Community-level firearm injury surveillance: local data for local action.

In the United States, firearms are used to commit homicide more frequently than all other methods combined. According to the US Department of Justice, firearms are used to commit more than 1 million crimes each year. Despite the magnitude of this problem, little is known about the epidemiology of firearm crimes and assaults. Many states require medical personnel to report all nonfatal shootings to law enforcement, but the rate of compliance with this requirement is unknown. To enhance cooperation between community emergency departments and law enforcement agencies, we created a unified firearm injury notification system for the City of Atlanta, Georgia, and 5 surrounding counties: Fulton, DeKalb, Cobb, Gwinnett, and Clayton. Our findings are reported here.

Public opinion about guns in the home.

OBJECTIVES: (1) Determine the frequency of gun ownership, acquisition, and transfer; (2) assess gun storage practices; and (3) compare the views of firearm owning and non-owning adults regarding the protective value of keeping a gun in the home. SETTING AND METHODS: Over three different time periods (1995, 1996, and 1999) stratified, random digit telephone surveys were conducted in a five county area of metropolitan Atlanta, Georgia. Five hundred adults (aged 21+ years) responded to each survey. RESULTS: The proportion of Atlanta area households reporting firearm ownership was generally stable over this interval (38%, 40%, and 35% respectively). The percentage of gun owning households containing a handgun (approximately 75%) was stable as well. In 1995, more than half of gun owning households kept one or more guns unlocked; since that time, the trend has been gradually downward. In 1995, 44% of gun owning respondents kept one or more guns loaded, compared with 38% in 1996 and 40% in 1999. A majority of respondents to all three surveys (55%) agreed with the statement "A home with a gun is less secure than a home without a gun, because a gun can be involved in an accidental shooting, suicide or family homicide". Among five home security measures, respondents rated a burglar alarm most effective, and keeping a gun in the home least effective. CONCLUSIONS: In Atlanta, many households keep a firearm for protection, but they are ambivalent about the associated risks. These findings suggest that education about gun safety should include a discussion of the risks of unsafe storage, and non-lethal alternatives for home security.

Do US emergency medicine residency programs provide adequate training for bioterrorism?

Currently, there is no standardized curriculum for training of emergency physicians about the health hazards related to weapons of mass destruction. Opportunities for the widespread teaching of this material have remained limited, and the range of knowledge regarding even general disaster medical care is also variable among most residency training programs in the United States. We developed a survey to ascertain whether any formal training in biological weapons is conducted in emergency medicine programs; to determine the overall subjective ability of program directors or residency directors to recognize and clinically manage casualties of biological weapons agents; and to identify which resources might be used by emergency physicians to identify and treat biological warfare casualties. We also document a baseline of current practices regarding biological weapons training in emergency medicine residency programs.