Health Aspects
of the Balkans-DU Crisis:
The Italian Experience
AD
HOC Committee on Depleted Uranium (AHCDU)
As reported at the last COMEDS Plenary, the Italian MOD, also because
of the media and public opinion pressure, at the end of last year took
the following decisions regarding the "D.U. crisis" (slide
1).
Even though field surveys for DU environmental contaminations gave negative
results, a new health protocol for pre-post deployment assessment in the
Balkans was carried out since January 2001 (slide
2).
On the 22nd December 2000 the Italian MOD appointed an ad hoc Commission
of experts (slide 3).
This Commission has been conducting the following studies (slide
4).
The studied population is shown in slide 5.
The confirmed cases of malignant neoplastic diseases (up to 31.1.2001)
are listed in slide 6.
In a first report, press released on the 18th March 2001 by the MOD Commission,
a comparison was made involving the relationship between the tumour cases
"observed" in military personnel deployed in Bosnia and Kosovo,
and the number of cases "expected" among that same population
referred to in the Italian tumour registries. Only 28 cases with confirmed
diagnosis were utilised (slide 7).
Data analysis shows that considering all the malignant neoplastic diseases
(haematological and non), there is a significantly lower number of cases
than those expected. There is instead an increase (but statistically not
significant) in cases of HL and ALL, although at present these figures
could be a chance occurrence (slide 8).
Regarding the role of Depleted Uranium (DU) a number of preliminary considerations
are being taken into account from data found in other scientific literature
and from the results of measurements carried out by International and
Italian Organizations (U.N.E.P., C.I.S.A.M.).
An evaluation of DU exposure effects on Italian military personnel deployed
in Bosnia or Kosovo is currently being undertaken: urine samples from
100 soldiers with different assignments will be analysed before deployment
and after at least two months service in Bosnia or Kosovo through radiotoxicological
examinations. The same soldiers, post deployment, will undergo a Whole
Body Counter (WBC) examination (High and Low energy). These examinations
are to determine the presence of DU as well as normal Uranium. The low
energy WBC allows the evaluation of U-238 presence in the lungs, the organ
considered mainly at risk from insoluble Uranium particle contamination.
The high energy WBC highlights the presence of other radioisotopes, both
natural and artificial, which are above normal values as they create disturbances
in the low energy spectrum. An example is the greater than average amount
of the natural radioactive isotope of potassium K-40 which can be found
in highly athletic people.
The urine samples supply data on the quantity of Uranium excreted, but
also highlight, when there is a significant amount, the differences between
various Uranium isotopes and in particular between U-235 and U-238 allowing
the evaluation of the DU component. The combined analysis of this data
will allow the detection of minimal quantities and at the same time reduce
the possibility of false results.
The minimum amount of DU detectable depends on many parameters, among
which the most important is the natural level of Uranium found in the
body, dependant on eating habits, physical build and place of residence.
In any case the measures proposed will guarantee a level of exposure below
the maximum yearly amount permitted for professional reasons (20 mSv),
a level which takes into account long term exposure, i.e. over the next
50 years (slide 9).
Preliminary conclusions (by MOD Commission):
· According to international scientific literature, a causal correlation
between HL and internal exposure to DU, has not been demonstrated so far.
· The excess number of HL, even though not statistically significant
at the moment, deserves to be carefully evaluated, therefore it has been
deemed necessary to follow over time the military personnel deployed in
Bosnia or Kosovo. Careful monitoring is indispensable to identify eventual
new cases.
· Specific exchange of information with other NATO Partners would
be highly appreciated.
· Of course it would also be very useful also to follow these
neoplastic diseases among the civilian population living in Bosnia and
Kosovo (slide10).
· However, if a significant excess were to be found, since a causal
relationship between external exposure to DU and lymphomas has never been
demonstrated, also other factors should also be considered (slide
11).
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