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Intentional mass-casualty incidents with civil society targets in Europe a descriptive analysis for 2000 to 2018

Valiño EM, Castro P, Castro Delgado R

Sistema Emergències Mèdiques, Catalunya, Spain. Área de Vigilancia Intensiva, IDIBAPS, Hospital Clínic de Barcelona, Universitat de Barcelona, Spain. SAMU Asturias, Servicio de Salud del Principado de Asturias, Spain.

Objective. To describe the main characteristics of intentional mass-casualty incidents (MCIs) with civil society targets in Europe between 2000 and 2018.
Methods. Retrospective, descriptive analysis of intentional MCIs in Europe between 2000 and 2018 recorded in the Global Terrorism Database. We collected information on country; year; main and secondary weapons used and main-weapon subtype; numbers of attackers, victims, and points of attack; targets; and type of location.
Results. A total of 469 points of attack were identified in 373 independent intentional MCIs (86% with multiple points of focus) that caused 15 066 victims (11 410 persons injured, 3656 deaths). The year with the most MCIs was 2014 (58 MCIs), and Russia saw the largest percentage (50.1%). Spain ranked third, with 8.7% of the MCIs in Europe, the highest proportion in Western Europe. Explosive devices were the weapons used most often (in 71.4%), followed by firearms (in 19.6%), and motor vehicles (in 2.6%). Vehicles, which use has been on the rise, caused the most injuries, with a median (interquartile range) of 19 (12-59) victims per intentional MCI (P = .026). The number of attackers in MCIs involving firearms correlated positively with the number of victims (r = 0.357, P = .011). The most frequent target was the civil population (in 53.1%), and public spaces and thoroughfares were the locations most often chosen (in 24.3%).
Conclusions. Nearly 500 intentional MCIs have occurred in Europe in this XXI century. Most involved explosives or firearms. However, motor vehicles are the most potentially harmful weapons, and their use is increasing. These data may help to improve MCI emergency response planning.

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