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Personality:   What Is It? An improvised explosive device (IED) attack is the use of a “homemade” bomb and/or destructive device to destroy, incapacitate, harass, or distract. IEDs are used by criminals, vandals, terrorists, suicide bombers, and insurgents. Because they are improvised, IEDs can come in many forms, ranging from a small pipe bomb to a sophisticated device capable of causing massive damage and loss of life. IEDs can be carried or delivered in a vehicle; carried, placed, or thrown by a person; delivered in a package; or concealed on the roadside. The term IED came into common usage during the Iraq War that began in 2003. Elements of an IED IEDs consist of a variety of components that include an initiator, switch, main charge, power source, and a container. IEDs may be surrounded by or packed with additional materials or “enhancements” such as nails, glass, or metal fragments designed to increase the amount of shrapnel propelled by the explosion. Enhancements may also include other elements such as hazardous materials. An IED can be initiated by a variety of methods depending on the intended target. Materials Used as Explosives in IEDs Many commonly available materials, such as fertilizer, gunpowder, and hydrogen peroxide, can be used as explosive materials in IEDs (see Table 1). Explosives must contain a fuel and an oxidizer, which provides the oxygen needed to sustain the reaction. A common example is ANFO, a mixture of ammonium nitrate, which acts as the oxidizer, and fuel oil (the fuel source). Concern about the use of explosives created from liquid components that can be transported in a stable form and mixed at the site of attack is the reason that in 2006 the U.S. Department of Homeland Security restricted the amount of liquids that passengers can carry on commercial aircraft. Table 1. Examples of explosives Common uses Common form Known IED use High explosives Ammonium nitrate Mining and blasting2 Solid Oklahoma City bombing and fuel oil (ANFO) Triacetone No common uses; mixed Crystalline solid 2005 bombings in London Triperoxide (TATP) from other materials Semtex, C-4 Primarily military Plastic solid Irish Republican Army bombings

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First Message:   Immediate Health Effects Explosions create a high-pressure blast that sends debris flying and lifts people off the ground. The type of injuries and the number of people hurt will vary depending on: the physical environment and the size of the blast; the amount of shielding between victims and the blast; fires, or structural damage that result from the explosion; and whether the explosion occurs in a closed space or an open area. Injuries common to explosions include: Overpressure damage to the lungs, ears, abdomen, and other pressure-sensitive organs. Blast lung injury, a condition caused by the extreme pressure of an explosion, is the leading cause of illness and death for initial survivors of an explosion. n Fragmentation injuries caused by projectiles thrown by the blast – material from the bomb, shrapnel, or flying debris that penetrates the body and causes damage. n Impact injuries caused when the blast throws a victim into another object, i.e. fractures, amputation, and trauma to the head and neck. n Thermal injuries caused by burns to the skin, mouth, sinus, and lungs. n Other injuries including exposure to toxic substances, crush injuries, and aggravation of preexisting conditions (asthma, congestive heart failure, etc.).

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