Terrorist Attacks Against Health Care Facilities, Health Care Workers, and First Responders: A Scoping Review.
Prehospital and Disaster Medicine · 2025-08-01 · Scoping review
Abstract
INTRODUCTION: Since 2001, the world has encountered an increase in terrorist attacks on civilian targets, during which conventional as well as unconventional modalities are being used. Terrorist attacks put immediate strains on health care systems, whilst they may also directly threaten the safety of first responders, health care workers, and health care facilities. STUDY OBJECTIVE: This scoping review aimed to systematically map the existing research on terrorist attacks targeting health care facilities, health care workers, and first responders, and to identify opportunities to improve future research and health care response to terrorist attacks. METHODS: A scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. A systematic search for relevant literature was conducted through electronic databases including PubMed, Cochrane, and Embase. Inclusion and exclusion criteria were applied to check eligibility. Extracted data from the articles included the title, first author, year of publication, journal, study design, number of attacks, number of injured, number of fatalities, target type, and weapon modalities. Furthermore, methodological quality assessment was performed. RESULTS: The initial search within three major databases yielded 4,656 articles, including 2,777, 1,843, and 36 articles from PubMed, Embase, and Cochrane Library, respectively. Finally, 11 studies were included, which were all database reviews. CONCLUSIONS: This scoping review included 11 studies focusing on terrorist attacks against health care facilities, health care workers, and first responders. Nearly all studies were exclusively based on the Global Terrorism Database (GTD). An increase of attacks on health care-related targets was consistently reported by all studies in this review, but there were significant discrepancies in reported outcomes. In order to improve counter-terrorism preparedness and the future protection of health care workers, counter-terrorism medicine (CTM) research may benefit from a more standardized and transparent approach to document and analyze terrorist attacks, as well as the inclusion of additional databases other than the GTD.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Terror attacks & active shooter events
Related articles
- Spontaneous and Unplanned Mass Gathering Events: A Scoping Review of Health Considerations for Riots, Civil Unrest, and Protest. (Disaster Med Public Health Prep, 2025)
- Is tactical combat casualty care in terrorist attacks suitable for civilian first responders? (J Trauma Acute Care Surg, 2021)
- The Physical and Mental Health Challenges Experienced by 9/11 First Responders and Recovery Workers: A Review of the Literature. (Prehosp Disaster Med, 2019)
- Care under attack: a qualitative study of healthcare system disruption and health worker resilience during airstrikes on Lebanon. (BMJ Glob Health, 2026)
- Reducing the therapeutic vacuum: a qualitative study learning from experiences of care delivery during terror attacks in the UK over the past 20 years. (BMJ Open, 2026)
- Examining the experiences of prehospital emergency workers in emergency medical intervention during terrorist attacks: a qualitative study. (Eur J Trauma Emerg Surg, 2025)