Effect of type and transfer of conventional weapons on civilian injuries: retrospective analysis of prospective data from Red Cross hospitals

OBJECTIVE: To examine the link between different weapons used in modern wars and their potential to injury civilians. DESIGN: Retrospective analysis of prospectively collected data about hospital admissions. SETTING: Hospitals of the International Committee of the Red Cross. SUBJECTS: 18 877 people wounded by bullets, fragmentation munitions, or mines. Of these, 2012 had been admitted to the hospital in Kabul within six hours of injury. MAIN OUTCOME MEASURES: Age and sex of wounded people according to cause of injury and whether they were civilians (women and girls, boys under 16 years old, or men of 50 or more). RESULTS: 18.7% of those injured by bullets, 34.1% of those injured by fragments, and 30.8% of those injured by mines were civilians. Of those admitted to the Red Cross hospital in Kabul within six hours of injury, 39.1% of those injured by bullets, 60.6% of those injured by fragments, and 55.0% of those injured by mines were civilians. CONCLUSIONS: The proportion of civilians injured differs between weapon systems. The higher proportion injured by fragments and mines is explicable in terms of the military efficiency of weapons, the distance between user and victim, and the effect that the kind of weapon has on the psychology of the user.