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Balkan Dust Storm

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It sounds so eerily familiar. young men in the prime of their lives return from the war zone and fall ill with an assortment of ailments. First a tiny handful, then dozens are diagnosed with leukemia, non-Hodgkins lymphoma, skin cancer and other tumors. Still more complain of intense fatigue, muscle pain, shortness of breath, rashes, chronic infections, sudden hair loss and other physical and psychological problems. Some die. Fear grips families. Politicians and defense chiefs express concern, squabble, float theories, point fingers or issue denials. Everyone demands an explanation. Nobody has a definitive one, especially not the scientists.

In what appears to be a mushrooming European version of the controversy over the host of debilitating, often fatal, illnesses that afflicted tens of thousands of soldiers and Iraqi civilians after the 1991 Gulf War, troops who served in the Balkans are being stricken by an array of illnesses. Suspicion and speculation about the cause of the problems — loosely labeled "Balkans syndrome" — have fallen on munitions containing depleted uranium. A toxic and slightly radioactive by-product of the nuclear fuel-processing chain, DU is the key component of the tank-busting shells used in NATO's 1999 campaign to drive Serbian forces from Kosovo. It was also deployed in Bosnia and Herzegovina in 1994-95, where anecdotal evidence of a leap in cancers is spreading.

But unlike the U.S. and Britain when the Gulf War cases first started to ring alarm bells, Europe's governments opted not to stonewall. In a remarkable flurry of activity, they drummed up support from the European Union's Swedish presidency and its executive Commission, stepped up health screening of Balkans veterans in several countries, sent investigators to the region and extracted a NATO pledge to provide all relevant information at the alliance's disposal to the numerous national and international inquiries now under way. Said Secretary-General George Robertson: "We have nothing to hide and everything to share."

The first thing shared was the widespread insistence by military officials and scientists alike that there is simply no evidence to link depleted uranium to the 60-some medical cases, including 20 deaths, being investigated. Half of the cases — and a third of the deaths — are Italian. Italy, along with Germany, Norway, Portugal and Greece, pleaded in vain at a meeting of NATO ambassadors last week for a moratorium on DU weapons. Most of the 19 member-nations agreed with the U.S., Britain and France — the three NATO allies that used DU munitions in the Balkans — that there was no scientific ground for sidelining the weapon. Calling concern over DU "more than legitimate," Prime Minister Giuliano Amato conceded the situation is "delicate."

Delicate, indeed. The debate comes at a time of particular sensitivity within NATO over transatlantic security issues. As the Bush administration prepares to take the reins in Washington, battles with Europe are brewing — over a U.S. missile defense system, the growing aspirations of the E.U. on political control of NATO military actions, a rethink of Balkan peacekeeping commitments and expansion of the alliance itself.

The latest controversy exploded this month after newspapers in Italy reported that the country's military prosecutor was investigating medical cases that could be linked to the DU shells. Portugal, Spain, the Netherlands and Belgium soon waded in, reporting a spate of suspicious cancers among their own former peacekeepers. After denying flatly that any of its troops had contracted leukemia, France acknowledged four cases, then six. Others were reported by Britain, the Czech Republic, Germany, Greece and Hungary.

While no questionable illnesses have yet been officially reported in Yugoslavia and its former republics, nerves are jangling, particularly among villagers living near contaminated sites. According to data NATO supplied to the U.N. Environment Program, DU ammunition was used in air attacks on Serbian targets at 112 locations in Kosovo and 10 sites in Serbia proper. Last week, as Bosnia set up a panel to coordinate data on DU effects, the Yugoslav government formed one to monitor the situation in Serbia and Montenegro.

"Everything is under control," says Colonel Dragan Velickovic, a Yugoslav army spokesman. "All con-taminated sites are clearly marked and the removal of debris is under way. So far, we have no reports of leukemia among our soldiers." And though it doesn't like to boast about it, the Yugoslav army also has DU ammunition in its arsenal. An officer with the army's procurement agency says Belgrade has been importing armor-piercing DU shells from Russia for at least 20 years. "We never used them in Kosovo because we never made contact with the enemy tanks," the officer said, "but we used them a lot in Bosnia — and on the training grounds, of course." He too believes the shells are "totally harmless — unless you're standing right in their path."  MORE>>
 
When news of leukemia cases among NATO soldiers reached Serbia, many civilians viewed them as a sign of heavenly justice. "God is punishing them," says Milica Simic, a Belgrade housewife whose son fought in Kosovo. "That's what they get for bombing us." Divine victims or not, the soldiers present scientists with an opportunity to attempt to track leukemia's cause. Several investigations have begun, carried out by teams from the U.N., the World Health Organization, Britain's Royal Society and Germany's National Research Center for Environment and Health, among others.

