Skip to main content

Abstract

Blast incidents and the resulting trauma are serious health threats. Blast incidents occur in military conflict, from both military and improvised munitions. Acts involving bombings and explosions are by far the most common types of terrorist acts. Blast injuries also result from nonintentional events, such as industrial explosions. Although blast incidents are rare outside of areas of military or social conflict, when they occur, the scale, in terms of number and types of injuries, can range from mild to catastrophic. This chapter briefly reviews the various types of injuries that result from blast trauma, introduces the settings in which blast injuries occur and the epidemiology of blast injuries in different settings, and provides a summary of health preparedness and response strategies for incidents involving blast trauma. These topics will be expanded upon in subsequent chapters.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Institute of Medicine. Gulf war and health: volume 9: long-term effects of blast exposures [Internet]. National Academies Press; 2014 [cited 2018 Aug 14]. 228 p. Available from: https://www.nap.edu/catalog/18253/gulf-war-and-health-volume-9-long-term-effects-of.

  2. DePalma RG, Burris DG, Champion HR, Hodgson MJ. Blast injuries. N Engl J Med. 2005;352(13):1335–42.

    Article  CAS  PubMed  Google Scholar 

  3. Wolf SJ, Bebarta VS, Bonnett CJ, Pons PT, Cantrill SV. Blast injuries. Lancet. 2009;374(9687):405–15.

    Article  PubMed  Google Scholar 

  4. Mathews ZR, Koyfman A. Blast Injuries. J Emerg Med. 2015;49(4):573–87.

    Article  PubMed  Google Scholar 

  5. Bellamy R, Zajtchuk R. Chapter 1. The weapons of conventional land warfare. In: Textbooks of military medicine. Conventional warfare: ballistic, blast and burn injuries. [Internet]. Washington, D.C. 20307–5000: Office of the Surgeon General at TMM Publications, Center of Excellence in Medical Research and Education Walter Reed Army Medical Center; 1991. Available from: http://www.cs.amedd.army.mil/borden/bookDetail.aspx?ID=a99f565c-4029-4f74-b57a-2a6747614173&pageTitle=Conventional Warfare: ballistic, blast, and burn Injuries.

    Google Scholar 

  6. Perl D. Military TBI: is it the same as civilian TBI? Bridges. 2016;46(1):65–8.

    Google Scholar 

  7. Ramasamy A, Hill AM, Clasper JC. Improvised explosive devices: pathophysiology, injury profiles and current medical management. J R Army Med Corps. 2009;155(4):265–72.

    Article  CAS  PubMed  Google Scholar 

  8. Improvised explosive device [Internet]. Camp Lejune NC 28542-0042: United States Marine Corps, Field Medical Training Battalion; [cited 2018 Aug 14] p. 17. Report No.: FMSO 211. Available from: https://www.trngcmd.marines.mil/Portals/207/Docs/FMTBE/Student%20Materials/FMSO%20Manual/211.pdf.

  9. Greer N, Sayer N, Kramer M, Koeller E, Velasquez T. Prevalence and epidemiology of combat blast injuries from the Military Cohort 2001–2014 [Internet]. Washington (DC): Department of Veterans Affairs (US); 2016 [cited 2018 Jul 25]. (VA Evidence-based Synthesis Program Reports). Available from: http://www.ncbi.nlm.nih.gov/books/NBK447477/.

  10. Owens BD, Kragh JF, Wenke JC, Macaitis J, Wade CE, Holcomb JB. Combat wounds in operation Iraqi freedom and operation enduring freedom. J Trauma. 2008;64(2):295–9.

    Article  PubMed  Google Scholar 

  11. Baker MS. Casualties of the global war on terror and their future impact on health care and society: a looming public health crisis. Mil Med. 2014;179(4):348–55.

    Article  PubMed  Google Scholar 

  12. Lafta R, Al-Shatari S, Cherewick M, Galway L, Mock C, Hagopian A, et al. Injuries, death, and disability associated with 11 years of conflict in Baghdad, Iraq: a randomized household cluster survey. Dalal K, editor. PLoS One. 2015;10(8):e0131834.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Afghanistan midyear report 2015: protection of civilians in armed conflict [Internet]. Kabul, Afghanistan: United Nations Assistance Mission in Afghanistan; 2015 Aug [cited 2018 Aug 14] p. 95. Available from: https://unama.unmissions.org/sites/default/files/unama_protection_of_civilians_armed_conflict_midyear_report_2015_final_august.pdf.

