What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?

Epidemiol Rev (2016) 38 (1): 140-157 first published online February 10, 2016

ABSTRACT Firearms account for a substantial proportion of external causes of death, injury, and disability across the world. Legislation to regulate firearms has often been passed with the intent of reducing problems related to their use. However, lack of clarity around which interventions are effective remains a major challenge for policy development. Aiming to meet this challenge, we systematically reviewed studies exploring the associations between firearm related laws and firearm homicides, suicides, and unintentional injuries/deaths. We restricted our search to studies published from 1950 to 2014.

Evidence from 130 studies in 10 countries suggests that in certain nations the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths. Laws restricting the purchase of (e.g., background checks) and access to (e.g., safer storage) firearms are also associated with lower rates of intimate partner homicides and firearm unintentional deaths in children, respectively. Limitations of studies include challenges inherent to their ecological design, their execution, and the lack of robustness of findings to model specifications. High quality research on the association between the implementation or repeal of firearm legislation (rather than the evaluation of existing laws) and firearm injuries would lead to a better understanding of what interventions are likely to work given local contexts. This information is key to move this field forward and for the development of effective policies that may counteract the burden that firearm injuries pose on populations.

Carotid artery injury from an airgun pellet:  A case report and review of the literature.
Syad Abad,   Ian DS McHenry, Lachlan M. Carter, David A Mitchell, 2009
Maxillofacial surgery, Pinderfields Hospital, Aberford Road, Wakefield, WK1 4DJ.

Following a case report re a 20 year old male suffering an air weapon injury to the neck and review of literature Doctors concluded “Airguns are capable of serious injury as demonstrated by our case.  The incidence and severity of such injuries is increasing.  We believe airguns should be governed by the same laws that relate to firearms… Many authors have rallied for a change in legislation to take into account the severity of airgun pellet injuries.  To date this has not yet materialised."

Air weapon injuries: A serious and persistent problem. H Ceylan, A McGowan, M. D. Stringer
Leading article in The Journal Archives of Disease in Childhood. "Air guns and rifles are potentially lethal weapons". 

Observations in Leeds with a retrospective review of accident and emergency records between January 1996 and June 2001.  Crime statistics: Serious and Fatal Injuries: Management of Injuries, and The Law. 

Should air guns be banned?  P. Holland, DF O'Brien, PL May, British Journal of Neurosurgery Vol l8 Issue 2 April 2004 p 124 - 129

Authors express concerns regarding the availability of airguns, the injuries that they cause and their abuse as weapons of assault and report a 5-year retrospective analysis of all airgun injuries to the head and neck presenting to Alder Hey Chilren's Hospital, Liverpool from June 1998 to June 2003.

Injury risk of Nonpowder guns. American Academy of Pediatrics.

According to a technical report nonpowder guns - ball-bearing (BB) guns, pellet guns, air rifles and paintball guns - are extremely powerful and continue to cause serious injury disability and even death to children and adolescents.  The Centers for Disease Control and Prevention and the U.S. Consumer Product Safety Commission (CPSC) claim there were approximately 21,840 nonpowder gun-related injuries treated in emergency departments in 2000.  Between 1990 and 200 the CPSC reported 39 nonpower gunrelated deaths, of which 32 were children age l5 and younger.  The report concludes nonpowder guns are weapons and should never be characterized as toys.

'Gun Crime' A review of evidence and policy
Professor Peter Squires with Dr. Roger Grimshaw and Enver Solomon (June 2008)

'Gun Crime' A review of evidence and policy includes an analysis of latest official data on firearms offiences to examine the scale and extent of gun crime. The report provides a synopsis of the legal situation relating to firearms, considers who is most affected by gun crime, examines the social context and makes an evidenced based assessment of government policy in this area. The report finds that most of the problems associated with the illegal use of firearms require social and economic rather than criminal justice solutions.

IMITATION GUN LAW: an Assessment

Henrietta Wheal formerly at the UCL Jill Dando Institute of Crime Science where the work was undertaken, and now at the Home Office; and Nick Tilley, visiting Professor at the UCL Jill Dando Institute of Crime Science.

