Study shows threefold increase in paintball injuries.

Injuries among adults and children from the warlike pursuit game paintball have tripled in recent years, according In a recent study published in the journal Pediatrics. Statistics show that children under 15 are especially at risk for eye injuries, including retinal detachment and bleeding that can lead to permanent vision loss. (David A. Listman, Paintball Injuries in Children: More Than Meets the Eye, 113 PEDIATRICS e15 (2004).)

Emergency room visits for paintball-related injuries rose from an estimated 926 in 1997 to 2,780 in the year 2000, said the study's author, David Listman, a pediatrician at St. Barnabas Hospital in New York City. About one-third of these injuries occurred in children younger than 15--mostly boys. Eye injuries, the most common type of injury reported, rose from 545 in 1998 to 1,200 in 2000, with players under 15 accounting for more than 40 percent of the injuries.

In paintball, contestants hunt each other down with guns that shoot gelatin pellets containing paint. A player who is shot, or "marked," is out of the game. The guns are powered by compressed gas, which can shoot the pellets as last as 300 feet per second.

The game is often played at designated paintball centers, which provide protective equipment, including face masks. But, Listman noted, most of the reported injuries have occurred at non-commercial sites like neighborhood backyards, where players, especially children, are less likely to wear protection.

"The advances in eye protection for participants in 'war games' have had little, if any, effect on the youngest population. Children and teens are unlikely to wear eye protection voluntarily when playing at undesignated or unsupervised locations," Listman said.

Despite its risks, paintball is gaining popularity. The number of players increased nearly 50 percent from 1998 (5.9 million) to 2002 (8.7 million), according to the Sporting Goods Manufacturers Association, which keeps statistics on sporting activity in the United States.

Given the steep rise in paintball-related injuries, Listman said, more must be done to warn participants, especially minors and their parents or caregivers, of the game's dangers. He urged pediatricians to advise patients to "avoid this activity or to take appropriate precautions to avoid eye injury" and to lobby for restrictions on the sale of paintballs and paintball guns to minors.

The study was based on published case reports and statistics gathered by the U.S. Consumer Product Safety Commission (CPSC), which keeps a database of representative emergency room visits at hospitals nationwide. Based on this information, the CPSC's epidemiology, department was able to estimate the number and type of paintball-related injuries for each of the years studied--1997 through 2000.

The study is available online at the Pediatrics Web site: http://pediatrics.aappublications.org.