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Half-a-Century of Terrorist Attacks: Weapons Selection, Casualty Outcomes, and Implications for Counter-Terrorism Medicine

Part of: Prehospital and Disaster Medicine Counterterrorism Collection

Published online by Cambridge University Press:  16 August 2021

Derrick Tin Open the ORCID record for Derrick Tin [Opens in a new window] ,
Colton Margus  and
Gregory R. Ciottone
Derrick Tin*
Affiliation:
Senior Fellow, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Cambridge, MassachusettsUSA
Colton Margus
Affiliation:
Fellow, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MassachusettsUSA
Gregory R. Ciottone
Affiliation:
Director, BIDMC Disaster Medicine Fellowship; Department of Emergency Medicine, Beth Israel Deaconess Medical Center; Associate Professor, Harvard Medical School, Boston, MassachusettsUSA
*
Correspondence: Derrick Tin, MBBS Senior Fellow, BIDMC Disaster Medicine Fellowship Department of Emergency Medicine Beth Israel Deaconess Medical Center Harvard Medical School E-mail: derrick@alphazodiac.com
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Abstract

Background:

High profile terrorist attacks in major capital cities have seemingly become a regular occurrence and the resultant mass-casualty events continue to challenge health care systems. Counter-Terrorism Medicine (CTM) addresses unique terrorism-related issues relating to the mitigation, preparedness, and response measures to asymmetric, multi-modality terrorist attacks. This study is an epidemiological examination of all terrorism-related events sustained from 1970-2019, analyzing historical weapon types used and the resulting fatal injuries (FI) and non-fatal injuries (NFI) sustained.

Methods:

The Global Terrorism Database (GTD) was searched for all attacks from 1970-2019. Attacks met inclusion criteria if they fulfilled the three terrorism-related criteria, as set by the GTD codebook. Ambiguous events were excluded. State-sponsored terrorist events do not meet the codebook’s definition, and as such, are excluded from the study. Available counts of FI and NFI in each incident were then sorted and aggregated by weapon type to enable mean and standard deviation calculations.

Results:

In total, 168,003 events were recorded from the years 1970-2019. Explosives, bombs, and/or dynamite (E/B/D) were the most commonly used weapon type and accounted for 48.78% of all terrorism events, followed by the use of firearms in 26.77% of events. A total of 339,435 FI and 496,225 NFI resulted from all terrorism events that occurred during the study period. Combined, E/B/D and firearms accounted for 75.55% of all events, 67.1% of all FI, and 79.3% of all NFI. Each individual terrorism event inflicted a mean FI rate of 2.14 FI per event (SD = 10.2) and a mean NFI rate of 3.22 NFI per event (SD = 45.19).

Conclusions:

Although terrorism is complex and does not solely rely on death tolls as a measure of success, this analysis shows a historic mean FI rate of 2.14 and NFI rate of 3.22 per event over the past 50 years. Proven weapons such as E/B/D and firearms combine to account for over 75% of weapon types used in all events. Use of weapons of mass destruction (WMDs) such as chemical, biological, radiation, and nuclear (CBRN) weapons has been rare (0.2%), yet has extreme high potential to inflict mass casualties with mean NFI rates of 49.62 and 28.75 for chemical and biological weapons, respectively.

Keywords

CBRNEcounter-terrorism medicinedisaster medicinemass casualtyterrorism
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 5 , October 2021 , pp. 526 - 530
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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