Epidemiology of Eye Injuries Caused by Personal Protection Devices and Kinetic Impact Projectile Weapons

The American Academy of Ophthalmology 1 issued a statement on June 4, 2020, condemning the use of rubber bullets for crowd control by law enforcement during protests.Rubber and plastic projectiles, including paintballs, tear gas, and pepper spray, 2-4 may cause serious ocular morbidity when used against unsuspecting persons.Population-level data on protest-related injuries are not readily available, but consumer product-related injury surveillance provides context to evaluate ocular trauma caused by products similar to those used for crowd control.The purpose of this report was to collect epidemiologic data to better understand the ocular trauma burden in emergency departments (EDs) associated with chemical irritants and kinetic impact projectiles. Methods | The US Consumer Product Safety Commission details patient-level injury data involving consumer products from ED encounters through the National Electronic Injury Surveillance System (NEISS), 5 which provides population esti-mates of consumer productrelated injuries.This study used existing deidentified public health surveillance data and was exempt from institutional review board review and informed consent in accordance with the Common Rule codified at 45-CFR-46.102.The study followed a modified version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.In this cross-sectional study, we queried NEISS data from January 1, 2010, to December 31, 2019, to identify eye injuries (body part code 77) caused by BBs and pellets (product code 1936); gas, air, or spring-operated guns (product code 1237); and personal protective devices (PPDs) (product code 1619).PPDs included pepper spray, tear gas, and bean bag guns.5 Narrative fields provided free-text descriptions of each encounter.Narratives not describing ocular injury caused by rubber or plastic projectiles, pepper spray, or tear gas were excluded.Counts, weighted national estimates, and 95% CIs were collected directly from the NEISS query.Trend analysis to determine average annual percent change and the 95% CI was performed using Joinpoint version 4.8.0.1 (National Cancer Institute).A 2-sided z test was performed to assess whether average annual percent change was significantly different from zero at the α = .05level.