. There is a prevailing tendency, in the absence of a functioning health information system and reliable population data, to speculate that each individual medical case may indicate a rising trend of illness. The presence of high levels of lead in people in the Mitrovica region and the lack of means to implement a strategy for the long-term reduction of exposure to lead, together with the alarmingly high rate of traffic-related deaths, were both observed by the team to require urgent attention by UNMIK and other organisations. Depleted uranium issues are small in comparison to these involuntary causes of death or incapacity. For a typical type of attack site on soft soil only a very small fraction of the depleted uranium from the penetrators is likely to exist in the form of uranium oxides or metallic dust on the surface. Even if dispersed, it would likely become diluted to background concentrations. It is not very soluble. So, even if some were ingested only a tiny percentage is likely to be absorbed in the body and even then, most what is absorbed would be eliminated from the body through the kidneys. Over 70% of the depleted uranium penetrators at a typical attack site on soft soil are likely to still be in solid form and buried at depths of up to 3 m., isolated from human contact. The corrosion and degradation of depleted uranium in solid metallic form occurs slowly over hundreds of years. For example, in soil containing 1.4 t of natural uranium per square kilometre, the entire, gradual degradation of depleted uranium at the illustrative attack site would only add about 5% to the natural uranium. The only sites where higher percentages of depleted uranium may be at the surface are those with hard ground surfaces. These should be regarded as the priority locations if or when any remedial measures were considered. The most likely way civilians could come into contact with depleted uranium is through picking up objects from the ground. Consequently, routine measures to remove depleted uranium objects from the ground surface would be beneficial. The likelihood of depleted uranium entering agricultural products is not known but can reasonably be expected to be small given that most of the depleted uranium is in a solid, very slow degrading metallic form. The likelihood of depleted uranium contaminating drinking water supplies is unlikely. Recommendations: Preparation of useful and realistic information on depleted uranium for distribution to the general public. Encouragement of the public understanding that penetrators should be treated with caution in the same way as any other type of munitions. The public should be advised that if a penetrator is found, it be reported to the authorities in the same manner as mines and unexploded ordnance. Reinforce the terms of reference of the Department of Health and Social Welfare Commission of Kosovar Experts to ensure that it is a focus of an emerging technical capacity within Kosovo to advise UNMIK in the future. Utilise the Commission of Experts to bring together the local, regional and international bodies to agree a common approach for an improved medical data recording system for Kosovo. This is urgently required. A comprehensive health information system should be operational as soon as possible. Mass screening of the population is not recommended on the basis of evidence found in the literature, deductions made by the mission team, and respected advice that was received. The team is sensitive to the strong beliefs held by some members of the public. If these beliefs persist then a more limited testing regime could be considered based on a medical referral by a local doctor. The creation of an immediate, separate, cleanup programme at depleted uranium sites is not recommended. Site surface cleanup should, whenever possible, be part of planned, routine de-mining activities. The buried penetrators are unlikely to decompose quickly and hence, their addition to the natural environmental abundance of total uranium in soil will be small. Facilities should be made available to include the measurement of uranium in routine drinking water quality samples taken by IPH for public health monitoring purposes. Longer-term Recommendations: UNMIK should make a firm commitment to recording and assessing all forms of medical illness and prepare six-monthly public reports on the incidence of all forms of illness initiated by whatever cause. Future environmental assessment and development planning measures initiated by UNMIK should ensure that potential developers near or at former attack sites are made aware of the possibility of buried munitions. They should be given clear instructions on who should be notified if ordnance is unearthed.