The body\u2019s air-filled structures are most vulnerable. In the lungs, the wave compresses and then rapidly decompresses delicate tissue, causing bruising<\/a>, tearing<\/a> and internal bleeding. This \u201cblast lung\u201d can fatally disrupt the lungs\u2019 ability to exchange oxygen<\/a> and may kill within minutes.<\/p>\n The ears are similarly exposed. Even relatively small explosions \u2013 involving less than 80kg of explosive material \u2013 can damage the eardrum and the sensory nerves responsible for hearing. One study<\/a> found that being within ten metres of a detonation makes hearing loss eight times more likely. In around one in three<\/a> blast-related ear injuries in military personnel, the nerve damage is permanent.<\/p>\n The brain is particularly susceptible. Consisting of around 80% water<\/a>, it is highly sensitive to pressure changes, and in built environments the blast wave bounces off walls and surfaces, converging from multiple directions at once. Evidence from Iraq and Afghanistan suggests that almost half<\/a> of military personnel exposed to blasts suffered some form of brain injury \u2013 the leading cause of disability and death<\/a> in those conflicts. Civilians face even greater risk, lacking helmets and body armour.<\/p>\n Symptoms range from concussion and disorientation \u2013 the \u201cshell shock\u201d of earlier wars \u2013 through to diffuse axonal injury<\/a>, where the brain\u2019s internal wiring is stretched and torn, and bleeding or swelling<\/a> within the skull. Some effects are immediate; others emerge over hours or days<\/a> as blood vessels in the brain narrow in response to the pressure<\/a>, restricting blood flow to critical areas.<\/p>\n The eyes \u2013 fluid-filled and exposed \u2013 are also at risk. Blast injuries to the eye frequently have poor outcomes<\/a> and can include ruptured globes, traumatic cataracts and a range of other serious damage<\/a>. The heart and aorta<\/a> can also be affected, in some cases causing a fatal cardiac event<\/a>, while changes in heart rate, breathing and blood pressure<\/a> may follow even in those not directly struck.<\/p>\n Abdominal organs are not spared. The small intestine, spleen and liver are the most commonly injured<\/a>, though symptoms may not appear until well after the explosion.<\/p>\n Those who survive the initial pressure wave face further hazards almost immediately. Fragments of building materials, glass and metal become high-velocity projectiles, causing lacerations and penetrating injuries. This is followed by the blast wind \u2013 a powerful rush of air that can exceed hurricane force<\/a> and hurl people against walls, vehicles and rubble.<\/p>\n The resulting injuries are similar to those seen in high-speed road traffic collisions: fractures, bruising<\/a>, traumatic brain injury<\/a> and, in severe cases, traumatic amputation<\/a>. <\/p>\nFlying debris and the blast wind<\/h2>\n
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