Abstract
BackgroundSince the 1970s, terrorist bombings in subways have been frequently occurring worldwide. To cope with this threat and to provide medical response countermeasures, we analyzed the characteristics of subway bombing terrorist attacks and used the Haddon matrix to explore medical response strategies.MethodsFirst, we analyzed 111 subway bombings from 1970 to 2017 recorded in the Global Terrorism Database to provide a reference for the strategy exploration. Then, we convened an expert panel to use the Haddon matrix to explore the medical response strategies to subway bombings.ResultsIn recent decades, at least one bombing attack occurs every 3 years. Summarized by the Haddon matrix, the influencing factors of medical responses to conventional subway bombings include the adequacy of first-aid kits and the medical evacuation equipment, the traffic conditions affecting the evacuation, the continuity and stability of communication, as well as the factors exclusively attributed to dirty bomb attacks in subways, such as ionizing radiation protection capabilities, the structure of the radiation sickness treatment network based on the subway lines, and the disposal of radioactive sewage. These factors form the basis of the strategy discussion.ConclusionSince subway bombings are long-term threats, it is necessary to have proper medical response preparation. Based on the Haddon matrix, we explored the medical response strategies for terrorist subway bombings, especially dirty bomb attacks. Haddon matrix can help policymakers systematically find the most important factors, which makes the preparations of the response more efficient.
Highlights
Since the 1970s, terrorist bombings in subways have been frequently occurring worldwide
We considered the possible occurrences of subway dirty bomb attacks and applied the Haddon matrix to explore exceptional medical response strategies
Implementation of training and drills Professional skill training should be conducted in accordance with an annual plan, and medical response drills for subway bombing attacks should be regularly incorporated into the overall antiterrorism and emergency preparedness plans
Summary
Since the 1970s, terrorist bombings in subways have been frequently occurring worldwide. To cope with this threat and to provide medical response countermeasures, we analyzed the characteristics of subway bombing terrorist attacks and used the Haddon matrix to explore medical response strategies. Since the 1970s, the global occurrence of subway terrorist bombings has been increasing, especially in the twenty-first century. Subway bombings have become a fixed mode of terrorist attacks and may occur at unpredictable times and places in the future. It is worth assessing the emergence response preparedness of every country that has a subway system. Subway bombings always paralyze the urban rail transit system, and (2019) 6:18
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