Skip to main content Accessibility help

Physical Health of Members of the Public Who Experienced Terrorist Bombings in London on 07 July 2005

  • Michael A. Catchpole (a1) and Oliver Morgan (a1)



On 07 July 2005, four bombs were detonated in London, killing 52 members of the public. Approximately 700 individuals received treatment either at the scene or at nearby hospitals.


Significant concerns about the potential long-term psychological and physical health effects of exposure to the explosions were raised immediately after the bombings. To address these concerns, a public health register was established for the purpose of following-up with individuals exposed to the explosions.


Invitations to enroll in the register were sent to individuals exposed to the explosions. A range of health, emergency, and humanitarian service records relating to the response to the explosions were used to identify eligible individuals. Follow-up was undertaken through self-administered questionnaires. The number of patients exposed to fumes, smoke, dust, and who experienced blood splashes, individuals who reported injuries, and the type and duration of health symptoms were calculated. Odds ratios of health symptoms by exposure for greater or less than 30 minutes were calculated.


A total of 784 eligible individuals were identified, of whom, 258 (33%) agreed to participate in the register, and 173 (22%) returned completed questionnaires between 8 to 23 months after the explosions. The majority of individuals reported exposure to fumes, smoke, or dust, while more than two-fifths also reported exposure to blood. In addition to cuts and puncture wounds, the most frequent injury was ear damage. Most individuals experienced health symptoms for less than four weeks, with the exception of hearing problems, which lasted longer. Four-fifths of individuals felt that they had suffered emotional distress and half of them were receiving counseling.


The results indicated that the main long-term health effects, apart from those associated with traumatic amputations, were hearing loss and psychological disorders. While these findings provide a degree of reassurance of the absence of long-term effects, the low response rate limits the extent to which this can be extrapolated to all those exposed to the bombings. Given the importance of immediate assessment of the range and type of exposure and injury in incidents such as the London bombings, and the difficulties in contacting individuals after the immediate response phase, there is need to develop better systems for identifying and enrolling exposed individuals into post-incident health monitoring.


Corresponding author

Deputy Director Centre for Infections Health Protection Agency 61 Colindale Avenue London NW9 5EQ UK E-mail:


