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In this issue of Injury Prevention, Hootman and colleagues present the latest information on non-fatal, non-gunshot injuries related to guns in the United States.1 The report is the latest in a series of snapshots that investigators at the United States Centers for Disease Control (CDC) have added to the ever-so-slowly evolving panoramic picture of our country's unique burden of gun injury (see http://www.cdc.gov/ncipc). The paper is of interest both for what it says and what it does not say.
What is said
The authors set the stage by reminding readers of the large, albeit recently falling, number of gunshot deaths and injuries in the United States each year. Then, using carefully constructed emergency department based estimates, they focus on the 16% of all medically treated gun related injuries due to mechanisms other than gunshot wounds. The authors observe that the risk for these injuries parallels that of gunshot wounds (males, youth, African-Americans) and identify possible prevention approaches for the unintentional injuries.
This study involved the development of two potentially important new coding schemes, that detail both mechanism of injury and activity at the time of injury.
What is missing, datawise
This research is based on data from the Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). The authors acknowledge the limitations of the data, which exclude non-medically attended injuries, does not permit local incidence estimates, relies for injury history on (often incomplete) medical recording, and suffers from missing information.
Other factors also limit the accuracy of the information presented. Non-powder firearms (airguns, “BB guns”), were excluded, though in terms of non-gunshot events are more like powder guns than not.2 This was due to small NEISS counts for these (J Mercy, personal communication, 15 August 2000). Injuries related to military contexts were excluded. Delayed deaths due to the non-gunshot wound injuries could …