May 2002

From Lancet

Rubber bullets not safe for crowd control

N.B. Please note that if you are outside North America the embargo date for all Lancet press material is 0001hours UK time Friday 24 May 2002

A study in this week's issue of THE LANCET which highlights the injuries sustained by Arab demonstrators after clashes with Israeli forces in 2000 concludes that rubber bullets are not a safe form of ammunition for crowd control.

Rubber bullets were first used by British forces in Northern Ireland in 1970. These missiles are intended to inflict superficial painful injuries, thereby deterring demonstrators from continuing further hostile activities, while at the same time avoiding serious injuries and deaths that arise with conventional firearms. Low-velocity rubber bullets were used by Israeli police to control riots by Israeli-Arabs in early October, 2000. Michael Krausz and colleagues from Rambam Medical Center, Haifa, Israel, aimed to establish the factors that contribute to the severity of blunt and penetrating injuries caused by these missiles.

152 people were included in the study, in whom 201 proven injuries by rubber bullets were detected. Injuries were distributed randomly over the body surface and were mostly located in the limbs (73), but those to the head, neck, and face (61), chest (39), back (16), and abdomen (12) were also frequently noted. 93 (61%) of patients had blunt injuries and 59 (39%) penetrating ones. Severity of injury was dependent on ballistic features of the bullet, firing range, and anatomic site of impact. Two casualties died after a penetrating eye injury into the brain and one died as a result of postoperative aspiration after a knee injury.

Michael Krausz comments: "The need for authorities to control civil disturbances is well acknowledged. Techniques used by police forces to deter such activity must be effective and able to keep serious injuries to demonstrators to a minimum. We reported a substantial number of severe injuries and fatalities inflicted by use of rubber bullets when vulnerable upper-body regions such as the head, neck, and upper torso were struck. This type of ammunition should therefore not be considered a safe method of crowd control. New types of ammunition with higher accuracy and less force of impact than those currently in use are urgently needed for control of civil demonstrations. Meanwhile, to prevent serious blunt and penetrating injuries and fatalities, the anatomic target area should be rigorously limited to the lower limbs, and the minimum firing range should always be kept above 40 m."

Contact: Professor Michael M Krausz, Department of General Surgery, Rambam Medical Center, POB 9602, 31096 Haifa, Israel; T) +972 4 854 2782 or +972 5 767 2076; F) +972 4 854 3273; E)

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