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Journal of Urban Health : Bulletin of the New York Academy of Medicine logoLink to Journal of Urban Health : Bulletin of the New York Academy of Medicine
. 2002 Mar 1;79(1):49–59. doi: 10.1093/jurban/79.1.49

Unintentional gun injuries, firearm design, and prevention: What we know, what we need to know, and what can be done

Shannon Frattaroli 1,, Daniel W Webster 1, Stephen P Teret 1
PMCID: PMC3456375  PMID: 11937615

Abstract

The public health community has long recognized unintentional gun injuries as a public health issue. In 1998 in the United States, 866 people died from unintentional gunshot wounds, resulting in a crude death rate of 0.32 per 100,000. Unintentional gun deaths have been declining since at least 1920, yet the reasons for this downward trend are not understood. Possible explanations, such as changes in gun ownership and demography, changes in access to guns among population subgroups, safety practices, and artifactual influences are discussed. Intervention strategies for reducing the risk of unintentional gun injury are also discussed.

Keywords: Firearm design, Unintentional gun injury

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References

  • 1.Murphy SL. Deaths: final data for 1998. Natl Vital Stat, Rep. 2000;48(11):67–70. [PubMed] [Google Scholar]
  • 2.The Web-Based Injury Statistics Query and Reporting System (WI SQARS), National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention. Available at: http://www.cdc.gov/ncipc/osp/data.htm. Accessed April 2, 2001.
  • 3.Teret SP, Baker SP. Children shooting guns: a failure in product design. Injury Prev. 1995;1(3):139–139. doi: 10.1136/ip.1.3.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Gotsch KE, Annest JL, Mercy JA, Ryan GW. Surveilance for fatal and nonfatal firearm-related injuries—United States, 1993–1998. MMWR Morb Mortal Wkly Rep. 2001;50(SS02):1–32. [Google Scholar]
  • 5.Dowd MD, Knapp JF, Fitzmaurice LS. Pediatric firearm injuries, Kansas City, 1992: a population-based study. Pediatrics. 1994;94(6):867–873. [PubMed] [Google Scholar]
  • 6.Roesler J, Ostercamp M. Pediatric firearm injury in Minnesota, 1998: fatal and nonfatal firearm injuries amongMinnesota youth. Minn Med. 2000;83:57–60. [PubMed] [Google Scholar]
  • 7.Sing RF, Branas CC, MacKenzie EJ, Schwab CW. Geogaphic variation in serious non-fatal firearm injuries in Pennsylvania. J Trauma. 1997;43(5):825–830. doi: 10.1097/00005373-199711000-00015. [DOI] [PubMed] [Google Scholar]
  • 8.Dodge GG, Cogbill TH, Miller GJ, Landercasper J, Strutt PJ. Gunshot wounds: 10-year experience of a rural, referral trauma center. Am Surgeon. 1994;60:401–404. [PubMed] [Google Scholar]
  • 9.Sadowski LS, Munoz SR. Nonfatal and fatal firearm injuries in a rural county. JAMA. 1996;275(22):1762–1764. doi: 10.1001/jama.1996.03530460066034. [DOI] [PubMed] [Google Scholar]
  • 10.General Accounting Office . Accidental Shootings: Many Deaths and Injuries Caused by Firearms Could Be Prevented. Washington, DC: United States General Accounting Office; 1991. [Google Scholar]
  • 11.Schwarz DF, Grisso JA, Miles CG, Holmes JH, Wishner AR, Sutton RL. A longitudinal study of injury morbidity in an African-American population. JAMA. 1994;271(10):755–760. doi: 10.1001/jama.1994.03510340045032. [DOI] [PubMed] [Google Scholar]
  • 12.Rushforth NB, Hirsch CS, Ford AB, Adelson L. Accidental firearm fatalities in a metropolitan county (1958–1973) Am J Epidemiol. 1975;100(6):499–505. doi: 10.1093/oxfordjournals.aje.a112062. [DOI] [PubMed] [Google Scholar]
