Work

A multi-country epidemiological analysis of mortality from landmines and other explosive ordnance

Year: 2026

Type: article

Abstract: Explosive ordnance including landmines, improvised explosive devices and explosive remnants of war are known to contaminate at least fifty-eight countries, threatening the health of affected communities across generations. Despite the scale of this problem, mortality estimates pertaining to these weapons are limited in scope. This study addresses this knowledge gap by conducting a multi-country epidemiological study on explosive weapons casualties in low-resource settings. A retrospective analysis of secondary data was conducted with data sourced from mine action authorities and centres, and international non-government organisations from across 17 countries. Casualty information contained included demographics, mortality, injury data, and incident details. Univariate and multivariate logistic regression models were used to assess which characteristics were associated with mortality and survival. Here we show one of the largest epidemiological analyses, to date, of explosive weapons casualties. The overall case fatality rate was 38.8% and females have an elevated risk of fatal outcomes. Overall, children experience lower odds of death compared to adults; and, improvised explosive devices have the highest lethality of the weapons examined. This research highlights the lethality of explosive weapons among local casualties, with a case fatality rate significantly higher than that observed in high-resource civilian or military trauma systems, illustrating the deadliness and indiscriminate nature of these devices. The findings of this analysis can inform injury prevention and trauma care initiatives targeting preventable death and disability for casualties of explosive ordnance. Explosive weapons such as landmines, improvised explosive devices and explosive remnants of war are known to pollute at least 58 countries. This study considered how these weapons impact health using casualty data to estimate mortality and understand the factors impacting death, such as age, gender and explosive type. Our results found that 38.8% of those injured die from their injuries, with improvised explosive devices the deadliest weapon type. Females experienced a higher risk of death compared to males, while children were found to have lower deaths compared to adults. This research shows the deadly nature of these weapons and impact on health. These findings can support plans to both prevent and treat injuries to reduce deaths during and after war. Pizzino et al. conduct a multi-country epidemiological analysis of landmine and other explosive ordnance casualties using data from over 100,000 casualties across 17 settings. They find a 38.8% case fatality rate, with females at higher risk than males, children less likely to die than adults, and improvised explosive devices most lethal.

Source: Communications Medicine

DOI: 10.1038/s43856-026-01430-y

Authors: Stacey Pizzino, Jo Durham, Hannah B. Wild, Vivienne Tippett, Michael Waller

Institutions: The University of Queensland, Queensland University of Technology, University of Washington, Royal Brisbane and Women's Hospital

Language: English

Topic: Health and Conflict Studies

Subfield: General Health Professions

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,690