Gun storage practices and risk of youth suicide and unintentional firearm injuries
Gun storage practices and risk of youth suicide and unintentional firearm injuries
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DOI：
10.1001/jama.293.6.707
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发表时间：
2005-02-09
影响因子：
120.7
通讯作者：
Harruff, R
中科院分区：
文献类型：
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作者：
Grossman, DC;Mueller, BA;Harruff, R
背景家庭枪支与家中居住者枪支死亡的风险增加有关。许多组织和卫生当局主张锁定枪支和弹药，以防止儿童和青少年获得枪支。这些枪支存放习惯与减少火器伤害风险的关系尚不清楚。目的测量特定家庭枪支存放习惯的相关性（锁定枪支，锁定弹药，保持枪支未上膛）和意外和自我造成的火器伤害的风险。设计和设置病例对照研究火器事件确定的法医和验尸官办公室从华盛顿，俄勒冈州和密苏里州，以及位于华盛顿州西雅图、斯波坎和塔科马以及密苏里州堪萨斯城的5个创伤中心。案件和控制案件枪支是通过参与20岁以下的儿童或青少年获得枪支并有意或无意地开枪自杀或无意地开枪射杀他人的事件来确定的。枪支攻击和杀人被排除在外。我们利用医院和体检医生的记录来确定这些事件。使用随机数字拨号电话抽样，通过确定至少拥有一支枪支的合格家庭和在家中居住或访问的儿童来确定管制枪支。主要暴露测量在这项研究中感兴趣的关键暴露是：（1）受试枪支是否储存在上锁的位置或外部锁;（2）枪支是否储存在未装子弹的位置;（3）枪支是否储存在上锁的位置;（4）枪支的弹药是否单独储存;（5）枪支是否储存在未装子弹的位置;（6）枪支是否储存在未装子弹的位置。及（五）弹药是否存放在上锁的地方。通过对案件枪支和管制枪支的家庭进行访谈，收集了有关案件枪支和管制枪支储存状况的数据。结果我们采访了106名案件枪支和480名管制枪支的受访者。在与案件枪支有关的枪击事件中，82起是自杀企图（95%致命），24起是无意伤害（52%致命）。在调整了潜在的混杂变量后，来自病例家庭的枪支不太可能储存在未装载的情况下（比值比[OR]，0.30; 95%置信区间[Cl]，0.16-0.56）。同样，与对照枪相比，弹壳枪不太可能被锁定储存（OR，0.27; 95% CI，0.17-0.45），与弹药分开储存（OR，0.45; 95% CI，0.34-0.93），或弹药被锁定（OR，0.39; 95% CI，0.23-0.66）。这些研究结果是一致的手枪和长枪，也是类似的自杀企图和无意injuries.Conclusions的4种做法，保持枪锁定，卸载，存储弹药锁定，并在一个单独的位置是每个相关的保护作用，并建议一个可行的策略，以减少这些类型的伤害，在家中与儿童和青少年的枪支被存储。
Context Household firearms are associated with an elevated risk of firearm death to occupants in the home. Many organizations and health authorities advocate locking firearms and ammunition to prevent access to guns by children and adolescents. The association of these firearm storage practices with the reduction of firearm injury risk is unclear.Objective To measure the association of specific household firearm storage practices (locking guns, locking ammunition, keeping guns unloaded) and the risk of unintentional and self-inflicted firearm injuries.Design and Setting Case-control study of firearms in events identified by medical examiner and coroner offices from 37 counties in Washington, Oregon, and Missouri, and 5 trauma centers in Seattle, Spokane, and Tacoma, Wash, and Kansas City, Mo.Cases and Controls Case firearms were identified by involvement in an incident in which a child or adolescent younger than 20 years gained access to a firearm and shot himself/herself intentionally or unintentionally or shot another individual unintentionally. Firearm assaults and homicides were excluded. We used records from hospitals and medical examiners to ascertain these incidents. Using random-digit dial telephone sampling, control firearms were identified by identification of eligible households with at least 1 firearm and children living or visiting in the home. Controls were frequency matched by age group and county.Main Exposure Measures The key exposures of interest in this study were: (1) whether the subject firearm was stored in a locked location or with an extrinsic lock; (2) whether the firearm was stored unloaded; (3) whether the firearm was stored both unloaded in a locked location; (4) whether the ammunition for the firearm was stored separately; and (5) whether the ammunition was stored in a locked location. Data regarding the storage status of case and control guns were collected by interview with respondents from the households of case and control firearms.Results We interviewed 106 respondents with case firearms and 480 with control firearms. Of the shootings associated with the case firearms, 82 were suicide attempts (95% fatal) and 24 were unintentional injuries (52% fatal). After adjustment for potentially confounding variables, guns from case households were less likely to be stored unloaded than control guns (odds ratio [OR], 0.30; 95% confidence interval [Cl], 0.16-0.56). Similarly, case guns were less likely to be stored locked (OR, 0.27; 95 % Cl, 0.17-0.45), stored separately from ammunition (OR, 0.45; 95% Cl, 0.34-0.93), or to have ammunition that was locked (OR, 0.39; 95% Cl, 0.23-0.66) than were control guns. These findings were consistent for both handguns and long guns and were also similar for both suicide attempts and unintentional injuries.Conclusions The 4 practices of keeping a gun locked, unloaded, storing ammunition locked, and in a separate location are each associated with a protective effect and suggest a feasible strategy to reduce these types of injuries in homes with children and teenagers where guns are stored.