33 the risk of a secondary injury, especially to the head; such injuries can be sustained in particular as a result of falling to the ground from a height or onto a hard surface, as individuals who have received an electrical charge will typically be physically incapable of using their hands to break a fall. 7.4.6 The risk of significant injury or even death is increased in certain conditions, including where the individuals who have been electrically shocked have heart disease; have taken certain prescription or recreational drugs, or alcohol, or both; or are for other reasons more susceptible to adverse cardiac effects. TASERTM guidance recommends that, when possible, users should avoid targeting the frontal chest area near the heart, in order to reduce the risk of potentially serious injury or death.99 Children and slender adults may be at greater risk of internal injury from tissue-penetrating barbs, as their body wall is generally less thick.100 The discharge of a conducted electrical weapon may trigger seizures in those affected by epilepsy, irrespective of barb location.101 Law enforcement officials should also avoid using conducted electrical weapons against genitals or other sensitive body areas. 7.4.7 Certain types of aggressive behaviour that may lead law enforcement officers to use conducted energy devices can be caused by mental health issues, language barriers, hearing disorders, visual impairment, neurodevelopmental or neurobehavioural disorders or learning difficulties.102 Law enforcement agencies should ensure that those working in situations where they are likely to encounter persons with pre-existing vulnerabilities have had detailed guidance and training in identifying such risks, and that they possess the knowledge, ability and tools necessary “TASER Handheld CEW Warnings, Instructions, and Information: Law Enforcement”, 19 May 2017, p. 5. 100 See Defence Scientific Advisory Council Sub-Committee on the Medical Implications of LessLethal Weapons (DOMILL), Statement on the Medical Implications of Use of the Taser X26 and M26 Less-Lethal Systems on Children and Vulnerable Adults, United Kingdom, 2012. 101 Ibid. 102 Defence Scientific Advisory Council Sub-Committee on the Medical Implications of Less-Lethal Weapons, Statement on the Medical Implications of Use of the Taser X26 and M26 Less-Lethal Systems on Children and Vulnerable Adults, para. 85. 99