Rubber bullets cause fatal injuries among three in every 100 cases, according to a study that used data from nine countries, including India, prompting calls for an alternative form of crowd control.
Researchers, including Rohini Haar of the University of California Berkeley, looked at 26 scientific reports published on the injury, disability, and death caused by rubber bullets between 1990 and 2017 in India, Israel and the Palestinian territories, the US, Northern Ireland, Nepal, and Switzerland.
In the data, a total of 1,984 people were found to have been injured, of whom 53 (three percent) died, researchers said.
"Some 300 (15.5 percent) of all survivors were left with a permanent disability as a direct result of the rubber bullet impact they sustained - usually to the head and neck," researchers wrote in the journal BMJ Open.
The kinetic impact projectiles (KIPs) or rubber baton rounds, rubber or plastic bullets, are used commonly in crowd-control settings.
They are meant to stun rather than kill people as a means of riot and crowd control but have left a long line of victims on their trail.
"We find that these projectiles have caused significant morbidity (injury) and mortality during the past 27 years, much of it from penetrative injuries and head, neck and torso trauma," researchers said.
"Given their inherent inaccuracy, the potential for misuse and associated health consequences of severe injury and death, KIPs do not appear to be appropriate weapons for use in crowd-control settings," they said.
"There is an urgent need to establish international guidelines on the use of crowd-control weapons to prevent unnecessary injuries and deaths," the researchers said.
The team pointed out that other crowd-control weapons such as tear gas, water cannons, acoustic weapons and electric tasers have also caused "significant injury" over the years.
"This discussion does not in any way suggest that other weapons are safer," they wrote.
"Appropriate use of force and alternatives to weapons must be considered in all contexts," the researchers noted and appealed for the urgent creation of "international guidelines" on the use of crowd-control weapons.