DOI: 10.3886/icpsr39644
title: Firearm Injury Surveillance Study, 2023
title: Archival Version

description: 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 2023. 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.
description: <strong>Do I need to use the sample weights in analyzing the data?</strong>

Yes, the sample weights are essential for computing the national estimates. Each sample weight
(weight) represents the inverse of the probability of selection of the case. The sample weights
are computed monthly and are adjusted for non-response. The sample weights also have a
post-stratification adjustment to account for changes in the annual number of emergency
department visits in U.S. hospitals. The sum of these weights over the group or subgroup
of interest will provide national estimates of injured persons treated in US hospital EDs.
description: Data were collected from a national sample of 76 NEISS hospitals that were selected as a stratified probability sample of United States hospitals with at least six beds that provided 24-hour emergency service excluding psychiatric and penal institutions. The sample included five strata of which four represented different levels of hospital size, measured by the number of emergency department visits. The fifth contained the children's hospitals. There were 31 hospitals in the small stratum, 10 hospitals in the medium stratum, 9 hospitals in the large stratum, 20 hospitals in the very large stratum, and 6 hospitals in the children's stratum.
<em>Control Operations:</em>

Trained hospital coders look at data for firearm injury-related cases from ED records at NEISS hospitals.
The coders coded all data elements, except for cause/mechanism of injury. These coded data and a narrative
were entered into a computer and electronically transmitted to CPSC headquarters in Bethesda, MD. NEISS-FISS
quality assurance coders at CPSC headquarters received the data electronically and reviewed all of the data
elements as well as a narrative (description) for each case from each of the NEISS-FISS hospitals.
Quality assurance coders then used the narrative and other data to assign codes for the precipitating
and direct causes/mechanisms of injury for each case.


The narratives, in most cases, provided enough detail about the circumstances of the injury event so that
trained quality assurance coders could assign codes for cause/mechanism of injury and confirm the intent of
injury code assigned by the hospital coder. NEISS hospital coders are trained not to interpret information
provided in the ED record when writing the narrative but rather to transcribe exactly what medical providers
recorded about the ED visit. Most narrative descriptions are based on doctors' and nurses' notes. This policy
helps ensure that the data from the narrative is accurate and consistent. In a joint effort, CDC and CPSC
developed the coding guidelines for cause/mechanism and intent of injury. The guidelines are consistent with
coding guidelines in the ICD-10-CM. For more details about coding procedures, see the NEISS-AIP training and
coding manuals.
description: Datasets: 
DS1: Firearm Injury Surveillance Study, 2023
description: United States hospitals providing emergency services.
description: computer-assisted self interview (CASI); self-enumerated questionnaireBeginning with the 2020 data, cases with a disposition of "DOA" were removed from the dataset. Previous study years include these cases; however, they were not included in the surveillance tables.ICPSR processed this data at the request of CDC to be in compliance with President Trump's January 2025 Executive Orders. The study documentation and data were updated to include sex as a biological variable. This change was first instituted with the release of the 2022 NEISS data.