Incidence and Circumstances of Nonfatal Firearm-Related Injuries Among Children and Adolescents

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Abstract
Objective To describe the incidence and circumstances of nonfatal firearm-related injuries among children and adolescents treated in US emergency departments. Design Data were obtained from the Firearm Injury Surveillance Study, 1993-1997; data were collected through medical record review at hospitals participating in the National Electronic Injury Surveillance System. Setting The hospitals participating in National Electronic Injury Surveillance System are a stratified probability sample of all US hospitals. Main Outcome Measures Numbers and population rates for nonfatal firearm-related injuries among children and adolescents younger than 20 years old. Results An estimated 115 131 (95% confidence interval, 76 769-153 493) children and adolescents were treated for a nonfatal gunshot wound during the study period. The estimated annual rates of injury (per 100 000) were 2.0 (children 0-4 years old), 2.2 (children 5-9 years old), 15.4 (children 10-14 years old), and 106.5 (adolescents 15-19 years old). The ratios of nonfatal to fatal firearm-related injuries were 4.0 (children 0-4 years old), 4.4 (children 5-9 years old), 5.0 (children 10-14 years old), and 4.4 (adolescents 15-19 years old). An additional estimated 103 814 children (95% confidence interval, 69 223-138 405) were shot with a nonpowder firearm (BB or pellet gun). Boys 5 to 9 and 10 to 14 years old had the highest rates of injury related to nonpowder firearms, an estimated 36.2 and 99.8 per 100 000, respectively. Fifty-six percent of those 15 to 19 years old were assault victims. An estimated 48% of children and adolescents with powder firearm–related gunshot wounds and an estimated 4% with nonpowder firearm injuries were admitted to the hospital. Conclusions Nonfatal injuries related to powder firearms and nonpowder firearms (BB or pellet guns) are an important source of injury among US children and adolescents. Ongoing surveillance of nonfatal firearm-related injury among children and adolescents is needed.