Epidemiology of civilian blast injuries inflicted by terrorist bombings from 1970-2016

Abstract

An upsurge of terrorist activity has occurred in the past two decades. As part of this, explosive devices continue to be extensively deployed against civilians in wide-ranging environments. Bombings remain the leading worldwide cause of civilian fatalities due to terrorism. This demands an understanding of modern terrorist bombing trends to inform mitigation strategy. The objective of this study was to identify the occurrence and severity of bombings against civilian targets in diverse attack settings, and to establish corresponding blast injury profiles. Data was obtained from analysis of the Global Terrorism Database (GTD) and a meta-analysis of blast injury data derived from the PubMed database. Closed environment explosions were associated with significantly greater (p < 0.05) mortality than in open spaces. The injury profiles were found to be influenced by attack setting, with higher rates of primary injury on trains and buses, and secondary injury in open space. Keywords: Terrorism, Bombings, Blast injury, Epidemiology, Blast mitigation