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Pediatric Terrorism and Disaster Preparedness: A ... - PHE Home

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Introduction<br />

Chapter 7. Blast <strong>Terrorism</strong><br />

In the short time between January <strong>and</strong> September 2003, explosive devices were involved<br />

in 73 of 189 terrorist events that occurred worldwide. A 1997 report by the Department of<br />

Justice found an abundance of evidence suggesting that given intent, the knowledge<br />

required to build bombs is readily available in print <strong>and</strong> on the Internet. The report cited<br />

at least 50 publications in the Library of Congress; several texts intended for military<br />

training, agricultural, <strong>and</strong> engineering use; 48 different underground pamphlets <strong>and</strong><br />

publications; <strong>and</strong> countless sources on the World Wide Web. Bomb data from the FBI<br />

indicate that from 1987 to 1997, bombing incidents increased approximately 2.5 times,<br />

peaking in 1994 with 3,163 domestic bombing incidents. Of those incidents, 66%<br />

involved explosive devices, <strong>and</strong> the remaining 24% involved incendiary devices. More<br />

recent bomb data indicate that the number of domestic bombing incidents has decreased<br />

since 1994, with 1,797 incidents in 1999. In most incidents, low-explosive fillers were<br />

used. High-explosive ammonium nitrate mixtures, however, were used during the first<br />

World Trade Center bombing <strong>and</strong> the Oklahoma City bombing, highlighting the<br />

tremendous destructive power of a significant amount of a high explosive.<br />

The raw materials for explosive devices are regularly found in areas of farming or mining<br />

activities. Due to the public accessibility of explosives materials <strong>and</strong> bomb-building<br />

knowledge, a domestic terrorist attack would probably take the form of a conventional<br />

explosive munitions attack. This chapter introduces the spectrum of injuries caused<br />

during an explosion <strong>and</strong> the differences between blast trauma <strong>and</strong> conventional trauma.<br />

Both blast trauma <strong>and</strong> conventional trauma have aspects of blunt, penetrating, burn,<br />

crush, <strong>and</strong> inhalational injuries. However, victims of a blast may suffer all of these<br />

injuries simultaneously, with additional injury caused by the blast wave itself, i.e.,<br />

primary blast injury. Primary blast injuries are lethal, unique, <strong>and</strong> often subtle. Although<br />

the vast majority of blast injury victims suffer from conventional injuries, lack of<br />

knowledge about primary blast injuries <strong>and</strong> failure to recognize a blast’s effect on certain<br />

organs can result in additional morbidity <strong>and</strong> mortality.<br />

Explosives<br />

Explosives are solid, liquid, or gaseous substances that, when detonated, transform<br />

rapidly into more stable products in the form of heat, gas, <strong>and</strong> energy. Explosives are<br />

frequently used in military, demolition, <strong>and</strong> industrial applications <strong>and</strong> are categorized as<br />

low explosives or high explosives. Low explosives are considered propellants <strong>and</strong> are<br />

used chiefly in small arms <strong>and</strong> munitions. Two examples are smokeless powder or black<br />

powder. High explosives have a greater potential for destruction due to their higher<br />

burning rate <strong>and</strong> therefore higher shattering effect. Notable examples of high explosives<br />

are TNT (trinitrotoluene), dynamite, RDX, C-4, ammonium nitrate, ammonium-nitrate<br />

fuel oil, HMX, <strong>and</strong> PETN. Due to their relative stability, these compounds require<br />

another explosive (e.g., a primer or detonator) to initiate a charge.<br />

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