Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-0636.
Department of Emergency Medicine, UBC
April 6, 2018
Non-powder firearm related research
I applaud the timely Annals of Internal Medicine (1) editorial on call for papers on fire-arm related harms. This is a invaluable opportunity and it would certainly result a high quality research contribution to the literature on firearm related violence prevention, an important national problem and focus guidance for clinician community advocacy and policy. This editorial request from a high impact and well respected journal, would no doubt, raise global awareness and shape the future firearm control policy, aimed at injury prevention and safety. I do certainly agree that physicians and other healthcare professionals can do more to combat this devastating public health crisis in our time. However, non-powder firearm related research is rarely appearing in the academic journals or in the social media, despite 3 million paintball guns, airsoft guns, BB guns, and pellet guns (non-powder firearms) are sold in the US each year (2). Between 2001 and 2011, 209,981 Americans were injured with non-powder firearms, and of those, 145,423 were children aged under19 years (2). Moreover, according to the United States Eye Injury Registry, the number of eye injuries due to non-powder firearm is higher than firearms. This study further suggests that increasing public’s awareness of the dangers presented by non-powder firearm to the eye should be a national priority (3).Currently, published information about the yearly frequency of fatal non-powder guns does not exist; however, recent New York Times article shows that, in 2007, 2008 and 2009, a total of 124 people, including 23 children and teenagers aged 18 and younger, were killed in Texas alone from accidents involving non-powder firearms (4).The American Academy of Pediatrics (AAP) American Academy of Ophthalmology (AAO) issued a joint policy statement in 2013, categorizing non-powder firearms use as a high eye injury risk activity. This policy statement further advocate for protective eyewear during non-powder firearms uses (AAP-AAO, 2013). All available research to date is clearly shows that non-powder firearms, in fact weapons with the ability to cause serious bodily harm and eye injury.Therefore, this issue is particularly important to vision care community. Ophthalmologists need to be aware of the risks associated with these weapons (non-powder guns are weapons and should never be characterized as toys) and provide proper counseling to patients and family. Advocacy for appropriate regulation on a federal or state level (as some state laws do not address non-powder guns at all) increase public awareness through education and encourage active prevention work by ophthalmologists would help reduce the incidence of these injuries in the future. I appeal to Annals of Internal Medicine editorial board to extend their request for high quality research in the area of non-powder firearm related research as well. Thank you for your consideration.RFERENCES:(1). Editorial-Editor’s Note: Call for Articles on Firearm-related harm. Annals of Internal Medicine-20th March 2018. Available at: http://annals.org/aim/fullarticle/2675741/editors-note-call-articles-firearm-related-harm (Accessed 06th April 2018)(2). Dandu KV, Carniol ET, Sanghvi S, Baredes S, Eloy JA. A 10-Year Analysis of Head and Neck Injuries Involving Nonpowder Firearms. Otolaryngol Head Neck Surg. 2017;156(5):853-856. (3). McGwin G Jr, Hall TA, Xie A, Owsley C. Gun-related eye injury in the United States, 1993-2002.Ophthalmic Epidemiol. 2006; 13(1):15-21.(4). Fernandez, M. “Texas Death Offers Grim Reminder That Gun Replicas Can Fool Police,” New York Times, Jan. 8, 2012,-Available at: http://www.nytimes.com/2012/01/09/us/teenagers-death-a-reminder-of-gun-replicas-dangers.html (Accessed 1 Nov.2017) (5). American Academy of Pediatrics (AAP) and American Academy of Ophthalmology (AAO) Communications Advisory Board -Protective eyewear for young athlete-2013-Available at: https://www.aao.org/clinical-statement/protective-eyewear-young-athletes (Accessed 31 Oct. 2017)
June 30, 2018
Risking dismissive criticism
Research into the impact of firearms on civilian health is long overdue. It's good that Annals is interested in publishing work on this topic. However I'm concerned that by calling for "Articles on Firearm-Related Harm," your efforts will be dismissed as politically motivated.Your search for "harms" will suggest to gun aficionados that Annals Editors have rushed to judgment. To avoid the perception of bias you should have called for research on "Firearm-related safety."
