Full length article A comparison between non-powder gun and powder-gun injuries in a young pediatric population Jennifer J. Freeman a, 1 , Marielena Bachier-Rodriguez a, 1 , Jessica Staszak b , Alexander Feliz a, * a Division of Pediatric Surgery, University of Tennessee, Health Science Center, Le Bonheur Children’s Hospital, 49 North Dunlap, Second Floor, Memphis, TN 38105, USA b Department of General Surgery, University of Tennessee, Health Science Center, 920 Madison Ave., Memphis, TN 38103, United States A R T I C L E I N F O Article history: Accepted 27 May 2017 Keywords: Non-powder guns Gun shot wounds Adolescents Health disparities A B S T R A C T Introduction: Non-powder guns (NPG) are viewed as toys for children by the general public. Literature on firearm injuries in the pediatric population is increasing, however there are still large gaps in the published literature regarding NPG. We intended to identify and compare the epidemiology, circumstances of injury and outcomes of children with NPG versus powder-gun injuries (GSW). Patients and methods: We performed a 6-year retrospective analysis of children 0–14 years old treated for NPG and GSW injuries at our level one pediatric trauma center. Mann-Whitney U test and Pearson’s X 2 were used to compare continuous and categorical variables, respectively. Results: There were 43 NPG and 112 GSWs. Patients were predominantly male (36 children; 84%) NPG vs. 92 children; 82% GSW) with a median age in both groups of 11 years. Analysis of residential zip codes showed that 74% (32 children) NPG injuries and 85% (95 children) GSW lived in regions with higher poverty than the national level. Children with NPG injuries were more likely to be Caucasian (24 children; 56%) and to have suffered an unintentional injury (36 children; 84%), while children with GSW were African-American (80 children; 71%; p = 0.0002) and victims of assault (50 children; 45%; p < 0.0001). When compared with NPG, children with GSW had more severe injuries, longer hospital stays, and higher overall mortality. There were no significant differences in rate of emergent OR intervention and ED mortality between the two groups. Conclusion: Our results highlight two important findings. First, NPG injuries were accidental and thus preventable with improved legislation and public education. Second, health disparities related to gun violence among African-Americans are prevalent even in early childhood and prevention efforts should include this younger population. © 2017 Elsevier Ltd. All rights reserved. Introduction Culturally, in the United States (and other similar developed countries) non-powder guns (NPG) are perceived as toys for children that do not cause serious injury nor lead to significant healthcare cost. The United States Consumer Product Safety Commission (US CPSC) estimates that approximately 3.2 million NPGs are sold yearly [1,2]. More importantly, the US CPSC reported 39 NPG related deaths occurred between 1990 and 2000. Even more concerning is that over 80% (32 of 39) of those reported deaths were children less than 15 years of age [3]. NPGs are abundantly available in toy stores, department stores, and online which only reinforces the false belief that NPGs are toys safe for children to enjoy. Non-powder guns (NPG) refer to weapons that utilize the power of compressed air to launch a projectile; this contrasts with powder-guns (i.e. injury that is most commonly considered a gunshot wound, abbreviated here as GSW) which launch projectiles by using the energy generated by burning of gunpow- der. The force of impact of a projectile upon tissue contact is mainly determined by muzzle velocity (MV). The projectile’s type (e.g. paintball, lead pellet), caliber (e.g. 9 mm), gun’s propulsion mechanism (e.g. spring piston, gas cartridge), and type of barrel (e.g. length, width) are the main determinants of MV. The upper limits of the MV of a NPG (150–1200 feet/s) are not widely different from the MV range of a powder-gun (750–1450 feet/s) [3–5]. Projectiles will puncture skin with MV ranging between 245 and 331 feet/second, and will lead to ocular penetration at 130 feet/s * Corresponding author at: 49 N. Dunlap St., Second Floor, Memphis, TN 38105, United States. E-mail addresses: afeliz@uthsc.edu, alexander1919@att.net (A. Feliz). 1 Freeman and Bachier-Rodriguez contributed equally to this study. http://dx.doi.org/10.1016/j.injury.2017.05.036 0020-1383/© 2017 Elsevier Ltd. All rights reserved. Injury, Int. J. Care Injured xxx (2017) xxx–xxx G Model JINJ 7262 No. of Pages 5 Please cite this article in press as: J.J. Freeman, et al., A comparison between non-powder gun and powder-gun injuries in a young pediatric population, Injury (2017), http://dx.doi.org/10.1016/j.injury.2017.05.036 Contents lists available at ScienceDirect Injury journal homepa ge: www.elsev ier.com/locate /injury