Recent decades have seen an accelerating trend in warfare whereby a growing proportion of conflict-related deaths have been caused by explosions. Analysis of blast injury features little in anthropological literature. We present a review of clinical literature that includes prevalence of injury to anatomical regions and potential indicators of blast injury which can be used by forensic anthropologists. This includes high prevalence of extremity (22.8-91.2%) and facial (19.6-40%) injury in combat contexts, lower limb fractures (19-74.3%) in suicide bombing, traumatic amputation (3-43%) and diffuse fracture patterns in terrorist bombings. Potential indicators of blast trauma include blowout fractures in sinus cavities from blast overpressure, transverse mandibular fractures, and visceral surface rib fractures. Ability to recognize blast trauma and distinguish it in the skeleton is of importance in investigations and judicial proceedings relating to war crimes, terrorism, and human rights violations and likely to become increasingly crucial to forensic anthropology knowledge.
A B S T R A C TAnthropology features little in published literature about blast injuries. Contributions through case studies and experimental research are beginning to expand our understanding of the effect these injuries have on the human skeleton. This study examines blast injury and gunshot related fractures through multiple correspondence analysis (MCA) with the aim of establishing injury patterns between the two types of trauma. Using a sample of 491 individuals from Bosnia, MCA is employed to identify which body regions differentiate between blast or gunshot related fractures. Cranial fractures were more closely associated with gunshot related cases. Post-cranial fractures were associated with blast-related cases. A differentiation in post-cranial and cranial fractures between gunshot and blast related cases was revealed in the samples. The high prevalence of extremity trauma in blast is similar to previous work, but the smaller amount of cranial blast-related fractures differs from previous studies and from what is found in gunshot-related cases. Differentiation of blast and gunshot wound injuries can be made on the human skeleton and can be used to possibly interpret injury mechanism in large skeletal assemblages as well as single cases.
Court cases at the International Criminal Tribunal for the Former Yugoslavia (ICTY) have seen questions raised about the recognition and causes of blast-related trauma and the relationship to human rights abuses or combat. During trials, defence teams argued that trauma was combat related and prosecutors argued that trauma was related to executions. We compared a sample of 81 cases (males between 18 and 75) from a Bosnian mass grave investigation linked to the Kravica warehouse killings to published combat-related blast injury data from World War One, Vietnam, Northern Ireland, the first Gulf War, Operation Iraqi Freedom and Afghanistan. We also compared blast fracture injuries from Bosnia to blast fracture injuries sustained in bombings of buildings in two non-combat 'civilian' examples; the Oklahoma City and Birmingham pub bombings. A Chi-squared statistic with a Holm-Bonferroni correction assessed differences between prevalence of blast-related fractures in various body regions, where data were comparable. We found statistically significant differences between the Bosnian and combat contexts. We noted differences in the prevalence of head, torso, vertebral area, and limbs trauma, with a general trend for higher levels of more widespread trauma in the Bosnian sample. We noted that the pattern of trauma in the Bosnian cases resembled the pattern from the bombing in buildings civilian contexts. Variation in trauma patterns can be attributed to the influence of protective armour; the context of the environment; and the type of munition and its injuring mechanism. Blast fracture injuries sustained in the Bosnian sample showed patterns consistent with a lack of body armour, blast effects on people standing in enclosed buildings and the use of explosive munitions.
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