In addition to rubber bullets - which often have a metal core - police used tear gas, flash bang grenades, pepper spray and projectiles to control crowds of protesters demanding justice for the deceased 46-year-old George Floyd after a Minneapolis the police officer knelt on the neck, while other police officers retained his body.
Some peaceful protests have turned violent, with people breaking windows, burning buildings and looting shops.
Police use of rubber bullets sparked outrage as graphic images flashed on social media showing people who lost an eye or suffered other injuries after being hit.
A study published in 2017 in the BMJ found that 3% of people hit by rubber bullets died from this injury. Fifteen percent of the 1,984 people studied were permanently injured by rubber bullets, also known as "kinetic impact projectiles".
The rubber bullets should only be used to control "an extremely dangerous crowd," said Brian Higgins, the former police chief for Bergen County, New Jersey.
"Shooting them in open crowds is reckless and dangerous," said Dr. Douglas Lazzaro, professor and expert in eye trauma at NYU Langone Health.
Last week, a grandmother from La Mesa, California, was hospitalized in an intensive care unit after being hit between the eyes with a rubber bullet. Actor Kendrick Sampson said he was hit by rubber bullets seven times during a protest in Los Angeles.
In Washington, D.C., the National Guard reportedly fired rubber bullets on Monday to disperse peaceful protesters near a historic church where President Donald Trump was then photographed.
In a statement, Attorney General William Barr defended the actions of local and federal law enforcement officials in Washington, saying they had "made significant progress in restoring order in the nation's capital."
Barr did not mention the use of tear gas or rubber bullets.
Freelance photographer Linda Tirado said she was blinded by a rubber bullet during a demonstration in Minneapolis.
In an email, Minneapolis Police Department spokesman John Elder said, "We use 40mm less lethal foam marking rounds. We don't use rubber bullets."
Elder did not mention the brand name of the foam marking rounds used by the Minneapolis police. But a website for the "Round Impact 40mm OC Crushable Foam Round" portrays a green bullet-shaped product described as a "point-of-sight and direct-impact projectile". The site claims that projectiles are "a great solution if you need to neutralize a single subject or control a crowd".
No one knows how many times the police use rubber bullets or how many people are injured each year, said Dr. Rohini Haar, professor at the University of California-Berkeley School of Public Health and medical expert with Physicians for Human Rights. Many victims do not go to hospital.
Police are not required to document their use of rubber bullets, so there is no national data to show how often they are used, said Higgins, now an adjunct professor at the John Jay College of Criminal Justice at New York. There are no nationally agreed standards for their use.
When aimed at the legs, rubber bullets can prevent a dangerous person or crowd from approaching a police officer, Lazzaro said.
But when fired at point-blank range, rubber bullets can penetrate the skin, break bones, fracture the skull and explode the eyeball, he said. Rubber bullets can cause traumatic brain damage and "serious abdominal injury, including damage to the spleen and bowels as well as major blood vessels," said New York emergency room physician and spokesperson Dr. Robert Glatter of the American College of Emergency Physicians.
Shooting rubber bullets at a distance decreases both their strength and accuracy, increasing the risk of shooting people in front or hitting bystanders, Lazzaro said.
Call to ban rubber bullets
Physicians for Human Rights, a New York-based non-profit advocacy group, called for a ban on rubber bullets.
The British military developed rubber bullets 50 years ago to control nationalist rioters in Northern Ireland, although the United Kingdom stopped using them decades ago.
Rubber bullets are used by Israeli security forces against Palestinian protesters. Last year, French police were criticized for using rubber bullets after dozens of demonstrators in "yellow jackets" were blinded and hundreds injured.
"Rubber balls are used almost every day around the world," said Haar. "Using them against unarmed civilians is a huge violation of human rights."
Many "less than deadly" police weapons can cause serious damage, according to Doctors for Human Rights.
- Acoustic weapons, such as sound cannons that make painfully loud noises, can damage hearing.
- Tear gas can make it difficult to see and breathe.
- The pepper spray, although painful and irritating, does not cause permanent damage, said Lazzaro.
- Pepper spray balls, which have been used to suppress recent protests, can be fatal when used improperly. In 2004, a 21-year-old Boston woman was hit in the eye and killed by a pepper spray fired by the police to disperse crowds celebrating the city's World Series victory.
- Disorientation devices that create loud noises and bright lights, known as a concussion grenade or flash bang, can cause severe burns and explosions, including damage to the eardrum. Panicked crowds can cause crush injuries. Water cannons can cause internal injuries, falls, and even frostbite in cold weather.
- Physical force, like hitting someone to control it, causes about 1 in 3 people to be hospitalized, said Dr. Howie Mell, spokesperson for the American College of Emergency Physicians and former tactical physician, who worked with SWAT teams.
Rubber bullets are less harmful than subduing people with "physical force or regular bullets," said Mell. "But we're getting a lot more out of it this week than usual."
Kaiser Health News (KHN) is a non-profit news service covering health issues. It is an independent program of the editorial staff of the Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
