This systematic review out of Berkeley investigated data on death, injury and disability resulting from crowd control projectiles:

• Rubber and plastic bullets
• Beanbag rounds
• Shot pellets
• Baton rounds

The researchers looked at published data from a 27 year period in the US, UK/N Ireland, Israel, Palestine, Switzerland, Turkey, Kashmir and Nepal.

The study was part of a larger effort from Physicians for Human Rights and the International Network of Civil Liberties Organizations.

What did they find?

Analysing 26 articles (mainly cohort studies) including 1,984 injured people, they identified 53 (3%) deaths and 300 (15%) permanently disabled. Half of total deaths and 83% of disabilities were due to head or neck strikes.

More than half (56%) of the deaths were from penetrative injuries, and 27% from chest or abdominal trauma.

The majority of permanent disability was vision loss, or abdominal injuries resulting in splenectomy or colostomy.

71% of survived injuries were severe, mostly to skin or extremities.

"Given their inherent inaccuracy, potential for misuse and associated health consequences of severe injury, disability and death, KIPs do not appear to be appropriate weapons for use in crowd-control settings."

Take-home

Although colloquially called 'non-lethal weapons', it would be more accurate to label kinetic impact projectiles (KIPs) as less-lethal weapons given the high risk of severe injury, permanent disability or even death.

"We identified only two basic contexts in which CCWs should be used in crowd-control settings:

1. Arrest of individuals engaged in unlawful behaviour, such as throwing rocks and;
2. Crowd dispersal in riot situations that threaten public safety."

Compounding issue...

Several articles highlighted the effect on morbidity of delays in accessing medical care due to police action and civil unrest.

"There is an urgent need to establish international guidelines on the use of CCWs to prevent unnecessary injury, disability and death, particularly in the use of operational models that avoid the use of weapons."

summary

• Rohini J Haar, Vincent Iacopino, Nikhil Ranadive, Madhavi Dandu, and Sheri D Weiser.
• School of Public Health, Division of Epidemiology, University of California, Berkeley, California, USA.
• BMJ Open. 2017 Dec 5; 7 (12): e018154.

ObjectiveWe conducted a systematic review of the available literature on deaths, injuries and permanent disability from rubber and plastic bullets, as well as from bean bag rounds, shot pellets and other projectiles used in arrests, protests and other contexts from 1 January 1990 until 1 June 2017.Data SourcesPubMed, Scopus, JSTOR and grey literature.Data SynthesisWe report on descriptive statistics as well as data on injury severity, permanent disability and death. We analysed potential risk factors for injury severity, including the site of impact, firing distance and access to medical care.ResultsOf 3228 identified articles, 26 articles met inclusion criteria. These articles included injury data on 1984 people, 53 of whom died as a result of their injuries. 300 people suffered permanent disability. Deaths and permanent disability often resulted from strikes to the head and neck (49.1% of deaths and 82.6% of permanent disabilities). Of the 2135 injuries in those who survived their injuries, 71% were severe, injuries to the skin and to the extremities were most frequent. Anatomical site of impact, firing distance and timely access to medical care were correlated with injury severity and risk of disability.ConclusionsKinetic impact projectiles (KIPs), often called rubber or plastic bullets, are used commonly in crowd-control settings. We find that these projectiles have caused significant morbidity and mortality during the past 27 years, much of it from penetrative injuries and head, neck and torso trauma. Given their inherent inaccuracy, potential for misuse and associated health consequences of severe injury, disability and death, KIPs do not appear to be appropriate weapons for use in crowd-control settings. There is an urgent need to establish international guidelines on the use of crowd-control weapons to prevent unnecessary injuries and deaths.© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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