Firearm Injury Surveillance Study, 2022

These data were collected using the National Electronic Injury Surveillance System (NEISS),
the primary data system of the United States Consumer Product Safety Commission (CPSC). CPSC
began operating NEISS in 1972 to monitor product-related injuries treated in United States
hospital emergency departments (EDs). In June 1992, the National Center for Injury Prevention
and Control (NCIPC), within the Centers for Disease Control and Prevention, established an
interagency agreement with CPSC to begin collecting data on nonfatal firearm-related injuries
in order to monitor the incidents and the characteristics of persons with nonfatal firearm-related
injuries treated in United States hospital EDs over time. This dataset represents all nonfatal
firearm-related injuries (i.e., injuries associated with powder-charged guns) and all nonfatal
BB and pellet gun-related injuries reported through NEISS from YYYY. The cases
consist of initial ED visits for treatment of the injuries.

The NEISS-FISS is designed to provide national incidence estimates of nonfatal firearm injuries
treated in U.S. hospital EDs. Data on injury-related visits are obtained from a national sample of
NEISS hospitals, which were selected as a stratified probability sample of hospitals in the United
States and its territories with a minimum of six beds and a 24- hour ED. The sample includes separate
strata for very large, large, medium, and small hospitals, defined by the number of annual ED visits
per hospital, and children's hospitals. The scope of reporting goes beyond routine reporting of injuries
associated with consumer- related products in CPSC's jurisdiction to include all firearm injuries. The
data can be used to (1) measure the magnitude and distribution of nonfatal firearm injuries in the
United States; (2) monitor unintentional and violence-related nonfatal firearm injuries over time;
(3) identify emerging injury problems; (4) identify specific cases for follow-up investigations of
particular injury-related problems; and (5) set national priorities. A fundamental principle of this
expansion effort is that preliminary surveillance data will be made available in a timely manner to a
number of different federal agencies with unique and overlapping public health responsibilities and
concerns. The final edited data will be released annually as public use data files for use by other
public health professionals and researchers.

These public use data files provide NEISS-FISS data on nonfatal injuries collected from January through
December each year.

NEISS-FISS is providing data on over 100,000 estimated cases annually. Data obtained on each case
include age, race/ethnicity, sex, principal diagnosis, primary body part affected, consumer products
involved, disposition at ED discharge (i.e., hospitalized, transferred, treated and released,
observation, died), locale where the injury occurred, work-relatedness, and a narrative description of the
injury circumstances. Also, intent of injury (e.g., unintentional, assault, self-harm, legal intervention)
are being coded for each case in a manner consistent with the International Classification of Diseases,
Tenth Revision, Clinical Modification (ICD-10-CM) coding rules and guidelines.

Users are cautioned against using estimates with wide confidence intervals to make conclusions about point
estimates. Firearm injuries have distinct geographic patterns and estimates can be imprecise or change over time
when based on a small number of facilities.

NEISS has been managed and operated by the U.S. Consumer Product Safety Commission since 1972 and is used
by the Commission for identifying and monitoring consumer product-related injuries and for assessing risk to
all U.S. residents. These product- related injury data are used for educating consumers about hazardous products and for identifying injury-related cases used in detailed studies of specific products and associated hazard patterns. These studies set the stage for developing both voluntary and mandatory safety standards.

Since the early 1980s, CPSC has assisted other federal agencies by using NEISS to collect injury- related
data of special interest to them. In 1992, an interagency agreement was established between NCIPC and CPSC to
(1) collect NEISS data on nonfatal firearm- related injuries for the CDC Firearm Injury Surveillance Study;
(2) publish NEISS data on a variety of injury-related topics, such as in- line skating, firearms, BB and
pellet guns, bicycles, boat propellers, personal water craft, and playground injuries; and (3) to address
common concerns. CPSC also uses NEISS to collect data on work-related injuries for the National Institute
of Occupational Safety and Health (NIOSH), CDC.

In July 2000, NCIPC, in collaboration with CPSC, expanded NEISS to collect data on all types and causes of
injuries treated in a representative sample of hospitals. This system is called the "NEISS All-Injury Program
(NEISS-AIP)". These data provide the basis for national estimates of all types of nonfatal injuries treated
in hospital emergency departments in the United States.

Beginning in 2019, CPSC initiated a redesign of the NEISS sample to update the sampling frame. The redesign
includes adding and replacing hospitals. The redesign includes a resample based on more recent hospital
information from the American Hospital Association, including the list of hospitals by hospital type. The
prior sample was drawn in 1997. The NEISS sample goal is 100 hospitals; hospital recruitment and onboarding
are ongoing. CDC and CPSC are continuing to release injury data while the onboarding is underway.