  14. Casualties. In landmine monitor 2017 [Internet]. International Campaign to Ban Land mines – Cluster Munition Coalition; 2017 Dec [cited 2017 Aug 15] p. 51–62. (Landmine Monitor). Available from: http://the-monitor.org/media/2615219/Landmine-Monitor-2017_final.pdf.

  15. Leatherdale D. How dangerous are unexploded bombs? [Internet]. BBC News. 2015 [cited 2018 Aug 20]. Available from: https://www.bbc.co.uk/news/uk-england-33861431.

  16. Routine disposal goes wrong: three killed in explosion of World War II bomb in Germany [Internet]. Spiegel Online. 2010 [cited 2018 Aug 20]. Available from: http://www.spiegel.de/international/germany/routine-disposal-goes-wrong-three-killed-in-explosion-of-world-war-ii-bomb-in-germany-a-698245.html.

  17. Nuclear Threat Initiative. Despite WMD fears, terrorists still focused on conventional attacks | Analysis | NTI [Internet]. 2013 [cited 2018 Aug 15]. Available from: http://www.nti.org/gsn/article/despite-wmd-fears-terrorists-still-focused-conventional-attacks/.

  18. Improvised Explosive Devices (IEDs) [Internet]. Department of Homeland Security. 2018 [cited 2018 Aug 15]. Available from: https://www.dhs.gov/topic/explosives.

  19. Edwards DS, McMenemy L, Stapley SA, Patel HDL, Clasper JC. 40 years of terrorist bombings - a meta-analysis of the casualty and injury profile. Injury. 2016;47(3):646–52.

    Article  CAS  PubMed  Google Scholar 

  20. National Consortium for the Study of Terrorism and Responses to Terrorism (START). (2017). Global terrorism database. [Internet]. Available from: http://www.start.umd.edu/gtd.

  21. Kluger Y, Peleg K, Daniel-Aharonson L, Mayo A. Israeli Trauma Group. The special injury pattern in terrorist bombings. J Am Coll Surg. 2004;199(6):875–9.

    Article  PubMed  Google Scholar 

  22. Arnold JL, Halpern P, Tsai M-C, Smithline H. Mass casualty terrorist bombings: a comparison of outcomes by bombing type. Ann Emerg Med. 2004;43(2):263–73.

    Article  PubMed  Google Scholar 

  23. Golan R, Soffer D, Givon A, Israel Trauma Group, Peleg K. The ins and outs of terrorist bus explosions: injury profiles of on-board explosions versus explosions occurring adjacent to a bus. Injury. 2014;45(1):39–43.

    Article  PubMed  Google Scholar 

  24. Jaffe DH, Peleg K. Israel Trauma Group. Terror explosive injuries: a comparison of children, adolescents, and adults. Ann Surg. 2010;251(1):138–43.

    PubMed  Google Scholar 

  25. The Paris Black Friday 13/11/2015 Attacks - What do we know? What should we do? [Internet]. Herzliya, Israel: International Institute for Counter-Terrorism; 2015 Nov [cited 2018 Aug 17] p. 2–3. Available from: https://www.ict.org.il/UserFiles/ICT-The-Black-Friday-Paris-Attacks-Nov15.pdf.

  26. Rabasa A, Blackwill RD, Chalk P, Cragin K, Fair C, Jackson B, et al. The lessons of Mumbai [Internet]. Arlington: RAND Corporation; [cited 2018 Aug 17] p. 37. Report No.: OP249. Available from: https://www.rand.org/content/dam/rand/pubs/occasional_papers/2009/RAND_OP249.pdf.

  27. Miller E. Mass-fatality, coordinated attacks worldwide, and terrorism in France [Internet]. College Park: National Consortium for the Study of Terrorism and Responses to Terrorism (START); 2015 Nov [cited 2018 Aug 17] p. 1–6. Available from: http://www.start.umd.edu/pubs/START_ParisMassCasualtyCoordinatedAttack_Nov2015.pdf.

  28. United States Bomb Data Center (USBDC) Explosives incident report 2017 [Internet]. US Department of Justice, Department of Alcohol, Tobacco and Firearms, US Bomb Data Center; 2017 [cited 2018 Aug 1] p. 19. Available from: https://www.atf.gov/file/128106/download.

  29. Combustible dust in industry: preventing and mitigating the effects of fire and explosions [Internet]. Washington DC: US Department of Labor, Occupational Safety and Health Administration, Directorate of Standards and Guidance, Office of Safety Systems; 2005 [cited 2018 Aug 17] p. 9. Report No.: SHIB 07-31-2005. Available from: https://www.osha.gov/dts/shib/shib073105.pdf.