Hide All
1.Intelligence and Security Committee. Report into the London Terrorist Attacks on 7 July 2005. Available at Accessed 15 May 2006.
2.Ryan, J, Montgomery, H: The London attacks—Preparedness: Terrorism and the medical response. N Engl J Med 2005;353(6):543545.
3.Agency for Toxic Substances and Disease Registry: Proceedings: Expert Panel on Public Health Registries, May 13th, 2004. ASTDR, Atlanta, 2004.
4.Whalley, MG, Brewin, CR: Mental health following terrorist attacks. Brit J Psychiatry 2007;190:9496.
5.Brewin, CR, Andrews, B, Valentine, JD: Meta-analysis of risk factors for post-traumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 2000;68:748766.
6.Holbrook, TL, Hoyt, DB, Stein, MB, Sieber, WJ: Gender differences in long-term posttraumatic stress disorder outcomes after major trauma: Women are at higher risk of adverse outcomes than men. J Trauma 2002:53:882888.
7.North, CS, Pfefferbaum, B, Tivis, Kawasaki A, Reddy, C, Spitznagel, EL: The course of post traumatic stress disorder in a follow-up study of survivors of the Oklahoma City bombing. Ann Clin Psychiatry 2004:16:209215.
8.Johansen, VA, Wahl, AK, Eilertsen, DE, Weisaeth, L: Prevalence and predictors of post-traumatic stress disorder (PTSD) in physically injured victims of non-domestic violence. A longitudinal study. Soc Psychiatry Psychiatr Epidemiol 2007;42:583593.
9.Grieger, TA, Cozza, SJ, Ursano, RJ, Hoge, C, Martinez, PE, Engel, CC, Wain, HJ: Posttraumatic stress disorder and depression in battle-injured soldiers. Am J Psychiatry 2006;163:17771783.
10.Rubin, J, Wessely, S: Psychological reactions to the London bombings. The Magazine of the Health Protection Agency 2007;7:2022.
11.Brackbill, RM, Thorpe, LE, DiGrande, L, Perrin, M, Sapp, JH, Wu, D, Campolucci, S, Walker, DJ, Cone, J, Pulliam, P, Thalji, L, Farfel, MR, Thomas, P: Surveillance for World Trade Center disaster health effects among survivors of collapsed and damaged buildings. MMWR Surveillance Summ 2006:55:118.
12.Shariat, S, Mallonee, S, Kruger, E, Farmer, K, North, C. A prospective study of long-term health outcomes among Oklahoma City bombing survivors. J Okla State Med Assoc 1999;92(4):178186.
13.Donker, GA, Yzermans, CJ, Spreeuwenberg, P, van der Zee, J: Symptom attribution after a plane crash: comparison between self-reported symptoms and GP records. Br J Gen Pract 2002;52(484):917922.
14.Brewin, CR, Rose, S, Andrews, B, Green, J, Tata, P, McEvedy, C, Turner, S, Foa, EB: Brief screening instrument for post-traumatic stress disorder. Br J Psychiatry 2002;181:157162.
15.Cohen, JT, Ziv, G, Bloom, J, Zikk, D, Rapoport, Y, Himmelfarb, MZ: Blast injury of the ear in a confined space explosion: auditory and vestibular evaluation. Isr Med Assoc J 2002;4(7):559562. Ceballos, JP, Turegano-Fuentes, F, Perez-Diaz, D, Sanz-Sanchez, M, Martin-Llorente, C, Guerrero-Sanz, JE: 11 March 2004: The terrorist bomb explosions in Madrid, Spain—An analysis of the logistics, injuries sustained and clinical management of casualties treated at the closest hospital. Crit Care 2005;9(1):104111.
17.Wilson, J, Murray, V Kettle: The July 2005 London Bombings: Environmental monitoring for non-infectious materials release, and initial health risk assessment. Chemical Hazards and Poisons Report 2008;12:1113.
18.Boscarino, JA, Figley, CR, Adams, RE, Galea, S, Resnick, H, Fleischman, AR, Bucuvalas, M, Gold, J: Adverse reactions associated with studying persons recently exposed to mass urban disaster. J Nerv Ment Dis 2004;192(8):515524.
19.Weisaeth, L: Importance of high response rates in traumatic stress research. Acta Psychiatr Scand Suppl 1989;355:131137.
20.Braverman, I, Wexler, D, Oren, M: A novel mode of infection with hepatitis B: Penetrating bone fragments due to the explosion of a suicide bomber. Isr Med Assoc J 2002;4(7):528529.
21.Centers for Disease Control and Prevention: Recommendations for postexpo-sure interventions to prevent infection with Hepatitis B virus, Hepatitis C virus, or human immunodeficiency virus, and tetanus in persons wounded during bombings and similar mass-casualty events—United States, 2008. MMWR 2008;57:(No RR-6).
22.Bascetta, C: September 11. Monitoring of World Trade Center health effects has progressed, but not for federal responders. A testimony before the Subcommittee on National Security, Emerging Threats and International Relations, Committee on Government Reform, [US] House of Representatives, 2006, p 19.
23.Slottje, P, Huizink, AC, Twisk, JW, Witteveen, AB, van der Ploeg, HM, Bramsen, I, Smidt, N, Bijlsma, JA, Bouter, LM, van Mechelen, W, Smid, T: Epidemiological study air disaster in Amsterdam (ESADA): Study design. BMC Public Health 2005;5:54.
24.Landrigan, PJ, Lioy, PJ, Thurston, G, Berkowitz, G, Chen, LC, Chillrud, SN, Gavett, SH, Georgopoulos, PG, Geyh, AS, Levin, S, Perera, F, Rappaport, SM, Small, C, the NIEHS World Trade Center Working Group: Health and environmental consequences of the world trade center disaster. Environ Health Perspect 2004;112(6):731739.
25.Morgan, O, Verlander, NQ, Kennedy, F, Moore, M, Birch, S, Kearney, J, Lewthwaite, P, Lewis, R, O'Brian, S, Osman, J, Reacher, M: Exposures and reported symptoms associated with occupational deployment to the Buncefield fuel depot fire, England 2005. Occup Environ Med 2008;65(6):404411.



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed