Questions and answers: Gun storage safety study in JAMA
- What did the study find?
- Why are these findings important?
- How was the study conducted?
- What kinds of guns were studied?
- Did the study include guns used in assaults or homicides?
- How does this study break new ground?
- How much did the various storage practices reduce the risk?
- Did the study show which kind of gun-locking device works best to prevent kids from gaining access?
- What are the implications of these findings for gun owners?
- What are the implications of these findings for policy-makers?
- What are the implications of these findings for pediatricians and others interested in the safety of children and teens?
- Who funded the study?
- Who conducted the study?
Q. What did the study find?
Four gun storage practices each appear to be protective against the risk of suicide and accidental gun injuries among children and teens. These practices are:
- Keeping a gun locked
- Keeping a gun unloaded
- Storing ammunition locked
- Storing ammunition in a location separate from the gun
The first two practices—keeping a gun locked and keeping a gun unloaded—each had a protective effect of around 70 percent. To put this in perspective, these measures are about as effective in protecting children and teens as wearing a seat belt in a car. The next two practices—storing ammunition locked and storing it separately from the gun—were slightly less protective, but still provided a protective effect of 61 percent and 55 percent, respectively.
Q. Why are these findings important?
Previous studies have shown that:
- The presence of a household firearm is associated with a 5-fold to 10-fold increased risk of suicide among adolescents.
- About 35 percent of homes in the United States with children younger than 18 years report having at least one gun. Of these, 43 percent have at least one unlocked gun.
- Suicide is the third leading cause of death among young people ages 15 to 19. There were 828 firearm suicide deaths among children 0 to 19 in the United States in 2002.
- And in 2001, firearms were used in 54 percent of youth suicides.
- Unintentional firearm injury is a less significant problem. In 2002, a total of 167 youth, ages 0 to 19 years, died in the United States from an unintentional gun injury.
Q. How was the study conducted?
Researchers interviewed 106 people from households where a child or teen under age 20 gained access to a gun and shot himself or herself, either intentionally or unintentionally, or shot another person unintentionally. Of these, 82 were suicide attempts (95 percent fatal) and 24 were unintentional injuries (52 percent fatal). The incidents were identified through medical examiner and coroner offices in 37 counties in Washington, Oregon, and Missouri, and five trauma centers in Seattle, Spokane, and Tacoma, Wash., and Kansas City, Mo.
The team then identified and interviewed a control group of 480 households with at least one gun where children lived and visited and where no shooting incidents had occurred. The control group households were found through random-digit dial telephone sampling. They were matched to the first group by age and county.
Finally, the researchers then interviewed adult household members from the two groups to determine differences in their gun storage practices.
Q. What kinds of guns were studied?
All the guns in the study were powder firearms such as handguns, rifles, or shotguns. Air guns and pellet ("BB") guns were not included in the study.
Q. Did the study include guns used in assaults or homicides?
No. The researchers excluded guns used in assaults and homicides because they believed that gaining access to a valid source of information regarding the storage status of the gun would be hampered by legal constraints.
Q. How does this study break new ground?
This is the first large, published study to analyze the protective effects of gun storage practices.
Previous studies have shown a link between laws intended to prevent children from having access to guns and a reduction in the rate of youth suicides. This new study may help to explain the reason for that association.
Q. How much did the various storage practices reduce the risk?
Having an unloaded gun was associated with a 70 percent reduction in risk of gun injury occurring unintentionally or during a suicide attempt.
Having a gun locked was associated with a 73 percent reduction in injury risk.
Having ammunition locked was associated with a 61 percent reduction in injury risk.
Storing the gun and ammunition in separate locations was associated with a 55 percent reduction in injury risk.
These findings were consistent for handguns and long guns (rifles and shotguns). They were similar for both suicide attempts and unintentional injuries.
Q. Did the study show which kind of gun-locking device works best to prevent kids from gaining access?
The study did not have the statistical power to distinguish which locking devices (safes, lock boxes, trigger locks, gun racks, gun cabinets) were most effective. However, lock boxes appeared to have a lower risk compared to trigger locks.
Using more than one locking device was not associated with any additional protective effect beyond that of one locking device.
Q. What are the implications of these findings for gun owners?
If you own a gun and keep it in a household where children and teens live or visit, it appears that you can significantly reduce the risk that they will use the gun for suicide or unintentional injury if you use one or more of these four storage practices:
- Keep the gun locked.
- Keep the gun unloaded.
- Keep the ammunition locked.
- Store the ammunition in a location separate from the gun
"These strategies are particularly important for families with teenagers who have high-risk conditions such as depression or substance abuse," said pediatrician David P. Grossman, MD, MPH, the study's primary investigator and medical director of preventive care at Group Health Cooperative.
"People often think of locking their guns as a way to protect small children," Grossman added. "But they need to realize that the storage practices we studied to appear to have a protective effect for kids of all ages."
Q. What are the implications of these findings for policy-makers?
Policy makers should consider the potential impact of programs and policies that limit young people's access to guns by keeping household guns locked and unloaded.
Q. What are the implications of these findings for pediatricians and others interested in the safety of children and teens?
Physicians and others may wish to inform gun owners with children in their homes that these safe-storage practices can significantly reduce the risk of tragic shootings involving children and teens.
Q. Who funded the study?
The study was funded by the Centers for Disease Control and Prevention.
Q. Who conducted the study?
David C. Grossman, MD, MPH, led the study when he was director of the University of Washington's Harborview Injury Prevention and Research Center (HIPRC) in Seattle, Washington. Grossman is now medical director of preventive care at Group Health Cooperative in Seattle. Grossman is also professor of health services at the University of Washington and an investigator at HIPRC.
Other researchers on the study were:
- Beth A. Mueller, DrPH, of the University of Washington Department of Epidemiology and Harborview Injury Prevention and Research Center (HIPRC)
- Christine Riedy, PhD, MPH, of HIPRC
- M. Denise Dowd, MD, MPH, of the Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
- Andres Villaveces, MD, MPH, of HIPRC
- Janice Prodzinski, BA, of HIPRC
- John Nakagawara, MHA, Medical Examiner's Office of King County, Washington
- John Howard, MD, Medical Examiner's Office of Pierce County, Washington
- Norman Thiersch, MD, Medical Examiner's Office of Snohomish County, Washington
- Richard Harruff, MD, Medical Examiner's Office of King County, Washington
RIGHTNAVBOX: Certain gun storage practices can reduce risk of youth suicide and accidental injuries
Group Health Center for Health Studies
Founded in 1947, Group Health Cooperative is a Seattle-based, consumer-governed, nonprofit health care system that coordinates care and coverage. Group Health Cooperative is ranked "Highest in Member Satisfaction among Commercial Health Plans in the Northwest Region" by J.D. Power and Associates. For 25 years, the Group Health Center for Health Studies has conducted research on preventing, diagnosing, and treating major health problems. Government and private research grants provide its main funding.