“I can vividly remember the last day,” said Emerico Maria Laccetti, former colonel of the military division of the Italian Red Cross.
During the Kosovo War in 1999 he was stationed in Albania, a few hundred metres from the border with Kosovo. He commanded a field hospital for refugees from the province, then part of Serbia.
“We stood on containers and watched the bombings,” he recalled. “It was like a perverse New Year’s Eve fireworks display. Even at a distance, you could feel the air pressure, the shock waves going through your body. But no, we were not told about the specific dangers of the weapons being used.”
In March 1999 NATO launched Operation Allied Force against Serbian security forces. Over 78 days the alliance flew missions with up to 1,000 aircraft. Official figures say more than 28,000 explosive devices were dropped, including ammunition that used depleted uranium (DU), a controversial material suspected of causing cancer.
DU has a uranium core depleted of most fissile isotopes, and is extremely dense—about three times denser than lead—making it useful against tanks and armoured targets. Impacts can aerosolise tiny uranium particles that remain radioactive and chemically toxic if inhaled or ingested.
NATO rejects links between DU and cancer. In written replies it said it takes health and environmental issues seriously and cited a 2001 committee finding that DU use in Kosovo “did not cause any lasting health risk to the population,” citing independent studies, and later UN reports from 2014 as reliable scientific evidence.
That stands at odds with rulings by Italian courts in lawsuits brought by roughly 500 veterans who developed cancer after service in Kosovo. Laccetti says his field hospital in Morina, Albania, was in a “hot zone” close to active bombing—an accepted risk—but that troops were never warned about long-term hazards from certain munitions, unexploded ordnance or production residues.
When Laccetti returned to Italy in July 1999 he developed breathing difficulties. Doctors discovered a malignant tumour in his lung measuring 24 × 12 × 14 cm. He was treated successfully at first, but in 2008 the cancer recurred. Tissue analysis revealed an “extraordinary amount of perfectly round ceramic particles — as if I had been standing in a blast furnace.” Experts concluded particles had become embedded over years and could cause further damage through migration or inflammation.
Laccetti found others of his cohort with similar diagnoses and, represented by lawyer Angelo Tartaglia, about 500 servicemen successfully sued the Italian state. In 2009 a Rome court certified Laccetti as a victim who had fulfilled his duties and awarded compensation.
After the war Italy’s Defence Ministry set up a commission that reported a statistically significant increase in non-Hodgkin lymphoma among affected soldiers. Other studies, including a 2001 WHO report, did not find clear evidence linking DU to individual disease cases.
Wim Zwijnenburg of the International Coalition to Ban Uranium Weapons (ICBUW), who has investigated DU for over 16 years, says the Italian court rulings show a duty of care was breached. He also stresses how difficult it is to make definitive scientific attributions: DU causes harm only when particles enter the body, typically as fine dust, but the amount actually absorbed by individuals was rarely measured. Long-term reliable studies are scarce. Cancer has many causes—lifestyle, environment, genetics—so proving a single trigger is complex.
Questions also remain about NATO’s post-conflict responsibilities. A 2002 UN resolution obliged states to inform affected countries after DU use and to assist with cleanup. It is unclear to what extent NATO fulfilled that duty in Kosovo. KFOR, the NATO peacekeeping force deployed after the war, does not provide information on decontamination work.
Site visits indicate many Kosovars remain unaware of potential risks and that decontamination has not been carried out except at one site west of the country, in the village of Lugbunari near Gjakova. Zwijnenburg argues NATO could be criticised for using DU and more so for failing to clean up afterwards. He notes protocols for protecting soldiers exist but civilians received little protection.
DU is officially classified as low- to intermediate-level radioactive waste, but in humid climates shells can corrode and leave dangerous residues. Uranium’s very long half-life means the material remains hazardous for a very long time. Zwijnenburg points to what he sees as double standards: had such a grenade been found in a Dutch park, authorities would cordon the area and handle it with protective suits and lead containers; elsewhere, risks have often been ignored.
Laccetti says the compensation awarded to veterans has not led to fundamental policy change. “Depleted uranium ammunition is still legal. We have tried in every conceivable way to ban it, like cluster munitions or anti-personnel mines,” he said. “We have failed.”
With additional reporting by Gabriele Cruciata in Rome and Marjolein Koster in Utrecht.
The research for this article was supported by Journalismfund Europe.
This article was originally published in German.
