Pediatric Unintentional Firearm Injuries |
| Firearm-related
injuries have surpassed motor vehicle collisions as the leading cause
of death for children and adolescents in the United States. Among these
incidents, unintentional firearm injuries represent a significant
portion of pediatric trauma cases. Despite being largely preventable,
unintentional firearm injuries continue to inflict substantial
morbidity and mortality on children, particularly in domestic settings.
This article synthesizes findings from six recent scientific studies to
highlight trends, risk factors, and prevention strategies related to
pediatric unintentional firearm injuries. Recent data indicate that unintentional firearm injuries account for approximately 3.5% of all pediatric firearm deaths, with a majority occurring in homes. Between 2017 and 2022, 17.6% of pediatric firearm injuries were classified as unintentional, with an increase in the absolute number of cases over time. The proportion of unintentional firearm injuries rose from 15.7% in 2017 to 16.5% in 2022, though statistical analysis suggests no significant year-over-year change. Younger children (ages 2-5) are disproportionately affected by unintentional firearm injuries, with these injuries occurring more frequently than intentional firearm injuries in this age group. In contrast, adolescents aged 12-18 are more likely to experience intentional firearm injuries. The vast majority (56.2%) of unintentional firearm injuries take place in private residences, underscoring the risks associated with unsafe firearm storage within homes. The risk of unintentional firearm injuries is not evenly distributed across racial and socioeconomic groups. Black (45.7%) and White (42.0%) children are the most affected demographics, with Black youth facing a disproportionate burden of overall firearm-related injuries. Children covered by public insurance, such as Medicaid, or those from lower-income households are at heightened risk, likely due to differences in firearm storage practices and access to safety education. The presence of firearms in a household dramatically increases the likelihood of firearm-related injuries and deaths. Studies indicate that in homes with firearms, the risk of unintentional injury, suicide, and homicide is three to four times higher than in homes without firearms. Additionally, up to 43% of households with children and firearms store at least one gun unlocked, and more than 10% keep a firearm both unlocked and loaded, greatly increasing the risk of accidental discharge. Secure firearm storage is a critical preventive measure against unintentional firearm injuries. Proper storage includes locking firearms, keeping them unloaded, and storing ammunition separately. Despite widespread agreement on the importance of secure storage, studies show that many firearm owners do not practice the safest storage methods. Only about 59% of firearm-owning families report locking their firearms, and even fewer store them both locked and unloaded. Efforts to improve firearm safety have included educational initiatives, legislative measures, and hospital-based interventions. Pediatric emergency departments (PEDs) have been identified as effective settings for firearm safety education. In a recent study, 93.4% of families approached in a PED setting agreed to participate in firearm safety education, and many received firearm locks. However, 82.8% of participants reported never receiving firearm storage education from a healthcare professional before the study, demonstrating a clear gap in outreach efforts. Legislation also plays a crucial role in firearm injury prevention. Child access prevention (CAP) laws, which hold firearm owners legally responsible if a child gains access to an unsecured firearm, have been associated with reductions in pediatric firearm injuries. States with strong CAP laws report significantly lower rates of unintentional firearm injuries among children compared to states with weaker regulations. The consequences of pediatric unintentional firearm injuries extend beyond immediate physical harm. Children who survive firearm injuries often face long-term health complications, including physical disabilities and psychological trauma. Approximately half of children hospitalized for firearm injuries are discharged with some form of disability, including impairments in vision, cognition, and mobility. Furthermore, exposure to firearm violence, even when not directly injured, has been linked to increased rates of anxiety, depression, and behavioral disruptions in children. Witnessing firearm-related violence is associated with an elevated risk of substance abuse and academic difficulties later in life. Given these far-reaching consequences, pediatric firearm injuries represent not only a critical issue for emergency medicine but also for long-term pediatric and mental health care. Addressing pediatric unintentional firearm injuries requires a multifaceted approach that combines education, legislation, and community engagement. Healthcare professionals should be encouraged to discuss firearm safety with families during routine pediatric visits. Studies have shown that physician counseling, especially when paired with the distribution of firearm locks, significantly increases adherence to safe storage practices. Community-based initiatives, such as the "Be SMART" program and Project ChildSafe, offer valuable resources for educating families on firearm safety. Public awareness campaigns emphasizing the importance of safe firearm storage can further contribute to injury prevention efforts. Finally, continued research and data collection are essential for guiding policy and intervention strategies. The increasing availability of national trauma databases allows researchers to track trends in pediatric firearm injuries more accurately and identify at-risk populations for targeted prevention programs. Pediatric unintentional firearm injuries are a preventable tragedy that continues to affect thousands of children in the United States each year. With firearms now the leading cause of death among children and adolescents, urgent action is needed to promote safe storage practices, strengthen legislative protections, and expand educational initiatives. By implementing evidence-based prevention strategies and increasing awareness, we can reduce the incidence of unintentional firearm injuries and improve the safety and well-being of children nationwide. References: 1-Hughes BD, Cummins CB, Shan Y, Mehta HB, Radhakrishnan RS, Bowen-Jallow KA: Pediatric firearm injuries: Racial disparities and predictors of healthcare outcomes. J Pediatr Surg. 55(8):1596-1603, 2020 2- Andrews AL, Killings X, Oddo ER, Gastineau KAB, Hink AB: Pediatric Firearm Injury Mortality Epidemiology. Pediatrics. 149(3):e2021052739. Erratum in: Pediatrics. 2022 Jun 1;149(6):e2022057373. Erratum in: Pediatrics. 2022 Aug 1;150(2):e2022058112, 2022 3- Burch C, Webb A, Jorge E, King B, Nichols M, Monroe K: Safe at home: prevention of pediatric unintentional injuries. Inj Epidemiol. 10(Suppl 1):30, 2023 4- Gastineau KAB, McKay S. Firearm Injury Prevention. Pediatr Clin North Am. 70(6):1125-1142, 2023 5- Scrushy MG, Abbe M, Wang S, Stone G, Pandya S, Ryan M:Trends in Intentional and Unintentional Firearm Injuries in Pediatric Trauma Patients: An 11-Year Retrospective Study. J Surg Res. 304:365-370, 2024 6- Glassman T, Geller JE, Burjonrappa S: At Home and at Risk: A Study on Pediatric Unintentional Firearm Injuries in the USA. J Pediatr Surg. 60(3):162012, 2025 |
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