Chemical, biological and radiological terrorism: the GP’s role in disaster response and triage

Biological agents have been used in warfare over many centuries, such as the catapulting of plague-infected bodies into cities to infect soldiers and civilians during sieges in the Middle Ages. The use of chemicals is a more recent development, the first extensive use of poisonous gases being in World War I. Nuclear weapons were developed and used during World War II, but other radiological weapons, such as the dirty bomb, have not yet been used. Technological advances in warfare have greatly reduced the overall numbers of casualties in conflicts, but the proportion of civilian wartime casualties has increased greatly and now exceeds troop casualties.