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Accidental firearm injuries more common among younger children

Shilpa J. Patel

ORLANDO, Fla. — A study presented here showed that children aged younger than 12 years were more likely to be shot by accident in the United States, reinforcing the need to safely store guns.

“Pediatricians need to remember that accidental intent is still the No. 1 cause of firearm-related injury in children, and that screening for firearms in the home is important,” Shilpa J. Patel, MD, MPH, an assistant professor in the division of emergency medicine at Children’s National Health System, told Infectious Diseases in Children. “In any patient interaction that you have, you should be screening to see if they have access to firearms — maybe not at home, maybe at other homes — and making sure they are locked safely and securely, unloaded and separate from the ammunition.”

Patel and colleagues conducted a cross-sectional analysis from the Nationwide Emergency Department Sample from 2009 to 2013. They examined records of 111,839 ED visits nationwide for firearm-related injuries among children and adolescents aged 21 years and younger, excluding ED visits related to air guns, pellets, BBs or paintballs.

According to the researchers, 63% of firearm injuries were defined as unintentional, 30% were categorized as an assault and 1% were defined as self-harm.

The researchers found that younger children were more likely to sustain unintentional firearm injuries, whereas teens were more likely to be victims of firearm-related assault or self-harm.

Additional findings from the analysis showed that:

• 89% of those injured were male, and the average age at the time of injury was 18 years.
• 38% percent of injuries occurred among publicly insured youth.
• 30% percent of injuries resulted in hospital admission.
• 6% of injuries resulted in death.

The researchers also found that geography played a role in the type of firearm-related injury. Unintentional firearm injuries were more common in the Western U.S. compared with the Northeast (adjusted OR = 6.9; 95% CI, 4-11.6), for example.

Patel and colleagues said children admitted to the ED with injuries because of an assault or self-harm were more likely to be admitted to the hospital and incur higher treatment costs compared with children with unintentional injuries.

Another study presented at the conference showed that most children could not tell a real gun from a toy gun in side-by-side photos, also underscoring the importance of safe gun storage.

Patel said it is important for parents to ask other parents if they keep a firearm in the house and whether the weapon is stored safely and unloaded before their children come over to visit. This can be an uncomfortable conversation, she said, but an important one.

“I actually think it can become contagious in some ways,” Patel said. “So, if you ask a parent, that parent can be like, ‘Oh, I should be asking, too.’” – by John Schoen

Reference:

Patel S, et al. Emergency department visits for pediatric firearm-related injury: by intent of injury. Presented at: AAP National Conference & Exhibition; Nov. 2-6, 2018; Orlando, Fla.

Disclosure: Patel reports no relevant financial disclosures.