WHO News

WHO to explore health risks in Gulf and Balkans war zones

WHO wants to carry out a US$ 20-million, four-year investigation into environmental risk factors, including depleted uranium and other radioactive metals, which may have led to alleged increases in cancers and other illnesses in the Balkans and the Gulf. In the shorter term, WHO is looking for US$ 2 million to fund operations in the two emergency areas over the next six months.

The two regions have been the scene of violent conflict over the past 10 years and WHO will investigate the health status of civilian populations and humanitarian personnel who have been working there. Europe has been in the grips of a panic since 30 Balkans veterans became ill, among them five who died from leukaemia.

The media have concentrated on depleted uranium (DU) as the likely cause of the purported increase in disease. More recently, the focus has widened to include other radioactive metals, such as plutonium, neptunium and americium, found in shells used by the US military in Kosovo, according to press reports. But Xavier Leus, Director of WHO’s department of emergency and humanitarian action, says the current speculation about possible health risks of DU is ‘‘unacceptable’’. ‘‘Evidence on the incidence of cancers needs to be strengthened in communities within Iraq and the Balkans in order to draw any epidemiological conclusions,’’ he said. ‘‘There is also very little information on other possible risk factors for civilians and the military that may be equally important.’’

Over the next four years, WHO will attempt to find out first of all whether or not there has been a true increase in cancers, including leukaemia, and in other noncommunicable diseases, and if so what environmental factors in the region might be to blame.

Possible risk factors include, for the Balkans, pollution from heavy industry and mining activities in the region and, for the Gulf, environmental pollution and chemicals which may have been used in the Gulf War and the Iran–Iraq War. Radioactive metals are just one category of possible agents being considered, WHO says.

WHO has appealed to the international community for US$ 2 million to cover its investigations in Iraq and the Balkans over the next six months and says about US$ 20 million will be needed over the next four years to carry out in-depth studies. The immediate needs include field surveys, the strengthening of national surveillance systems for noncommunicable diseases, including cancers, and the deployment of toxicologists, and radiation and chemical experts.

WHO has invited experts from Iraq to a meeting in Geneva, at a still unspecified date, to help draw up guidelines for the investigation into the possible health effects of environmental contamination in the Gulf Region. The Iraq government maintains that exposure to DU is responsible for an increase in cancers and congenital malformations among the civilian population. Since 1995, WHO has been working with the ministry of health in Iraq to rebuild the country’s cancer registries, so that trends in cancer incidence can be recorded and verified.

In late January, WHO sent a team of environmental health experts to Kosovo to make an initial assessment of the data available on population exposure to DU and other contaminants and its possible damage to health. It is currently reviewing hospital data on cancer incidence and has made recommendations for improved surveillance and environmental safety measures.

WHO is currently completing a thorough review of the scientific evidence for health effects from exposure to DU. ‘‘This report should be completed in March and will form a reference from which health risk assessments can be made for different exposure situations,’’ Mike Repacholi, who is coordinating the production of the WHO scientific review, told the Bulletin.

Meanwhile, samples of DU found at 8 of the 11 sites in Kosovo inspected by the United Nations Environment Programme (UNEP) during a field assessment in November 2000 are currently being analysed at five European laboratories. The UNEP team collected samples of soil, water, milk, and vegetation, and carried out smear tests on buildings, vehicles, and weapons. Some 340 samples are currently being examined for both radioactivity and toxicity. The results are due in early March.

Most studies to date — mainly involving uranium workers and people affected by the Chernobyl disaster — suggest that, at low exposure rates, the health risks from exposure to DU are low. However, WHO maintains that the evidence available is too limited to be conclusive.

What is known is that the heavy metal component of uranium can cause kidney damage in experimental animals. And some studies suggest that long-term exposure could cause similar damage in humans. The radiological risks include a possible increased risk of lung cancer if DU particles are inhaled and an elevated risk of other cancers, including leukaemia, only if DU is absorbed into the blood or other organs.

However, it is thought unlikely that DU could be responsible for the leukaemia cases reported among military personnel who served in the recent conflict in Kosovo, since the disease normally takes at least five years to develop after exposure to radiation.

Sheila Davey,
, Switzerland

World Health Organization Genebra - Genebra - Switzerland
E-mail: bulletin@who.int