School shootings unnerve Americans, but the number of children injured or killed in those tragic events is just a fraction of the young people harmed by firearms each year in the United States, a new study finds.

Injuries from firearms send over 7,000 kids to the hospital annually, an average of 20 per day. Among those admitted to the hospital, 6 percent die from their injuries, according to the study published in Pediatrics Monday.

“That’s more than 7,000 children injured badly enough to be hospitalized,” said Dr. John Leventhal, the study’s lead author and pediatrics professor at the Yale School of Medicine. “All are unnecessary hospitalizations because preventing gun violence is something that can actually be done.”

In addition to children hospitalized for gun injuries, another 3,000 die before they can make it to the emergency room, meaning guns hurt or kill about 10,000 American children each year, Leventhal said.

Previous research has tracked hospitalizations of Americans due to firearms, but the new study is the first to look just at children.

Studying the 2009 Kids’ Inpatient Database (KID), which tracks pediatric hospital stays, the Yale researchers discovered 7,391 children under age 20 had been hospitalized for firearm related injuries, with 453 of those patients dying. The data in KID has been gathered since 1997 as part of the Healthcare Cost and Utilization Project on behalf of the Department of Health and Human Services, with 2009 the most recent release.

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Most of the injuries, 4,559, resulted from assaults, while 2,149 were from accidents and 270, the result of suicide attempts. The most common types of injury, were open wounds at 52 percent and fractures at 50 percent. Brain injuries were more common in the younger kids, most of whom were hurt in accidental shootings.

Brain and spinal cord injuries accounted for one-seventh of the injuries. The aftermath of those types of injuries can be devastating, Leventhal said.

Earlier studies, which looked at child mortality related to firearms found about 3,000 deaths a year, experts said.

“This study reinforces what we know from the mortality data,” said Daniel Webster, director of the Johns Hopkins Center for Gun Policy and Research. “We have an extraordinary health burden in our youth associated with firearms injuries.”

In that, the U.S. stands out, Webster said. “When you look at firearms-related mortality in the United States compared to other high income nations, our rates are roughly 10-fold higher,” he said. “This is a very unique and abnormal problem that such a wealthy nation should have such high mortality and morbidity in youth related to firearms.”

The new study “highlights the critical effect that firearms are having on children’s health and safety,” said Patrick Tolan, a professor of education and psychiatry at the University of Virginia and director of the Youth-Nex, the U. Va. Center for Positive Youth Development. “It’s clear that this needs to be a part of the conversation about firearms. There’s been such a strong focus on whether somebody’s liberty might be fettered.”

The high number of accidental injuries, especially in the youngest children, underscores the need for parents to keep guns locked in a safe place that is separate from where ammunition is stowed and secured, Leventhal said.

One change that could make a big difference, Webster said, is to make it illegal for anyone under 21 to own a handgun. “In order to drink beer legally you have to be 21,” he said. “While you have to be 21 to purchase a handgun from a dealer, if you’re an 18-year-old you can go to a private seller and legally purchase a handgun in 45 out of 50 states.”

If you look at homicide as a function of age, you’ll see that there is a peak between 18 and 20, Webster said. “So for this very high risk group of 18- to 20-year olds, we think it’s too dangerous to drink beer, but in 45 states they can legally possess as many handguns as they like.

“We have weak laws, and for that we pay a dear cost.”