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.
The presence of toxic and carcinogenic metals in wound tissue is indicative of the presence in weapon inducing the injury. 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 these data suggest the need for epidemiological and environmental surveys.
We show that metals, in particular known toxic and carcinogenic metals, were delivered by "not fragmentation weapons" producing amputations, body charring, burns, and were associated with WP burns.
We show that in each class of injury were detected metals carcinogenic for human, possible carcinogenic, or fetotoxic (i.e. genotoxic or/and teratogenic or/and impairing fetal development), with acute intoxicating effects and active in time, causing pathologies. In all cases, these were in amounts higher than the MRL for acute exposures, and than the known cumulative MRL for chronic exposures.
We show that the presence of these metals in fragment-free wounds differs for each class of injury, identifying a "specific metal signature" for each causing weapon.
We are not aware of data of similar nature or impact published before.
The information we present, that a specific cluster of metals characterizes different class of injuries without fragments, might be useful also for specific countermeasures, of immediate application, on survivors from injuries.
Projects of study on environmental and human contamination and remediation strategies should be undertaken and made possible through the International Institutions committed to these studies.