The Epidemiology of Terrorism Casualties

Recent years brought about an increase in terrorist activities worldwide. Israel has been exposed to sporadic periods of terrorist activities for decades, with a noteworthy increase since September 29, 2000. By the end of 2003, 6049 persons have been injured and over 904 killed due to terrorism acts in the country (1). Many of these attacks are explosion of suicide bombers resulting in mass casualty events. Mass casualty events are incidents in which the medical system is overwhelmed and the balance between resources and demands is destabilized (2). These latest terror attacks were characterized by a new bomb makeup bombs that contain metal particles of various shapes that increase their wounding potential (3, 4). The consequences are more severe injuries than encountered before, bringing up the possible need for updating protocols for evacuation, triage and hospital preparedness (5, 6). Furthermore, since injuries were different from previously encountered trauma, the pattern of demand for resources, and the medical proficiency necessary for treating new terror victims were different than before (6–12). Additionally, as mass casualty incidents became a frequent event, there was need to maintain continuous preparedness of emergency care services and trauma centers in the country in order to cope with them. In the strive for better preparedness of hospitals and physicians to treat terror casualties, we aimed to learn as much as possible about the characteristics and epidemiology of this new disease.