Robert B. Sklaroff, M.D.
July 9, 2018
Editors' Note: Call for Articles on Firearm-Related Harm
When the Annals Editors issue a “call for articles on firearm-related harm,” the positive first impression is properly supplanted by a sense of caution.Unlike the foundation for the decision two decades ago to devote entire issues of JAMA to combat the tobacco scourge by its Editor-in-Chief, George D. Lundberg, M.D. (2), the impact of firearm violence on public health is societal more than medical.Such over-exuberant advocacy threatens to generate second-class science, as has already transpired.Indeed, it has been necessary on numerous occasions to submit critique of peer-reviewed articles published in the Annals related to firearms during recent years (3,4); fortunately, the Editors concurred with the suggestion that a flimsy submission be rejected, following provision of scathing analysis.Nevertheless, many of the Annals pieces compiled during recent years (http://annals.org/aim/pages/firearm-related-content) merit this level of analysis by experts in the field; it appears that efforts promulgated by this physician constitute the sole manifestation of such disputation.Of particular concern is an apparent campaign against retaining weapons in the home, notably prominent in the “On being a doctor” essays; the right-to-bear-arms is not delimited by risk of abuse.In contrast, it was proposed three years ago that a MANDATORY system be established whereby any private seller can CHOOSE to acquire a background-check at either gun-shows or any/all local police-stations for FREE. The NRA-ILA website [https://www.nraila.org/issues/background-checksnics/] details multiple federal restrictions on private gun purchases that, one would think, a seller would find desirable to honor … for his/her personal benefit; thus, facilitating the process of acquiring relevant info would appear to be an optimal approach to this problem, absent any “registration” process.This was proffered during the height of the initiative by Senators Pat Toomey (PA-R) and Joe Manchin (WV- D), remitted both to a regional NRA lawyer-leader and to Senator Toomey.Therefore, the reading-public (professional and lay) should know that the Editors have demonstrated their reticence to publish articles in this realm uncritically, notwithstanding the bold invitation that they be submitted for expedited scrutiny.As elucidated during discussion of the accompanying “Ideas and Opinions” essay (5), it is mandatory that interventions be based on data that are accepted by responsible thinkers on all sides of this ongoing debate, transcending perennial polemics. This will preclude adopting a sense of resignation (e.g., “Chicago hoodlums inevitably get out-of-state guns”), as consensus development is stripped of those seeking only to validate preconceived notions. 1. The Editors. Editors' Note: Call for Articles on Firearm-Related Harm. Ann Intern Med. 2018;168(12):887. Accessed on 7/7/2018: http://annals.org/aim/fullarticle/2675741/editors-note-call-articles-firearm-related-harm.2. Lundberg G. In the AMA, policy follows science: A case history of tobacco. JAMA 1985;253(20):3001-3003. Accessed on 7/7/2018: https://jamanetwork.com/journals/jama/article-abstract/398693 3. Weinberger S, et al. Firearm-Related Injury and Death in the United States: A Call to Action From 8 Health Professional Organizations and the American Bar Association. Ann Intern Med. 2015;162(7):513-516. Accessed on 7/7/2018: http://annals.org/aim/fullarticle/2151828/firearm-related-injury-death-united-states-call-action-from-8 4. Anglemyer A, Horvath T, Rutherford G. The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis. Ann Intern Med. 2014; 160:101-10. Accessed on 7/7/2018: http://annals.org/aim/fullarticle/1814426/accessibility-firearms-risk-suicide-homicide-victimization-among-household-members-systematic 5. Dzau VJ & Leshner AI. Public Health Research on Gun Violence: Long Overdue. Ann Intern Med. 2018;168(12):876-877. Accessed on 7/7/2018: http://annals.org/aim/fullarticle/2675740/public-health-research-gun-violence-long-overdue
The Editors. Editors' Note: Call for Articles on Firearm-Related Harm. Ann Intern Med. 2018;168:887. [Epub ahead of print 20 March 2018]. doi: https://doi.org/10.7326/M18-0636
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Published: Ann Intern Med. 2018;168(12):887.
Published at www.annals.org on 20 March 2018
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