Imitation gun-enabled crime has received extensive political and media coverage in the UK over recent years. The Violent Crime Reduction Act 2006 (VCRA) was introduced to control public possession, manufacture, import and sale of imitation guns. The Metropolitan Police Service (MPS) has drawn on the Act: publicising it, enforcing it and running a targeted surrender scheme enabling the hand-in of imitation weapons at police stations. A series of significant loopholes in the Act have emerged. Moreover MPS experience also suggests surrender schemes may not be an effective way of reducing the use of imitation weapons in crimes but can serve as useful awareness tools.

Source: The Howard Journal Vol 48 No 2. May 2009

"American Roulette" : Murder suicide in the United States.  Violence Policy Centre

Murder suicide is a dramatic violent event in which a person, almost always a man, commits one murder or multiple murders and then shortly afterwards commits suicide. In the analysis 88.5% of murder-suicide incidents involved a firearm. Most multiple victim murder-suicides involving a male murderer are perpetrated by family annihilators.  Family annihilators are men who kill their wives/girlfriends and children as well as other family members before killing themselves. Domestic violence is associated with a very significant number of murder-suicides. In this study 75% of murder suicides occurred in the home. The most common catalytic component in murder suicide is the use of a firearm.  Firearms allow shooters to act on impulse. The presence of a gun allows the offender to quickly and easily kill a greater number of victims. Researchers called for efforts to be made to restrict access to firearms where there is an increased risk of murder-suicide.
CANADA Exploring the links between firearms, family violence and animal abuse. Deborah Doherty (Lead Researcher) Muriel McQueen Fergusson Centre for Family Violence.

Research suggests a strong link between family violence, the use of firearms, and animal abuse as a means of intimidation. Doherty conducted surveys with 391 abused women who live in rural households in New Brunswick and Prince Edward Island.The report shows that 25 per cent of those women had a gun in their house, with 70 per cent saying the presence of that gun affected their decision to tell others or seek help. Forty-five per cent also said their partner had threatened to injure or kill a family pet or farm animal, with 41 per cent actually following through with those threats.

Association of rates of household handgun ownership, lifetime major depression, and serious suicidal thoughts with rates of suicide across US census regions. 

Hemenway D, Miller M.Harvard School of Public Health, Boston, MA 02115, USA.

OBJECTIVE: Cross sectional studies in the United States often find a significant positive association between levels of household firearm ownership and suicide rates. This study investigates whether the association can be explained by differences in levels of mental health.
CONCLUSIONS: In United States regions with higher levels of household handgun ownership, there are higher suicide rates. This relationship cannot be explained by differences in the prevalence of two mental health indicators-lifetime rates of either major depression or suicidal thoughts. After controlling for major depression and suicidal thoughts (and any of the four additional control variables), handgun ownership rates remain significantly associated with the overall suicide rate.

Rates of household firearm ownership and homicide across US regions and states, 1988-1997.

Miller M, Azrael D, Hemenway D. Harvard School of Public Health, Boston, Mass 02115

OBJECTIVE: In this study we explored the association between rates of household firearm ownership and homicide across the United States, by age groups.
RESULTS: In region- and state-level analyses, a robust association between rates of household firearm ownership and homicide was found.
CONCLUSIONS: Although our study cannot determine causation, we found that in areas where household firearm ownership rates were higher a disproportionately large number of people died from homicide.

Firearms injuries in children and adolescents: epidemiology and preventive approaches.

Christoffel KK, Naureckas SM. Children's Memorial Hospital, Chicago, Illinois.

Firearm injury, now a leading cause of death in childhood and adolescence, had jointed the ranks of pediatric conditions that threaten child health and development. This paper reviews articles on epidemiology (of firearm injuries and the firearms themselves) and prevention. Epidemiology of injuries: 5356 Americans under 20 years of age died of firearm injuries in 1991; most of these were homicides, and most involved 15 to 19 years olds. The same year, firearm deaths exceeded motor vehicle deaths in seven states and the District of Columbia. Case-control studies showed that handguns in the home raised the risk of homicide threefold, and that handguns raised the risk of suicide ninefold; In a school survey, three-fourths of first and second graders who knew there was a gun at home knew where it was.$=relatedreviews&logdbfrom=pubmed


Wightman, G., Beard, J. and Allison, R.

Questions have been raised over air rifle safety and airguns cannot be judged on power of the weapon alone according to findings of a Dundee Study.

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