Page 54 - JSOM Fall 2021

Results were exported into an Excel spreadsheet for analysis. be a mass murder committed by the group’s leaders after their
11
Attacks met inclusion criteria when they fulfilled the follow- predictions of the apocalypse failed to come about. The use
ing three terrorism-related criteria as established by the GTD. of sulfuric acid as a fire accelerant in a church inferno has been
Ambiguous events were excluded when there was uncertainty documented. 12,13 Multiple reports of poisoning are also men-
as to whether an incident met any of the criteria for inclusion tioned in the grey literature, but no definitive determination of
as a GTD terrorist incident. Attacks that were attempted but the chemical was provided. 12,14
not successfully carried out were included. These criteria are
determined within the database, rather than by the authors. East Asia sustained the highest NFI toll of 7,007 as a result
of chemical attacks (Table 1). A total of 12 deaths and 5,500
• Criterion I: The act must be aimed at attaining a politi- NFIs were attributed to the Tokyo subway sarin gas attack in
cal, economic, religious, or social goal. 1995 by the Aum Shinrikyo cult.
• Criterion II: There must be evidence of an intention to
coerce, intimidate, or convey some other message to TABLE 1 Terrorism-Related Chemical Weapon Attacks by Region,
a larger audience (or audiences) than the immediate Fatalities, and Nonfatal Injuries
victims. Region Events Fatalities Nonfatal Injuries
• Criterion III: The action must be outside the context Australia and Oceania 11 0 23
of legitimate warfare activities, that is, the act must be Central America and
outside the parameters permitted by international hu- Caribbean 2 0 0
manitarian law, particularly the admonition against de- Central Asia 1 15 53
liberately targeting civilians or noncombatants. East Asia 19 21 7,007
Eastern Europe 14 6 36
GTD-listed events of significance were cross-referenced with
lay news reports and other grey literature to ensure there were Middle East and 70 184 2,293
North Africa
no major discrepancies in reporting and to fill in any details
not included in the GTD description of events. North America 25 1 102
South America 26 108 80
South Asia 101 297 3,006
Results Southeast Asia 14 19 144
South Asia accounted for nearly 30% of CWA attacks (101 of Sub-Saharan Africa 16 264 517
347), with 73 of the 101 occurring in Afghanistan (Figure 1). Western Europe 48 6 100
The Taliban was implicated in 40 of the 101 events, utilizing Global total 347 921 13,361
a mixture of agents including unknown chemical gases (likely
representing trials of a number of different chemicals), con- Chemical attacks predominantly targeted private citizens or
taminating water sources with pesticides, and using corrosive buildings (49 of 70) in the Middle East, businesses (10 of 25)
acid. Although the exact chemical modality used in such at- in North America, educational facilities (34 of 101) and po-
tacks often remain unconfirmed, grey literature searches sug- lice (32 of 101) in South Asia, and government (13 of 48) in
gested possible use of white phosphorus. 9 Western Europe. Only 13 documented chemical attacks were
targeted toward the military during the study period.
FIGURE 1 Chemical warfare agent events by region.

Discussion
The use of CWAs in domestic terrorism has the potential to
create high levels of complexity in the tactical prehospital
response. Recent events, such as the Novichok attack in the
United Kingdom, have seen first responders treating patients
prior to toxidrome identification, resulting in contamination
of responding staff. 15
State-sponsored use of CWAs, such as the VX gas assassina-
tion of North Korean Kim Nam Jong or the Salisbury, United
Kingdom, poisoning with Novichok, appears more likely to
tend toward individual effect, with highly potent agents used.
It is worth noting that the GTD database does not include
acts of state terrorism. Nonstate actors without the same ac-
Cult-related chemical events accounted for both the highest cess to potent agents may target larger groups or more public
death toll and highest NFI toll from an individual attack. The areas for a more visible and destructive effect, but they may
largest death toll from a single event was attributed to the mass not have the same means to implement focused individual
murder of followers of the Movement for the Restoration of assassinations.
the Ten Commandments of God cult in the Kasese District of
Uganda in March 2000, in which 200 people died. The exact The 2017 terrorist plot to place an improvised explosive device
10
circumstances surrounding the event remain elusive. Followers on a commercial passenger jet flying out of Sydney, Australia,
of the religious cult movement died in an intentional church also uncovered a crude dispersal device created by the attackers
fire and a series of poisonings and killings. These were initially using hydrogen sulphide. Use of toxic industrial chemicals can
thought to be a group suicide, but it was later determined to bypass the requirement for hard-to-produce CWAs and allow

52 | JSOM Volume 21, Edition 3 / Fall 2021