Serious and fatal firearm injuries among children and adolescents in Alaska: 1991-1997.

STUDY OBJECTIVE To describe demographics, causal factors, intent, and incident locations of serious and fatal firearm injuries among children and adolescents in Alaska, for the years 1991 through 1997. METHODS Data from the Alaska Trauma Registry plus Vital Statistics death certificates were reviewed for a seven-year period (1991-1997). Data elements included are: intent (ICD 9-CM E-Codes and narratives); age group; region of incident; place of occurrence; alcohol or drug involvement; type of firearm used; and perpetrator. RESULTS During the seven-year study period, 222 children and adolescents ages 0-19 years were admitted to a hospital for a non-fatal firearm injury, plus 165 others received fatal firearm injuries. Of these 387 serious and fatal injuries, 34.9% (135) were determined to be unintentional, 36.4% (141) were suicides or suicide attempts, 23.3% (90) were homicide/assaults, 0.5% (2) were legal intervention, and for 4.9% (19) intent was unknown. Rates of serious and fatal firearm injuries per 100,000 youth for the six-year study period ranged from 14 in the Fairbanks North Star Borough and the Kenai Peninsula Borough to 105 in the Yukon-Kuskokwim Region. The statewide average for this period was 27.1 per 100,000 children and adolescents. CONCLUSIONS Firearm injuries are a leading cause of serious and fatal injuries to children and youth in Alaska. This study suggests that many children and adolescents in Alaska who were injured by firearms, or who caused injury to other children or youth by firearms, had easy access to them. Efforts should be made to convince adults not to let children or at risk teenagers have unsupervised access to firearms, and to promote safe storage of firearms.