  30. Sugar dust explosion and fire, imperial sugar company [Internet]. Chemical Safety Board; [cited 2018 Aug 17] p. 90. Report No.: 2008-05-I-GA. Available from: https://www.csb.gov/assets/1/20/imperial_sugar_report_final_updated.pdf?13902.

  31. Bureau of Labor Statistics. Case and demographic characteristics for work-related injuries and illnesses involving days away from work. Table R64, Detailed event or exposure by industry division. [Internet]. [cited 2018 Jul 26]. Available from: https://www.bls.gov/iif/oshcdnew2016.htm.

  32. Bureau of Labor Statistics. Census of Fatal Occupational Injuries (CFOI) - Current and Revised Data. Table A-9. Industry by event or exposure, 2016 [Internet]. 2016 [cited 2018 Jul 26]. Available from: https://www.bls.gov/iif/oshcfoi1.htm.

  33. A public health report on injuries related to the west (Texas) fertilizer plant explosion, April 2013 [Internet]. Waco-McLennan County Public Health District; 2014 Jun [cited 2018 Aug 17] p. 16. Available from: http://www.waco-texas.com/userfiles/cms-healthdepartment/file/pdf/West-Texas-Report-6-2014.pdf.

  34. Thompson D, Brown S, Mallonee S, Sunshine D. Fatal and non-fatal injuries among U.S. Air Force personnel resulting from the terrorist bombing of the Khobar Towers. J Trauma. 2004;57(2):208–15.

    Article  PubMed  Google Scholar 

  35. Know a serious bleed when you see it [Internet]. Stop the bleed. [cited 2018 Aug 17]. Available from: https://stopthebleed.usuhs.edu/.

  36. Hunt R, Kapil V, Basavaraju S, Sasser S, McGuire L, Sullivent E. Updated in a moment’s notice: surge capacity for terrorist bombings [Internet]. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Response; 2010 [cited 2018 Aug 17] p. 60. Available from: https://stacks.cdc.gov/view/cdc/5713/.

  37. Kluger Y, Mayo A, Soffer D, Aladgem D, Halperin P. Functions and principles in the management of bombing mass casualty incidents: lessons learned at the Tel-Aviv Souraski Medical Center. Eur J Emerg Med. 2004;11(6):329–34.

    Article  PubMed  Google Scholar 

  38. Hospital incident command system guidebook, 5th ed [Internet]. Rancho Cordova: California Emergency Medi cal Services Authority; 2014 [cited 2018 Jul 26]. Available from: http://hicscenter.org/Shared%20Documents/HICS_Guidebook_2014_7.pdf.

  39. Byrne-Dugan CJ, Cederroth TA, Deshpande A, Remick DG. The processing of surgical specimens with forensic evidence: lessons learned from the Boston Marathon bombings. Arch Pathol Lab Med. 2015;139(8):1024–7.

    Article  PubMed  Google Scholar 

  40. de Ceballos JPG, Turégano-Fuentes F, Perez-Diaz D, Sanz-Sanchez M, Martin-Llorente C, Guerrero-Sanz JE. 11 March 2004: the terrorist bomb explosions in Madrid, Spain--an analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital. Crit Care. 2005;9(1):104–11.

    Article  PubMed  Google Scholar 

  41. Gutierrez de Ceballos JP, Turégano Fuentes F, Perez Diaz D, Sanz Sanchez M, Martin Llorente C, Guerrero Sanz JE. Casualties treated at the closest hospital in the Madrid, March 11, terrorist bombings. Crit Care Med. 2005;33(1 Suppl):S107–12.

    Article  PubMed  Google Scholar 

  42. Aschkenasy-Steuer G, Shamir M, Rivkind A, Mosheiff R, Shushan Y, Rosenthal G, et al. Clinical review: the Israeli experience: conventional terrorism and critical care. Crit Care. 2005;9(5):490–9.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Disclaimer

The appearance of US Department of Defense (DoD) visual information does not imply or constitute DoD endorsement.

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Deitchman, S.D., Ashkenazi, I., Falk, H. (2020). Overview of Blast Injury. In: Callaway, D., Burstein, J. (eds) Operational and Medical Management of Explosive and Blast Incidents. Springer, Cham. https://doi.org/10.1007/978-3-030-40655-4_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-40655-4_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-40654-7

  • Online ISBN: 978-3-030-40655-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics