PC3042: Pediatric Casualties in Terrorist Attacks: a Semi-quantitative Analysis of Global Events Through the Lens of Counter-terrorism Medicine

Background: Terrorism remains a major threat and concern in many countries around the world. Children represent 25% - 30% of the world’s population and can be potential targets or collateral victims of future terrorist events. This study is a semi-quantitative epidemiological analysis of all terrorism-related pediatric fatalities and injuries sustained between 1970 - 2019.

Methods: Data collection was performed using a retrospective database search through the Global Terrorism Database (GTD). The complete GTD which includes events worldwide which occurred January 1, 1970 - December 31, 2019, was searched using the internal database search functions of 120 variables, which include location, weapons, casualties, and target. Summaries of events including search terms associated with children were individually reviewed and those describing the deaths, injuries or abduction of children were tallied. The events were further subclassified based on the regions and attack methods (as determined by the GTD).

Results: Of the over 200,000 terror events in the GTD, 2,302 of these events met inclusion criteria. This represents 1.14% of total terrorist events which involved death, injury, or abduction of children between 1970-2019.
Of these 2,032 events, a total of 2,275 pediatric fatal injuries (FI) were recorded, as well as 2,280 pediatric non-fatal injuries (NFI). The most common weapons used in all attacks involving the pediatric population were explosives (1539 [66.8%]), firearms (543 [23.5%]), other (169 [7.3%]) and melee (83 [3.6%]). 275 of the 2,032 were related to abductions, with 71 cases involving the abduction of 10 children or more.

Conclusion: Pediatric casualties in terrorist events represent a small proportion of overall victims, however, casualties in this vulnerable cohort can cause long-term physical, psychosocial and community impacts. More collaborative research and discussions are needed among disaster, counter-terrorism medicine and pediatric specialists around mitigation strategies and health impacts of terrorist attacks involving children.