Eber Gabriel B, Annest Joseph L, Mercy James A, Ryan George W
Office of Statistics and Programming, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA.
Pediatrics. 2004 Jun;113(6):1686-92. doi: 10.1542/peds.113.6.1686.
To provide national estimates of fatal and nonfatal firearm-related (FA) injuries among children < or =14 years old and to examine the circumstances under which these injuries occurred.
For nonfatal FA injuries among children, we analyzed data on emergency department (ED) visits from the National Electronic Injury Surveillance System for 1993 through 2000. National estimates of injured children who were treated in hospital EDs were examined by selected characteristics, such as age, gender, race/ethnicity of the patient, primary body part affected, intent of the injury, the relationship of the shooter to the patient, where the injury occurred, and activity at the time of injury. For fatal FA injuries among children, we analyzed mortality data from the National Vital Statistics System for 1993 through 2000. Data from both sources were used to calculate case-fatality rates.
From 1993 through 2000, an estimated 22,661 (95% confidence interval [CI]: 16,668-28,654) or 4.9 per 100,000 (95% CI: 3.6-6.2) children < or = 14 years old with nonfatal FA injuries were treated in US hospital EDs. Assaults accounted for 41.5% of nonfatal FA injuries, and unintentional injuries accounted for 43.1%. Approximately 4 of 5 children who sustained a nonfatal, unintentional FA injury were reportedly shot by themselves or by a friend, a relative, or another person known to them. During this period, 5542, or 1.20 per 100,000 (95% CI: 1.17, 1.23), children < or =14 years old died from FA injuries; 1 of every 5 children who were wounded by a firearm gunshot died from that injury. Most FA deaths were violence related, with homicides and suicides constituting 54.7% and 21.9% of these deaths, respectively. For individuals < or =14 years old, the burden of morbidity and mortality associated with FA injuries falls disproportionately on boys, blacks, and children 10 to 14 years old. Both fatal and nonfatal injury rates declined >50% during the study period.
Although rates of nonfatal and fatal FA injuries declined during the period of study, FA injuries remain an important public health concern for children. Well-designed evaluation studies are needed to examine the effectiveness of potential interventions aimed at reducing FA injuries among children.
提供14岁及以下儿童与枪支相关的致命和非致命伤害的全国估计数，并研究这些伤害发生的情况。
对于儿童非致命的与枪支相关的伤害，我们分析了1993年至2000年国家电子伤害监测系统的急诊科就诊数据。通过选定的特征，如年龄、性别、患者的种族/族裔、受影响的主要身体部位、伤害意图、枪手与患者的关系、伤害发生地点以及伤害发生时的活动，对在医院急诊科接受治疗的受伤儿童进行全国估计。对于儿童致命的与枪支相关的伤害，我们分析了1993年至2000年国家生命统计系统的死亡率数据。来自这两个来源的数据用于计算病死率。
1993年至2000年期间，估计有22661名（95%置信区间[CI]：16668 - 28654）14岁及以下儿童因非致命的与枪支相关的伤害在美国医院急诊科接受治疗，即每10万人中有4.9名（95% CI：3.6 - 6.2）。袭击占非致命的与枪支相关伤害的41.5%，意外伤害占43.1%。据报道，在遭受非致命意外伤害的儿童中，约五分之四是被自己或朋友、亲戚或他们认识的其他人开枪击中。在此期间，5542名14岁及以下儿童死于与枪支相关的伤害，即每10万人中有1.20名（95% CI：1.17，1.23）；每5名受枪伤的儿童中有1名死于该伤害。大多数与枪支相关的死亡与暴力有关，其中凶杀和自杀分别占这些死亡的54.7%和21.9%。对于14岁及以下的个人，与枪支相关伤害相关的发病和死亡负担在男孩、黑人以及10至14岁的儿童中分布不均。在研究期间，致命和非致命伤害率均下降了50%以上。
尽管在研究期间非致命和致命的与枪支相关伤害率有所下降，但与枪支相关的伤害仍然是儿童重要的公共卫生问题。需要精心设计评估研究，以检验旨在减少儿童与枪支相关伤害的潜在干预措施的有效性。
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