Nonpowder Firearm Injuries to Children Treated in Emergency Departments

Pediatrics. 2019 Dec;144(6):e20192739. doi: 10.1542/peds.2019-2739.


Objectives: To investigate nonpowder firearm injuries treated in US emergency departments among children <18 years old.

Methods: National Electronic Injury Surveillance System data from 1990 through 2016 were analyzed.

Results: An estimated 364 133 (95% confidence interval 314 540-413 727) children <18 years old were treated in US emergency departments for injuries related to nonpowder firearms from 1990 to 2016, averaging 13 486 children annually. From 1990 to 2016, the number and rate of nonpowder firearm injuries decreased by 47.8% (P < .001) and 54.5% (P < .001), respectively. Most injuries occurred among 6- to 12-year-olds (47.4%) and 13- to 17-year-olds (47.0%). Boys accounted for 87.1% of injured children, the most common diagnosis was foreign body (46.3%), and 7.1% of children were admitted. BB guns accounted for 80.8% of injuries, followed by pellet guns (15.5%), paintball guns (3.0%), and airsoft guns (0.6%). The rate of eye injuries increased by 30.3% during the study period. Eye injuries accounted for 14.8% of all injuries and the most common diagnoses were corneal abrasion (35.1%), hyphema (12.5%), globe rupture (10.4%), and foreign body (8.6%).

Conclusions: Although the number and rate of nonpowder firearm injuries declined during the study period, nonpowder firearms remain a frequent and important source of preventable and often serious injury to children. The severity and increasing rate of eye injuries related to nonpowder firearms is especially concerning. Increased prevention efforts are needed in the form of stricter and more consistent safety legislation at the state level, as well as child and parental education regarding proper supervision, firearm handling, and use of protective eyewear.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Contusions / epidemiology
  • Emergency Service, Hospital*
  • Eye Injuries / epidemiology
  • Female
  • Firearms / legislation & jurisprudence
  • Foreign Bodies / epidemiology
  • Fractures, Bone / epidemiology
  • Humans
  • Lacerations / epidemiology
  • Male
  • Retrospective Studies
  • United States / epidemiology
  • Wounds, Gunshot / epidemiology*
  • Wounds, Gunshot / prevention & control
  • Wounds, Gunshot / therapy