Serum heavy metals in patients with fragments and shells of improvised explosive devices

Abstract

Background: Iraq is the most affected country by injuries of improvised explosive devices (IED) including bomb car, bomb born on person and roadside bombs. Embedded fragments and shells can release heavy metal. High level of heavy metal in serum carries dangerous long term risk for injured patients.Objective: The aim of this study is to estimate the serum level of heavy metals (copper, lead, cadmium, nickel, and zinc) in patients with fragments and shells from IED including bomb car, bomb born on person and roadside bombs. Material and methods: Serum concentrations of heavy metals (copper, lead, cadmium, nickel, and zinc) were assayed using atomic absorption spectrophotometry in 52 patients with fragments and shells from IED. Serum concentrations of heavy metals were measured in 52 healthy adults as control group. Results: The mean serum level of copper, lead, cadmium, nickel, and zinc in patients were 1304 ± 258.1 µg/L, 36.5 ± 16.7 µg/L, 6.203 ± 2.372 µg/L, 0.387 ± 0.183 µg/L, and 1651 ± 532 µg/L respectively, while in control were 824.2 ± 203.6 µg/L, 31 ± 15.1 µg/L, 1.654 ± 0.4 µg/L, 0.239 ± 0.028 µg/L, 619 ± 234 µg/L respectively. The differences in serum copper, lead, cadmium, nickel, and zinc between patient and control is highly significant, (P value < 0.0001), while the differences in serum lead between patient and control is not significant ( P value > 0.05).Conclusion: The present study demonstrates that a highly significant increase in serum level of copper, cadmium, nickel, and zinc in patient with fragments and shells from IED in comparison with control group, while the difference in serum lead in patients and control was not significant. Keywords: Improvised explosive devices, fragment, shell, metal, serum level.