TRENDS IN NONFATAL AND FATAL FIREARM-RELATED INJURY RATES IN THE UNITED-STATES, 1985-1995

Study objective: To characterize trends in annual estimates of nonfata l firearm-related injuries treated in US hospital emergency department s and to compare trends in quarterly rates of such injuries with those of firearm-related fatalities in the US population. Methods: Data on nonfatal firearm-related injuries were obtained from the National Elec tronic Injury Surveillance System (NEISS) by review of medical records for June 1, 1992, through May 31, 1995. Data on firearm-related fatal ities were obtained from the National Vital Statistics System for Janu ary 1, 1985, through December 31, 1995. NEISS comprises 91 hospitals t hat represent a stratified probability sample of all hospitals in the United States and its territories that have at least six beds and prov ide 24-hour emergency service. The main outcome measures were numbers, percentages, and quarterly population rates for nonfatal and fatal fi rearm-related injuries. Results: An estimated 288,538 nonfatal firearm -related injuries (95% confidence interval [CI], 169,776 to 407,300) w ere treated in EDs during the 3-year study period. The annual number o f nonfatal firearm-related injuries increased from 99,025 for June 199 2 through May 1993 (95% CI, 58,266 to 139,784) to 101,669 for June 199 3 through May 1994 (95% CI, 59,822 to 143,516), then decreased to 87,8 44 for June 1994 through May 1995 (95% CI, 51,687 to 124,001). Before the third quarter of 1993, quarterly nonfatal and fatal firearm-relate d injury rates in the total US population and quarterly nonfatal firea rm assaultive injury and firearm homicide rates for males aged 15 to 2 4 years were observed to be on the rise. Since then, these rates have significantly declined. Conclusion: Analysis of national trends indica tes that nonfatal and fatal firearm-related injuries are declining in the United States, although the rate of firearm-related deaths remains high, especially among males aged 15 to 24 years, in relation to othe r leading causes of injury death. An assessment of factors responsible for the decline in firearm-related injuries is needed to design furth er prevention efforts.