Aim To determine metal and metalloid exposure in the people of east Croatia exposed to heavy and moderate fighting during the 1991–1995 war in Croatia.

Methods The concentrations of 18 elements, that is, aluminium (Al), arsenic (As), barium (Ba), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), niobium (Nb), nickel (Ni), lead (Pb), titanium (Ti), uranium (U), vanadium (V), tungsten (W), zinc (Zn) and zirconium (Zr), reported to be associated with military operations, were determined in hair, serum and urine samples using inductively-coupled plasma mass spectroscopy (ICP-MS). A total of 391 participants from east Croatian areas of heavy and moderate fighting were included in this biomonitoring cross-sectional study.

Results Higher concentrations of the selected elements associated with fire arms (Al, As, Ba, Cd, Cr, Cu, Mn, Mo, Ni, Pb, U, V, W, Zn i Zr) were determined in one or more samples of study participants from east Croatia as compared with literature data available.

Conclusion Study results revealed high concentrations of the selected elements in biological samples of the study population from east Croatia, pointing to the need of comprehensive risk assessment and extensive monitoring of metal and metalloid exposure in the populations living in former conflict zones, emphasising the role of biomonitoring through ecologic and preventive activities.