Fatal and non-fatal injuries among U.S. Air Force personnel resulting from the terrorist bombing of the Khobar Towers.

Background: Culminating with the events of September 11, 2001, U.S. civilian and military populations are vulnerable to terrorist attacks. Information about the patterns of injuries and their causes inform disaster management planning and can improve structural and architectural design. This report documents the injuries following an estimated 20K bomb at the Khobar Towers military compound in Dhahran, Saudi Arabia.

Methods: US Air Force personnel in the compound at the time of the bombing were evaluated. Data were collected through a mail survey, and a review of military medical records and autopsy reports. Outcome measures included injury types, treatment status, severity, and causes of injuries.

Results: The study identified 574 persons who were injured in the bombing; 19 persons died. A total of 420 (73%) persons were injured directly in the blast and 154 (27%) persons were injured during evacuation, search and rescue, during cleanup, or sustained only auditory or inhalation trauma. Sixteen percent of survivors injured directly in the blast were hospitalized; 6% were critical. Soft tissue and foreign body injuries of the lower extremities were the most common injuries among survivors, most often caused by glass. Persons who died suffered extensive, multiple injuries from blunt trauma and one death was caused by glass.

Conclusions: All deaths were immediate and the majority of survivors suffered minor to moderate injuries. Injuries and deaths were consistent with extensive glass damage in the compound and fragmentation of building concrete. Improved building designs and retrofits such as blast-resistant glass and prevention of structural collapse or building fragmentation should be considered in building design and construction in high threat areas.