1 child or youth injured by ‘firearms’ nearly every day in Ontario, pediatricians find

The number of children and young people injured by firearms in Ontario amounts to nearly one a day, according to a study published in Monday’s issue of CMAJ.

Researchers from the Hospital for Sick Children and the Institute for Clinical Evaluative Sciences analyzed health and administrative databases with a focus on firearm injuries among residents in Ontario aged 24 and younger between 2008 and 2012.

Sick Kids staff physician Dr. Natasha Saunders and her team found of the 355 firearm injuries each year, approximately 23 to 25 children or youth — or about seven per cent — die from those injuries. Deaths, but not injuries, are tracked nationally.

?”When we were putting together all the numbers we kind of went, ‘Oh my goodness, this is unbelievable,'” Saunders said in an interview. “We were definitely shocked.”

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The injuries include loss of sight and loss of limbs.

Around 75 per cent of the injuries are unintentional and preventable, Saunders said.

Assault-related firearm injuries accounted for the other 25 per cent.

Emergency room physicians and pediatricians wanted to identify which populations are at highest risk so that violence prevention strategies can be targeted.

Having a firearm in the home is probably the most important risk factor for injury among those age 25 and younger, researchers say. (Sean Kilpatrick/Canadian Press)

They found the risk of being a victim of firearm assault was 43 per cent higher for refugees than for Canadian-born youth. (Refugees were victims of firearm assault at a rate of 4.7 per 100,000 people, compared with non-refugees at 2.4 firearm assaults per 100,000 people.)

Nationals from Central America and Africa accounted for 68 per cent of immigrants with assault-related firearm injuries. The researchers hope to understand why they’re being injured and victimized, and how to support people better to prevent gun violence.

Firearms ‘designed to kill’

Separately on Monday, the Canadian Paediatric Society released an updated position statement on prevention of firearm injuries. The group notes adolescent and young men are disproportionately affected.

Canada’s rate of firearm ownership is lower than that of the United States but high compared with many other high-income countries, the society said.

From 2008 to 2012, 3,688 Canadians of all ages died from firearm injuries, which includes accidents, suicides and homicides. 

The group urged the federal government to implement stricter controls on how people acquire, own and store firearms, including classifying air guns and BB guns powerful enough to cause eye injury or skin penetration as firearms under Canada’s Firearms Act.

“Firearms by their very nature are designed to kill, and you need to be very cautious of safety,” said Dr. Alan Drummond, an emergency room physician in Perth, Ont. He was not involved in the study or the position statement.

In the emergency department, doctors routinely ask about access to firearms in the home because it’s associated with a greater risk of death by homicide or suicide.

‘When I raise guns as an issue to me and as an issue of safety for the family and to the community, they actually sit up and listen.’
– Dr. Alan Drummond

The society would like all health care providers to counsel families that firearms shouldn’t be present where children and teens live and play. 

“When a firearm is present, it must be stored according to the regulations of Canada’s Firearm Act: unloaded, locked and separate from ammunition,” the society wrote.

Firearms safety also becomes a public health issue, said Drummond. For instance, when assessing an individual who comes into the emergency department with depression, suicidal thoughts or alcoholism, “we want to be sure that firearms aren’t part of the equation,” he said. 

In the clinic, “as a rural physician, when I raise guns as an issue to me and as an issue of safety for the family and to the community, they actually sit up and listen,” Drummond said.

Patients may not have thought of guns in the context of health promotion. “Grandad brought his gun home from the war. It was stored in the closet. That’s where it always was,” Drummond said. “But when we start asking questions, people start saying, ‘Well, he’s taking it seriously. Maybe we need to as well.'”

Next, the researchers hope to compare the extent of the problem in Ontario to other provinces.