Nonpowder firearms like BB and paintball guns aren't typically considered lethal weapons. But as the rate of eye injuries linked to these weapons surges, researchers say it's time to take these types of guns seriously, too.
Between 1990 and 2016, the overall rate of injuries from nonpowder firearms among children declined more than 54%. But the rate of eye injuries, often severe, jumped more than 30%, according to a new study published in Pediatrics.
"Nonpowder firearms should be regarded as potentially lethal weapons," the study's authors wrote.
Researchers combed through statistics from the National Electronic Injury Surveillance System collected between 1990 and 2016. Anytime a nonpowder firearm -- specifically, BB, airsoft, paintball and pellet guns -- sent a child or teen to the hospital with an external injury, researchers counted it toward the total.
BB guns most common culprit; eye injuries on the rise
During the 26-year time period, 364,133 children were injured by direct contact with the guns. BB guns accounted for more than 80% of those injuries, mostly located in the head and neck area.
Boys were significantly more likely to be injured -- more than 87%. The majority of patients were between 6 and 12 years old.
Eye injuries accounted for about 53,994 of those injuries -- almost 15%, researchers said. The most common variety was corneal abrasion, a scratch to the eyeball that typically heals within a day or two.
But it was followed by more serious injuries: Hyphema, when blood pools in the eye and can impair vision if untreated; globe rupture, when blunt trauma injures the cornea and sclera, or white of the eye; and foreign body, when an object becomes lodged in the eye.
BB and pellet guns are powerful and dangerous, experts say
BB and pellet guns are "much more powerful than they used to be," and that's partly why parents don't consider them dangerous weapons, said Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio, and study author.
As a pediatric emergency medicine physician, Smith said he's seen pellets pierce the skull and enter the brain and lodge near the pericardium, the sac that protects the heart.
Some high-velocity BB guns have the same muzzle velocities as handguns, increasing the likelihood that a shot can be fatal, he said. The Consumer Product Safety Commission reported that four people die every year from BB guns or pellet rifles.
"These are really very powerful weapons," he said. "They're much more powerful than they used to be. That's the reason why we're so concerned about them."
How to prevent a BB gun injury
There isn't any federal regulation for nonpowder firearm safety, Smith said, though 23 states offer varying degrees of restriction. Most of them limit the guns to use with parental permission or adult supervision, but some lift those restrictions for children as young as 12.
Those age cutoffs can be arbitrary, he said, so he encourages parents to consider their child's maturity and skill level before allowing them to use a BB gun or similar weapon. Supervising them until they can be trusted to use them safely on their own is a must, too, he added.
The American Academy of Pediatrics advises children who play paintball to wear protective eye gear at all times and only play at insured commercial paintball fields to prevent injury.