Citation

Hamilton EC, Miller CC, Cox CS, Lally KP, Austin MT. J. Trauma Acute Care Surg. 2018; 84(4): 613-619.

Affiliation

Department of Pediatric Surgery, The McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin Street, Suite 5.258, Houston, Texas 77030 Center for Surgical Trials and Evidence-Based Practice, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas Children's Memorial Hermann Hospital, Houston, Texas.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001786

PMID

29283962

Abstract

BACKGROUND: State-level Child Access Prevention (CAP) laws impose criminal liability on adults who negligently allow children access to firearms. CAP laws can be further divided into strong CAP laws which impose criminal liability for negligently stored firearms and weak CAP laws that prohibit adults from intentionally, knowingly, and/or recklessly providing firearms to a minor.We hypothesized that strong CAP laws would be associated with a greater reduction in pediatric firearm injuries than weak CAP laws.

METHODS: We constructed a cross-sectional national study using the HCUP-Kids Inpatient Database from 2006 and 2009 using weighted counts of firearm related admissions among children <18 years. Poisson regression was used to estimate the association of CAP laws with pediatric firearm injuries.

RESULTS: After adjusting for race, sex, age, and socioeconomic income quartile, strong CAP laws were associated with a significant reduction in all (incidence rate ratio 0.70; 95% confidence interval 0.52 to 0.93), self-inflicted (incidence rate ratio 0.46; 95% confidence interval 0.26 to 0.79), and unintentional (incidence rate ratio 0.56; 95% confidence interval 0.43 to 0.74) pediatric firearm injuries. Weak CAP laws, which only impose liability for reckless endangerment, were associated with an increased risk of all pediatric firearm injuries.

CONCLUSIONS: The association of CAP laws on hospitalizations for pediatric firearm injuries differed greatly depending on whether a state had adopted a strong CAP law or a weak CAP law. Implementation of strong CAP laws, which require safe storage of firearms, by each state has the potential to significantly reduce pediatric firearm injuries. LEVEL OF EVIDENCE: Level III, prognostic and epidemiology study.

Language: en