Comparing the top 100 attacks in the Global Terrorism Database: high injury rate versus high fatality rate attacks

BACKGROUND

Terrorist attacks have the potential to be mass casualty events, causing multiple injuries and deaths. High injury rate attacks will particularly place a high burden on emergency medical systems. This study aimed to assess if there is a difference between attacks with high injury rates and high fatality rates.

METHODS

The top 100 terrorist events causing the highest number of fatalities versus the highest number of injuries were selected from the Global Terrorism Database. Analyses were performed on temporal factors, location, target type, attack and weapon type, and perpetrator type.

RESULTS

The 9/11 attacks caused the highest number of both fatalities and injuries. With regards to injury rates, the sarin attacks in Tokyo, Japan ranked second. Events with high fatality rates were overrepresented in Sub-Saharan Africa, whereas events with high injury rates were predominant in the Middle East & North Africa. High fatality rates were most often associated with armed assaults and hostage takings. Bombings were responsible for the highest number of injuries. CBRN attacks were overrepresented in the top 100 injuries, and accounted for 11% of the incidents.

CONCLUSION

High injury rate incidents place a heavy burden on the health care system as the number of injuries is nearly ten times as high as the number of injuries in high fatality rate incidents. Epidemiological analysis of high impact terrorist events may contribute to counter-terrorism preparedness, to an increased focus on dealing with CBRN-events, and thus to a proper medical response to future terrorist events.

Pattern of bioterrorism in ancient times: lessons to be learned from the microbial and toxicological aspects

The current research aimed to analyze the history of bioterrorism in antiquity and to adapt the data to modern medical knowledge. To this end, a thorough evaluation of the literature related to the ancient history of bioterrorism and modern data was done using the Web of Sciences, Science Direct, Scopus, PubMed, and Google Scholar. Results showed that knowledge of bioterrorism has existed since antiquity in different civilizations. Biological and toxicological agents were used as an instrument of legal execution, as a warfare tool in battles, or to eliminate political rivals across nations. Ancient people researched bioterrorism to apply it against enemies and at the same time provide countermeasures in favor of themselves and allies. Despite the existence of the principles of bioterrorism since ancient times, adaptation of the data to modern research can assist in planning countermeasure efforts, preventive actions, and treatments in the framework of modern counterterrorism medicine.