本数据集数据采集自全国电子伤害监测系统（National Electronic Injury Surveillance System, NEISS）——美国消费者产品安全委员会（United States Consumer Product Safety Commission, CPSC）的核心数据系统。CPSC于1972年启用NEISS，用于监测美国医院急诊科（emergency departments, EDs）收治的与产品相关的伤害病例。1992年6月，美国疾病控制与预防中心下属的国家伤害预防与控制中心（National Center for Injury Prevention and Control, NCIPC）与CPSC达成跨机构协议，开始采集非致命枪支相关伤害数据，以长期监测美国医院急诊科收治的非致命枪支相关伤害病例的发生情况及患者特征。本数据集涵盖YYYY年起通过NEISS上报的所有非致命枪支相关伤害（即与装药枪支相关的伤害）以及非致命BB弹枪与气弹枪相关伤害病例。所有病例均为因该类伤害首次前往急诊科就诊的案例。

NEISS枪支伤害监测子系统（NEISS-Firearm Injury Surveillance System, NEISS-FISS）旨在提供美国医院急诊科收治的非致命枪支伤害的全国发病估计数据。伤害相关就诊数据来自NEISS医院的全国概率抽样样本：该样本采用分层概率抽样方法，选取美国及领地内床位不少于6张且设有24小时急诊科的医院，按年急诊就诊量分为超大型、大型、中型、小型医院层以及儿童医院层。其上报范围已超出CPSC管辖范围内的消费产品相关伤害常规上报范畴，涵盖所有枪支伤害。该数据可用于：(1) 衡量美国非致命枪支伤害的规模与分布；(2) 长期监测意外及与暴力相关的非致命枪支伤害；(3) 识别新发伤害问题；(4) 针对特定伤害相关问题确定需跟进调查的具体病例；(5) 制定国家优先工作方向。本次数据扩容的核心原则是：将初步监测数据及时向一批职责独特且存在公共卫生责任重叠的联邦机构开放。最终编辑完成的数据将以公共使用数据集的形式每年发布，供其他公共卫生从业者与研究人员使用。

上述公共使用数据集提供每年1月至12月采集的NEISS-FISS非致命伤害数据。

NEISS-FISS每年预计上报超过10万例估算病例。每例病例的采集数据包括：年龄、种族/族裔、性别、主要诊断、受累主要身体部位、涉事消费产品、急诊科出院处置方式（即住院、转院、治疗后出院、留观、死亡）、伤害发生地点、是否与工作相关，以及伤害发生经过的叙述性描述。此外，伤害意图（如意外、攻击、自残、执法干预）将按照《国际疾病分类第十版临床修订版（International Classification of Diseases, Tenth Revision, Clinical Modification, ICD-10-CM）》的编码规则与指南进行编码。

使用者需注意，避免使用置信区间过宽的估计值对点估计值作出结论。枪支伤害存在显著的地域分布特征，若基于少量医疗机构的数据进行估算，结果可能不够精确或随时间发生变化。

NEISS自1972年起由美国消费者产品安全委员会管理运营，该委员会利用其识别与监测消费产品相关伤害，并评估所有美国居民面临的风险。此类产品相关伤害数据可用于向消费者宣传危险产品的危害，以及识别用于特定产品及相关危害模式详细研究的伤害病例，相关研究为制定自愿与强制性安全标准奠定基础。

自20世纪80年代初以来，CPSC通过NEISS协助其他联邦机构采集其关注的专项伤害数据。1992年，NCIPC与CPSC达成跨机构协议，具体包括：(1) 为CDC枪支伤害监测研究采集非致命枪支相关伤害的NEISS数据；(2) 发布与多项伤害相关主题的NEISS数据，如直排轮滑、枪支、BB弹枪与气弹枪、自行车、船用螺旋桨、个人水上摩托以及游乐场伤害；(3) 回应公众普遍关切的问题。此外，CPSC还通过NEISS为美国疾病控制与预防中心下属的美国国家职业安全与健康研究所（National Institute of Occupational Safety and Health, NIOSH）采集与工作相关的伤害数据。

2000年7月，NCIPC与CPSC合作扩容NEISS，采集美国代表性医院样本收治的所有类型与原因的伤害数据，该系统被称为"NEISS全伤害项目（NEISS All-Injury Program, NEISS-AIP）"。此类数据为美国医院急诊科收治的各类非致命伤害的全国估计值提供了依据。

2019年起，CPSC启动NEISS样本的重新设计以更新抽样框架，包括新增与替换医院。本次重新设计基于美国医院协会（American Hospital Association）的最新医院信息（包括按医院类型分类的医院清单）进行重抽样。此前的样本于1997年抽取。NEISS的样本目标为100家医院，医院招募与入职工作仍在进行中。在入职工作开展期间，CDC与CPSC仍将持续发布伤害数据。