Contextual Factors Among Indiscriminate or Large Attacks on Food or Water Supplies, 1946-2015

This research updates previous inventories of malicious attacks on food and water and includes data from 1946 through mid-2015. A systematic search of news reports, databases, and previous inventories of poisoning events was undertaken. Incidents that threatened or were intended to achieve direct harm to humans and that were either relatively large (more than 4 victims) or indiscriminate in intent or realization were included. Agents could be chemical, biological, or radionuclear. Reports of candidate incidents were subjected to systematic inclusion and exclusion criteria as well as validity analysis (not always clearly undertaken in previous inventories of such attacks). We summarize contextual aspects of the attacks that may be important for scenario prioritization, modelling, and defensive preparedness. Opportunity, and particularly access to dangerous agents, is key to most realized attacks. The most common motives and relative success rate in causing harm were very different between food and water attacks. The likelihood that people were made ill or died also varied by food or water mode and according to motive and opportunity for delivery of the hazardous agent. Deaths and illness associated with attacks during food manufacture and prior to sale have been fewer than those in some other contexts. Valuable opportunities for food defense improvements are identified in other contexts, especially food prepared in private or community settings.