Beirut Port Ammonium Nitrate Explosion

Abstract

Background: On the fourth of August, 2020 a major explosion struck the capital city of Lebanon. Our aim was to ascertain the number of casualties following the Beirut Port Ammonium Nitrate Explosion (BPANE). Methods: Retrospective review of emergency department (ED) statistics in the first 54 hours following BPANE. Hospitals within 99 km diameter were included. Results: ED utilization included the influx of 8,643 casualties in 33 private and nine public hospitals. A majority of patients suffered multiple soft tissue lacerations by shattered glass and were treated by suturing. Hospital admissions counted 1,056 patients representing 12·21% of ED admissions. Admissions to intensive care units (ICU) or operating room (OR) accounted respectively for 156 and 534 (1·80% and 6.18% of patients admitted to ED). ICU admissions were for cerebral contusion or hemorrhage (69·1%), lung injuries (9·1%), or polytrauma (9·1%). Primary surgeries included hand, upper or lower extremity fractures (36·7%), tendon repair (19·7%), open eye (14·5%), craniotomies (8·1%), polytrauma (7·5%) and plastic repairs (4·6%). In hospital, immediate ED mortality was 37, early mortality within 54 hours was 56, and the global official mortality at one month exceeded 200. Conclusions: BPANE resulted in several thousands of soft tissue lacerations, several hundreds of related operations including fractures, tendon repairs, ocular lacerations, and craniotomies, as well as several dozens of intensive care admissions mainly from brain or less often lung injury. We call for action so that the production, sales, transport, and storage of ammonium nitrate to be under strict regulations and supervision of the United Nations. Funding Statement: None. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: The study received Institutional Review Board approval in 9 centers that supplied the diagnosis for admission to the hospital. The study conformed to the Declaration of Helsinki provisions.