ArticlesCasualties in civilians and coalition soldiers from suicide bombings in Iraq, 2003–10: a descriptive study
Introduction
Analysis of deaths and injuries in the civilian population from a weapon improves understanding of its effect on public health and vulnerable demographic subgroups.1, 2, 3, 4 Inclusion of combatant casualties increases understanding of a weapon's effect and use in the context of armed conflict.2, 3 Findings from a study of suicide bomb attacks from 1980 to 2003 showed suicide bombing to be the deadliest form of terrorism used internationally,5 killing an average of 12 victims per attack, not including deaths from the suicide attack on the World Trade Center in New York, USA, on Sept 11, 2001.5 Suicide bombing in Iraq since 2003 has been described as the mass-destruction weapon of sectarian and insurgent combatants.6, 7, 8 In 2009, we analysed Iraqi civilian deaths from armed violence and showed that nearly 9000 Iraqi civilians were killed in 725 suicide bomb attacks during 2003–08.9 In a subsequent study of violent deaths of Iraqi civilians in 2003–08, we showed that suicide bombers attacking so-called soft, civilian targets killed, on average, 19 civilians per lethal attack—the highest death rate for any weapons used in the war. By contrast, suicide bombers attacking so-called hard, coalition-associated targets (eg, Iraqi security forces) killed eight civilians per lethal attack.1
In this Article, we analyse suicide bombings in Iraq in more detail from 2003 to 2010, expanding our analysis to include suicide bomb subtypes, civilian injuries, and coalition soldier deaths. Our specific aims were to analyse Iraqi civilian deaths and injuries documented from suicide bombs and bomb subtypes, distribution of casualties over time and demographic group, the lethality of suicide bombings with injured-to-killed ratios (ie, the number of individuals injured for every fatality),10 percent killed in those wounded or killed,11, 12 deaths generated per event,11 the proportion of children in demographically identifiable deaths, and documented deaths of coalition soldiers from suicide bombs in Iraq, with comparison to Iraqi civilians.
Section snippets
Data collection for Iraqi civilian casualties
The Iraq Body Count13 (IBC) database was prospectively developed by HD and JAS to document and collate all reported deaths of Iraqi civilians from armed violence beginning from the first day of the Iraq war on March 20, 2003. On a daily basis, the IBC systematically identifies reports of armed violence in Iraq that directly results in civilian deaths with search engines and subscription-based press and media collation services (mainly, LexisNexis, Reed Elsevier, London, UK) to scan reports from
Results
Table 1 shows documented Iraqi civilian casualties from suicide bombs, subtypes of suicide bomb, and all forms of armed violence (including suicide bombs) that occurred in Iraq between March 20, 2003, and Dec 31, 2010, in the IBC dataset. Of the total documented civilian casualties from armed violence in Iraq during 8 years of armed conflict, suicide bombs caused 19% (42 928 of 225 789) of all Iraqi civilian casualties, 26% (30 644 of 117 165) of injured civilians, and 11% (12 284 of 108 624)
Discussion
Our findings show a substantial direct public health effect from suicide bombings in Iraq from March 20, 2003, to Dec 31, 2010. In these 8 years, 12 284 Iraqi civilians were documented killed and 30 644 injured in more than 1000 suicide bomb attacks, which caused one-tenth of civilian deaths and one-quarter of civilian injuries documented from armed violence in our dataset. Other studies20 have shown that civilians with suicide bomb injuries, compared with civilians with non-conflict-related
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2015, Journal of Forensic and Legal MedicineCitation Excerpt :Studies on casualties of Iraq War which started in 2003 showed civil casualties were far higher than military deaths. Most of the civilians were killed by bombing from air attacks and suicide bombers.11–13 In this study injuries were distributed mostly as multiple part and head injuries, death was mostly caused by bombing with shrapnel injuries.