Falls and Injuries After Heading to a Bomb Shelter Following Rocket Warning Sirens in Israel

In recent years, Israel has experienced a rise in rocket attacks, forcing civilians to evacuate quickly to bomb shelters. These rapid evacuations have resulted in increased fall-related injuries, particularly among vulnerable groups such as the elderly and those with preexisting medical conditions.

To assess the patterns of injuries, the contributing factors to falls and orthopedic injuries, particularly fractures, sustained during falls in the process of evacuation to shelters during rocket warning sirens.

We conducted a retrospective cohort study, including 174 patients treated at Rambam Health Care Campus for falls and injuries sustained during evacuation to bomb shelters following rocket warning sirens.

The mean age was 54.4 years; 106 (60.9%) were female. We found that women were significantly older than men, with a 50% likelihood of being >56 years (P = 0.017; relative risk (RR) = 1.50; 95% confidence interval (CI) = 1.07-2.09). The most prevalent injuries were contusions (100, 57.5%) and fractures (60, 34.5%). The most common injury sites were the neck (42, 24.1%), back (29, 16.7%), wrist (23, 13.2%), and knee (21, 12.1%). The predominant chronic diseases were metabolic (74, 42.5%) and cardiovascular (46, 26.4%). Most injuries occurred at home (153, 87.9%).

Falls during shelter evacuation constitute a major orthopedic hazard. Women were significantly older and consequently more susceptible to serious fall incidents. Comorbidities (especially metabolic and cardiovascular) may further increase risk. Preventive measures should focus on house security and the specific protection of high-risk individuals.