Paper Title
Menace of Chemical Terror Attacks in India in the Last Five Decades

Abstract
Objective: To be better prepared for future chemical terror attacks and to train healthcare providers and policy-makers for these adverse events in India by reviewing a large publicly-available database having five decades of worldwide incidents of terrorism . Methods: A descriptive study of chemical agent terror attacks was conducted to understand historical trends in agents, targets and routes of exposure using The Global Terrorism Database (GTD) containing International terror attacks, maintained by the National Consortium for the Study of Terrorism and Responses to Terrorism (START), University of Maryland, USA. Full dataset of 191,000 incidents from 1970-2018 were downloaded onto Microsoft Excel. Cases without chemical agents as the primary weapon were eliminated and included 401 cases in which a chemical weapon was employed, from which only Indian data were taken for analysis. Results: Out of the 401 international terror incidents involving chemical weapon use from 1970 to 2018, 14 Indian incidents during this period were included for this study. This is 3.5 percent (%) of the international chemical terror attacks. There has been an increase in the absolute number of chemical attacks after the year 2000, particularly in Jammu and Kashmir region. Seven percent of chemical attacks involved an acid bomb. The most common targets were private citizens and property (64%), religious figures/Institution(7%), and educational institutions(7%). Acid was used in 50 % of cases and cyanide and Pepper spray were used in 7% of the cases each. The most frequent routes of exposure were dermal and mucosal. In 21% of the cases unknown poisons were used. Conclusions: Jammu and Kashmir region appear to be most at risk for chemical weapon use hence preparedness efforts should prioritize this region. Training activities should focus on Police, educational facilities, and private citizens. Keywords - Chemical Weapons, Terrorism, Preparedness