Disproportionate sales of crime guns among licensed handgun retailers in the United States: a case-control study.

OBJECTIVE To determine risk factors among licensed firearm retailers for disproportionate sales of handguns that are later subjected to ownership tracing, generally after use in crime. DESIGN Case-control; the study period was 1998-2003. Cases were all eligible firearm retailers whose handguns were later traced at a rate that significantly (p<0.05) exceeded the expected value. Controls were a 4:1 random sample of the remainder. Data were obtained from sales and tracing records for 1998-2003 and site visits conducted August-December, 2004. SUBJECTS AND SETTING 60 cases and 240 controls, from the 573 retailers in California selling >or= 50 handguns annually during the study period. MAIN OUTCOME MEASURE Status as a case. Odds ratios were used to measure relative risk. RESULTS In multivariate analyses, cases had larger sales volumes, sold inexpensive handguns more often, had a higher percentage of sales denied because the prospective purchasers were prohibited from owning firearms, and were more likely to be in an urban area, in or near a city with a policy of tracing all recovered crime guns. The effects of several risk factors, including status as a pawnbroker and sales to law enforcement personnel, appeared to be mediated by purchaser characteristics for which denied sales are a proxy measure. CONCLUSIONS A number of factors-most of them characteristics of the retailers or of their handgun purchasers, and most of them available in existing data-were linked to disproportionate sales of handguns that are later used in crime.