The Beirut Port explosion: injury trends from a mass survey of emergency admissions

Analysis of ocular injury 1-year outcome in survivors of Beirut Port ammonium nitrate blast

“…A previous study showed that the most common surgeries performed following the Beirut blast were fractures, tendon repair, and suturing of ocular wounds (Table 3 ) [ 1 ]. This traumatic event with unique ophthalmological importance is reminiscent of the inordinate number of eye casualties following the 1917 Halifax Explosion [ 5 ].…”

“…The general setup in 1917 included chloroform anesthesia and topical cocaine anesthesia, operating with the naked eye under the light of a bulb, use of commercially available silk sutures, and operating over a period of 4 days by a general eye ear nose throat practitioner. In the Beirut disaster a century later, 14,000 were injured, 219 died [ 1 ], 48 subjects underwent ocular surgery, and 4 received immediate enucleations (8.3%) [ 2 , 3 ]. The general setup included development of better instrumentation (operating microscope, vitrector, phacoemulsification, intraocular lens, intraocular magnet and forceps), smaller sutures with needles, use of viscoelastics, and prompt surgical management by vitreoretinal fellowship-trained ophthalmologists well trained in trauma management.…”

“…1 ) that starts with formation of a semi-nuclear orange mushroom-shaped cloud. The magnitude of the blast overpressure and the injuries are proportional to the amount of exploded AN and to the distance from the blast [ 1 ]. A second wave of injuries can occur due to the collapse of buildings or because of falling objects [ 22 ].…”

“…A consignment of an estimated 2750 tons of discretely and unsafely stored ammonium nitrate (AN) (NH 4 NO 3 ) in the warehouse facility of the port of Beirut exploded at 6:05 pm on August 4, 2020, destroying a large part of the capital of Lebanon, killing 218, wounding some 14,000 people [ 1 ], and leaving around 300,000 residents homeless [ 2 , 3 ]. Wounded individuals were rushed to still-functional hospitals (those that did not sustain major structural damage), which in turn became severely overcrowded in 2 h. The blast lofted a white mushroom cloud over the Lebanese capital with two million inhabitants and is considered the most severe anthropological disaster of the decade with a consequent direct and indirect financial and economic loss edging 10 billion US dollars [ 1 – 3 ]. The Beirut Port explosion traumatized the living population after a series of political unrest, COVID-19 outbreak, security challenges, and unprecedented economic collapse, transforming Lebanon from a functioning nation to a failing one.…”

“…Most of the literature have dealt with the immediate human bodily injuries and economic aftermath of collapsed historic buildings [ 1 – 3 ]. Except for a few reports [ 4 – 10 ], publications on major nuclear or major non-nuclear disasters did not focus on ocular injuries, and those that did tackled only the acute phase.…”