The U.N. Environment Program has been focusing on the health and environmental consequences of the Kosovo conflict. Blocked at times by unexploded ordinance, unep researchers spent 12 days in Kosovo in November, taking radioactivity readings and samples of soil, water, vegetation and cows' milk at 11 sites where DU ammunition was used. The materials are being analyzed, and a final report is due by early March. "It was surprising to find remnants of DU ammunition just lying on the ground one-and-a-half years after the conflict," says Pekka Haavisto, chairman of unep's assessment team. "Also, the ground directly beneath the DU ammunition was slightly contaminated... We paid special attention to the risks that uranium toxicity might pose to the ground waters around the sites." Direct contact with such spots, they concluded, would be "an unnecessary risk."

NATO aircraft rained more than 30,000 DU shells on Kosovo during the 11-week air campaign. The military likes the shells because, 1.7 times heavier than lead, they can punch through armored vehicles. They then erupt in a burning cloud of vapor, which settles as radioactive dust. (In addition to its military applications, DU is used in civilian industry, chiefly for stabilizers in boats and planes and for radiation shielding.) About 10 tons of the debris were scattered across Kosovo. While internal U.S. and British defense documents have warned of a "potential" increase in cancer risk from DU dust, the Pentagon insists there is no actual danger. "We have studied depleted uranium at considerable length over the years," said spokesman Kenneth Bacon. "And we have not been able to find any connection between exposure to depleted uranium on the one hand and the constellation of illnesses or symptoms included in the Gulf War illness on the other hand."

Scientists generally agree. While none can spell out a conclusive reason why the European soldiers are falling sick — or explain the myriad illnesses afflicting veterans of the Gulf War, the first conflict in which DU munitions were used — they are certain that DU is not the cause. "So far," notes Naomi Harley, professor of environmental medicine at the New York University School of Medicine, "there are 16 epidemiological studies following 30,000 people, most of them from the atomic energy industry, and following them over 35 years. No one has seen anything. There is just nothing you can ascribe to uranium exposure."

While cancer is the only radiation-associated human disease linked so far to inhalation of radioactive particles, study after study has failed to find a link between the disease and either natural uranium (found all around us) or depleted uranium (about 40% less radioactive than the natural variety). As a heavy metal, though, it has a chemical toxicity that, as with lead, can cause poisoning in high doses. It is this toxicity, rather than radioactivity, that is considered DU's greatest potential hazard in battlefield conditions. DU emits mainly alpha particles, which are blocked by skin, while beta particles are blocked by military clothing and boots. Gamma rays, though highly penetrating, are given off in extremely low amounts. When uranium is ingested, the kidney is the main organ that is targeted. But even wounded Gulf War veterans who have DU fragments imbedded in their bodies suffered no kidney disease attributable to uranium's chemical toxicity, according to a 1999 rand report. Nor do the men appear to show any signs of radiation effects.

So just what is going on with Europe's Balkans veterans? Epidemiologists call it a cluster. Cancer clusters have been identified for well over a century, and a large number involve leukemia. "Except for occupational settings, health researchers almost invariably do not get the cause," says Michael Thun, the American Cancer Society's chief of epidemiological research.

One theory is known as the "two-hit" hypothesis. Cancer generally results from an accumulation of damage — five or six "hits" — to the genes. Some experts think leukemia may need only two. If so, that may also explain why the disease appears relatively quickly — and perhaps an infectious agent, such as a virus, is the second "hit."

Unlike the Gulf War illnesses, the DU cases have spawned investigations shortly after the first signs of trouble. That, to soldiers and their families, officials and scientists, is an important first step. For others, the studies and guidelines on how to deal with DU material have come too late. But before depleted uranium dust settles on another land, the challenge is, simply, to determine the truth.   BACK>>

— Reported by Dejan Anastasijevic/Belgrade, James Graff/Brussels, Andrew Purvis/Vienna, Thomas Sancton/Paris and Dick Thompson/Washington, with other bureaus
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