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A funny thing happened on the way to the meeting: on guns and triggers
  1. Polly Bijur
  1. Albert Einstein College of Medicine, Rose F Kennedy Center, 1410 Pelham Parkway South, Bronx, NY 10461, USA

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Two women who were attending the 1997 American Public Health Association (APHA) annual meeting in Indianapolis were shot in a restaurant while waiting to be seated. A man with a registered .32 caliber handgun was leaning over to pick something up from the floor when a weapon fell out of his pocket, dropped on the floor, and fired two bullets. In the gun world, this is known as a drop-fire, a close kin to a bump-fire, both due to defective trigger mechanisms. When a child chokes on a small ball, or loses an eye from a toy rocket, the regulatory machinery of government is immediately engaged. No such scenario was set in motion by this shooting in Indianapolis. Although the Bureau of Alcohol Tobacco and Firearms regulates the sale and interstate commerce in handguns, it has virtually no authority to set standards for the design or safety of domestic handguns. And firearms are among the few products specifically excluded from the jurisdiction of the Consumer Product Safety Commission. This is despite the fact that guns are second only to automobiles as the consumer products most frequently responsible for death in the US.

Children under the age of 15 in the US are 12 times more likely to die from firearms than in 25 other developed countries and the rate of unintentional firearm injuries in this age group is nine times higher than in the comparison countries.1 A study of US handgun owners by the National Institute of Justice estimated that there are 65 million handguns in circulation in the US. This same study found that 55% of handgun owners keep their guns unlocked and 30% keep them unlocked and loaded.2 The deadly combination of accessible handguns and children is underscored by a recent study which found that 25% of 3–4 year olds and 70% of 5–6 year olds have the finger strength and coordination to fire most of the commonly available handguns in the US.3

There are a number of effective countermeasures to unintentional firearm injury to children. The most obvious, and the one recommended by the American Academy of Pediatrics, is to keep guns out of the home. Locked storage boxes for handguns and separate locked storage of ammunition are others. A properly designed safety lock, a device that prevents the trigger from moving without a key or other unlocking device, can also be an effective countermeasure. On 7 October 1997, President Clinton announced that eight major handgun manufacturers have agreed to provide child safety locks on all new handguns they sell by the end of 1998. While this is an important first step, the voluntary nature of the agreement, the application only to new handguns, and the lack of regulatory power over the design of the safety locks and the firearms themselves, raises the concern that this is a token action which will not translate into many young lives saved.

The two APHA participants survived, sustaining only minor injuries. Would that this were true of the 200 children killed unintentionally and the 800 children intentionally killed by guns in the US each year.

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