  • 13.Lee RK, Waxweiller RJ, Dobbins JG, Paschetag T. Incidence rates of firearm injuries in Galveston, Texas, 1979–1981. Am J Epidemiol. 1991;134(5):511–521. doi: 10.1093/oxfordjournals.aje.a116123. [DOI] [PubMed] [Google Scholar]
  • 14.Copeland AR. Childhood firearms fatalities: the metropolitan Dade County experience. South Med J. 1991;84(2):175–178. doi: 10.1097/00007611-199102000-00006. [DOI] [PubMed] [Google Scholar]
  • 15.Li G, Baker SP, DiScala C, Fowler C, Ling J, Kelen GD. Factors associated with the intent of firearm-related injuries in pediatric trauma patients. Arch Pediatr Adolesc Med. 1996;150:1160–1165. doi: 10.1001/archpedi.1996.02170360050008. [DOI] [PubMed] [Google Scholar]
  • 16.Sinauer N, Annest JL, Mercy JA. Unintentional, nonfatal firearm-related injuries. JAMA. 1996;275(22):1740–1743. doi: 10.1001/jama.1996.03530460044029. [DOI] [PubMed] [Google Scholar]
  • 17.Carter GL. Accidental firearm fatalities and injuries among recreational hunters. Annals Emerg Med. 1989;18:406–409. doi: 10.1016/S0196-0644(89)80581-5. [DOI] [PubMed] [Google Scholar]
  • 18.Cina SJ, Lariscy CD, McGown ST, Hopkins MA, Butts JD, Conradi SE. Firearm-related huntingfatalities in North Carolina: impact of the “Hunter Orange” law. South Med J. 1996;89(4):395–396. doi: 10.1097/00007611-199604000-00008. [DOI] [PubMed] [Google Scholar]
  • 19.Cole TB, Patetta MJ. Huntingfirearm injuries, North Carolina. Am J Public Health. 1988;78(12):1585–1586. doi: 10.2105/AJPH.78.12.1585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Ikeda RM, Gorwitz R, James SP, Powell KE, Mercy JA. Fatal Firearm Injuries in the United States, 1962–1994. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 1997. [Google Scholar]
  • 21.Wintemute GJ. Firearms as a cause of death in the United States, 1920–1982. J Trauma. 1987;27(5):532–536. doi: 10.1097/00005373-198705000-00013. [DOI] [PubMed] [Google Scholar]
  • 22.Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention. CDC WONDER. Available at: http://wonder.cdc.gov. Accessed April 2, 2001.
  • 23.Cummings P, Grossman DC, Rivara FP, Koepsell TD. State gun safe storage laws and child mortality due to firearms. JAMA. 1997;278:1084–1086. doi: 10.1001/jama.1997.03550130058037. [DOI] [PubMed] [Google Scholar]
  • 24.Webster DW, Starnes M. Reexamining the association between child access prevention laws and unintentional firearm deaths among children. Pediatrics. 2000;106:1466–1469. doi: 10.1542/peds.106.6.1466. [DOI] [PubMed] [Google Scholar]
  • 25.Frattaroli S, Teret SP. Why firearm injury surveillance? Am J Prev Med. 1998;15(3S):2–5. doi: 10.1016/S0749-3797(98)00067-1. [DOI] [PubMed] [Google Scholar]
  • 26.Cook PJ, Ludwig J. Guns in America: Results from a Comprehensive National Survey of Firearm Ownership and Use. Washington, DC: The Police Foundation; 1996. [Google Scholar]
  • 27.Baker SP, O’Neill B, Ginsburg MJ, Li G. The Injury Fact Book. 2nd ed. New York: Oxford University Press; 1992. [Google Scholar]
  • 28.US Bureau of the Census . Statistical Abstract of the United States: 1998. Washington, DC: US Dept of Commerce; 1998. [Google Scholar]
  • 29.Perry MJ, Mackun PJ. Population Change and Distribution: Census 2000 Brief. Washington, DC: US Dept of Commerce; 2001. [Google Scholar]
  • 30.Smith TW. 1997–1998 National Gun Policy Survey of the National Opinion Research Center: Research Findings. Chicago, IL: University of Chicago; 1998. [Google Scholar]
  • 31.Fingerhut LA, Ingram DD, Feldman JJ. Firearm and nonfirearm homicide among persons 15 through 19 years of age. JAMA. 1992;267(22):3048–3053. doi: 10.1001/jama.1992.03480220066029. [DOI] [PubMed] [Google Scholar]
