Cross-sectional biomonitoring of metals in adult populations in post-war eastern Croatia: differences between areas of moderate and heavy combat.

AIM To determine differences in metal and metalloid exposure between residents of areas in eastern Croatia exposed to heavy fighting during the war in Croatia and residents of areas exposed to moderate fighting. METHODS Concentrations of aluminum (Al), arsenic (As), barium (Ba), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), nickel (Ni), lead (Pb), uranium (U), vanadium (V), and zinc (Zn), reported to be associated with military operations, were determined in hair, serum, and urine samples using inductively-coupled plasma mass spectroscopy. A total of 127 and 46 participants from areas of heavy and moderate fighting, respectively, were included. RESULTS Compared with participants from areas exposed to moderate fighting, participants from areas exposed to heavy fighting had significantly higher serum concentrations of Al (87.61 vs 42.75 μg/L, P=0.007), As (5.05 ∓ 1.79 vs 4.16 ∓ 1.55 μg/L, P=0.003), Ba (7.12 vs 6.01 μg/L, P=0.044), and V (17.98 vs 16.84 μg/L, P=0.008); significantly higher urine concentrations of As (43.90 vs 11.51 μg/L, P<0.001) and Cd (0.67 vs 0.50 μg/L, P=0.031); and significantly higher hair concentrations of Al (12.61 vs 7.33 μg/L, P<0.001), As (0.32 vs 0.05 μg/L, P<0.001), Cd (0.03 vs 0.02 μg/L, P=0.002), Fe (22.58 vs 12.68 μg/L, P=0.001), Pb (1.04 vs 0.69 μg/L, P=0.006), and V (0.07 vs 0.03 μg/L, P<0.001). CONCLUSION Differences between populations from eastern Croatian areas exposed to heavy and populations exposed to moderate fighting point to the need for extensive monitoring of metal and metalloid exposure, emphasizing the role of biomonitoring through ecologic and preventive activities.