Open Access Open Badges Research article

Metals detected by ICP/MS in wound tissue of war injuries without fragments in Gaza

Sobhi Skaik1, Nafiz Abu-Shaban2, Nasser Abu-Shaban3, Mario Barbieri4, Maurizio Barbieri5, Umberto Giani6 and Paola Manduca7*

Author affiliations

1 Shifa Hospital, Gaza, Palestine

2 Plastic surgery Dept. and Burn Unit, Shifa Hospital, Gaza, Palestine

3 FRCSI, Gaza, Palestine

4 Istituto di Geologia Ambientale e Geoingegneria, C.N.R., Rome, Italy

5 Dept. Scienze della Terra, University of Rome, Rome, Italy

6 Dept. of Preventive Medical Sciences, Faculty of Medicine, University Federico II, Naples, Italy

7 Dept Biology, University of Genoa, Genoa, Italy

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Citation and License

BMC International Health and Human Rights 2010, 10:17  doi:10.1186/1472-698X-10-17

Published: 25 June 2010



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.


Biopsies of "wounds without fragments" from clinically classified injuries, amputation (A), charred (C), burns (B), multiple piercing wounds by White Phosphorus (WP) (M), were analyzed by ICP/MS for content in 32 metals.


Toxic and carcinogenic metals were detected in folds over control tissues in wound tissues from all injuries: in A and C wounds (Al, Ti, Cu, Sr, Ba, Co, Hg, V, Cs and Sn), in M wounds (Al, Ti, Cu, Sr, Ba, Co and Hg) and in B wounds (Co, Hg, Cs, and Sn); Pb and U in wounds of all classes; B, As, Mn, Rb, Cd, Cr, Zn in wounds of all classes, but M; Ni was in wounds of class A. Kind and amounts of metals correlate with clinical classification of injuries, exposing a specific metal signature, similar for 2006 and 2009 samples.


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.