  • 32.Blumstein A, Rivara FP, Rosenfeld R. The rise and decline of homicide-and why. Annu Rev Public Health. 2000;21:505–541. doi: 10.1146/annurev.publhealth.21.1.505. [DOI] [PubMed] [Google Scholar]
  • 33.The Brady Campaign to Prevent Gun Violence. Available at: http://www.bradycampaign./org/facts/statelaws/. Accessed September 27, 2001.
  • 34.Hardy MS, Armstrong FD, Martin BL, Strawn KN. A firearm safety program for children: they just can’t say no. Dev Behav Pediatr. 1996;17:216–221. doi: 10.1097/00004703-199608000-00002. [DOI] [PubMed] [Google Scholar]
  • 35.Hanzlick R, Combs D. Medical examiner and coroner systems: history and trends. JAMA. 1998;279:870–874. doi: 10.1001/jama.279.11.870. [DOI] [PubMed] [Google Scholar]
  • 36.Goodin J, Hanzlick R. Mind your manners. Part II: General results from the National Association of Medical Examiners manner of death questionnaire, 1995. Am J Forensic Med Pathol. 1997;18:224–227. doi: 10.1097/00000433-199709000-00002. [DOI] [PubMed] [Google Scholar]
  • 37.Farberow NL, MacKinnon DR, Nelson FL. Suicide: who’s counting? Public Health Rep. 1997;92:223–232. [PMC free article] [PubMed] [Google Scholar]
  • 38.Barber CW, Ozonoff VV, Schuster M, et al. Massachusetts Weapon-Related Injury Surveillance System. Am J Prev Med. 1998;15(3 suppl):57–66. doi: 10.1016/S0749-3797(98)00065-8. [DOI] [PubMed] [Google Scholar]
  • 39.Vernick JS, Meisel ZF, Teret SP, Milne JS, Hargarten SW. “I didn’t know the gun was loaded”: an examination of two safety devices that can reduce the risk of unintentional firearm injuries. J Public Health Policy. 1999;20:427–440. doi: 10.2307/3343129. [DOI] [PubMed] [Google Scholar]
  • 40.Robinson KD, Teret SP, Vernick JS, Webster DW. Personalized Guns: Reducing Gun Deaths Through Design Changes. Baltimore, MD: Johns Hopkins Center for Gun Policy and Research; 1996. [Google Scholar]
  • 41.The Firearm Injury Center at the Medical College of Wisconsin. Available at: http:// www.mew.edu/fic/. Accessed September 27, 2001.
  • 42.Smith KC. Is this a smart gun? Handguns. January 2000:54.
  • 43.GSI, Incorporated. Available at: http://www.gsifirearms.com/product/s-pistol-safety. html. Accessed April 5, 2001.
  • 44.Spomer R. Loaded and Locked. Popular Mechanics. September 1998:88–89.
  • 45.Metcalf D. A high-tech holster for the 21st century. Shooting Times. March 2001; 42–44.
  • 46.Teret SP. Litigating for the public’s health. Am J Public Health. 1986;76:1027–1029. doi: 10.2105/AJPH.76.8.1027. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Pub L No. 94-284, § 3(e), May 11, 1976; 90 Stat 504 (1976).
  • 48.940 CMR 16.00.
  • 49.American Shooting Sports Council, Incorporated, and Others v Attorney General, 429 Mass 871 (1999).
  • 50.Maryland Annotated Code Article 27, § 442C (2001).
  • 51.Vernick JS, Teret SP. New courtroom strategies regarding firearms: tort litigation against firearm manufacturers and constitutional challenges to gun laws. Houston Law Rev. 1999;36(5):1713–1754. [Google Scholar]
  • 52.Azrael D, Miller M, Hemmenway D. Are household firearms stored safely? It depends on whom you ask. Pediatrics. 2000;106(3):E31–E31. doi: 10.1542/peds.106.3.e31. [DOI] [PubMed] [Google Scholar]
  • 53.PAX information is available at: http://www.paxusa.org. Accessed September 5, 2001.
  • 54.Grossman DC, Cummings P, Koepsell TD, et al. Firearm safety counseling in primary care pediatrics: a randomized, controlled trial. Pediatrics. 2001;106:22–26. doi: 10.1542/peds.106.1.22. [DOI] [PubMed] [Google Scholar]

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