📊 Data to Answer the "Is Paintball Safe?" Question

[HalfThank]

(x-post from r/paintball)

I'm looking for data on paintball-related injuries, preferably those that include sources. This part of a broader effort I've been musing to #GrowTheSport by providing helpful information to new players, their parents, and/or their partners.

Please share what you got!

What I've found thus far is from research and reports that are from the US and 10+ years old. Here's what I found and my potential explanations for interesting findings:

📉 Paintball vs Air Guns: Fewer PB-related Hospital Visits

Number of ED visits for injuries caused by air and paintball guns declined between 2006 and 2008. Bar chart; Newborns and infants under 1 year, 4,600,700 (72%), 1 to 4 years, 564,800 (9%), 5 to 9 years, 358,200 (5%), 10 to 14 years, 372,400 (6%), 15 to 17 years, 497,600 (8%). Source: AHRQ, Center for Delivery, Organization and Markets, Healthcare Cost and Utilization Project, Nationwide Emergency Department Sample, 2006-2008.

Emergency room visits for paintball gun related injuries are rare, especially compared to injuries from air guns (2008: 2 per 1,000,000 people for paintball vs 54 per 1,000,000 people for air guns). [1]

[EDIT: Air guns fire metal objects (e.g. metal BB or pellet). These do NOT include airsoft guns. Airguns are NOT designed to be shot at people. H/t to u/DasBeasto for catching this!]

Why fewer hospital visits for paintball vs air guns?

🧑⚖️ Supervision: One potential explanations include how paintball was commonly played in supervised/commercial fields during this time, but air gun shooting (e.g. BB or pellet guns) may not have been. I do not air gun ranges being very common place in 2006-2008 and recall shooting BB guns in my friend's backyard. In supervised settings, referees are supposed to regularly chronograph markers and enforce mask wearing. In unsupervised settings, these safety policies are less rigorously enforced.

💥 Different Projectiles: Another potential explanation is from the physics and design of paintballs vs BBs & pellets. Paintballs are larger and have a soft core that is designed to break. In contrast, BBs and pellets are smaller, have a solid core (e.g. metal or plastic) that is designed to maintain its integrity. Therefore, paintballs may result in force distributed over a greater area (larger projectile) or in different directions (paint exploding). (Someone please let me know if they have the calculations or have conducted these tests.)

👀 PB-Related Eye Injuries Decreased

Eye injuries accounted for 15% of paintball-related US hospital visits in 2008, down from 43% in 1997-2001.

For the US in 2008, most paintball-related hospital visits were for open wounds or superficial injuries, with 15% of paintball-related hospital injuries for eye-related injuries [1]. This is greater in percentage than air gun related eye injuries (3.7%), but still far fewer in overall number of eye injuries (2008 hospital visits: 92 paintball-related eye injuries; 728 air gun-related eye injuries).

An older review of US hospital visits from 1997-2001 found that eye injuries accounted for 43% (+/- 12%) of paintball-related hospital visits [2].

🎭 People who sustained eye injuries mostly (all?) removed their masks or were not wearing them.

A 2022 review of 30 research articles found that 45.6% of people who sustained eye injuries had removed their eye protection/mask prior to the injury and 54.4% were not wearing eye protection (these numbers add up to 100%, but I’m not sure if they were mutually exclusive categories). [3]. An even older study of 35 patients who sustained eye injuries from paintball 1985-1998 found that only 9% (3/35) were wearing eye protection when their injuries occurred, 51% (18) removed their eye protection before the injury (due to fogging, paint on goggles, or unknown reasons), and 40% were not wearing eye protection [5].

This is all to say that wearing masks significantly reduces the risk of eye injuries!

Why the decrease in eye injuries?

Given that most eye injuries were sustained by people who took off their eye protection or were not wearing any, I suspect the explanation relates to more rigorous mask wearing.

One potential explanations include more affordable or comfortable masks encouraging more wearing of masks. For example, better rentals masks could result in fewer people taking them off to catch their breath or to de-fog them, a commonly stated reason for removing eye protection [5]. Another explanation is changes to how fields insured, incentivizing fields to have more referees or be more rigorous in enforcing mask wearing. A final explanation could be ASTM standards for masks being introduced, improved on, or more widely adopted for paintball masks. ASTM standards for paintball masks have existed since at least 2001 [4].

🧓 Adults be Tripping

Estimated percentage of paintball game related injuries treated in hospital emergency departments by age and cause, United States, 1997–2001. Percentages do not sum to 100 because of rounding. (From Injury Prevention 2004)

A study of US hospital data from 1997-2001 compared hospitalizations for PB-related injuries of minors (7-17 years old ) to adults (18+) [2]. It found that overexertions/fall injuries were 3.1x more prevalent for adults that minors. Most PB-related hospital visits for minors were because of being shot by a paintball (77%). This was 1.7x higher than for adults (45.5%).

Main takeaways:

1. Paintball is safest when played in supervised/commercial settings and when wearing a mask. Eye injuries have decreased over time and almost all (up to 90%) are because eye protection was not being properly worn.
2. Historically, paintball has resulted in 20-30x fewer hospital visits compared to air guns (e.g. BB and pellet guns), which may be because paintball is was more often played in supervised settings. (Note that air guns do NOT include airsoft guns)
3. Three in four PB-related injuries to minors are because of getting shot by a paintball gun (vs less than half for adults). Four in ten PB-related injuries to adults are because of overexertion or falls (compared to 1 in 10 for children)

LMK what you think and please send me other data you have! Thanks.

Dog (in mask) tax

Sources

1. Mutter, Ryan and Owens, Pamela. Emergency Department Visits for Injuries Caused by Air and Paintball Guns, 2008. Agency for Healthcare Research and Quality. 2011. https://hcup-us.ahrq.gov/reports/statbriefs/sb119.jsp
2. Conn JM, Annest JL, Gilchrist J, Ryan GW. Injuries from paintball game related activities in the United States, 1997-2001. Inj Prev. 2004 Jun;10(3):139-43. doi: 10.1136/ip.2003.004101. PMID: 15178668; PMCID: PMC1730099. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1730099/
   1. Based on stratified random sample of 100 US hospitals from 1997-2001.
3. Laird, Lauren and Finlay, Fiona. 181 Dangers of Paintballing. Disease in Childhood. 2002.https://adc.bmj.com/content/107/Suppl_2/A433.1
   1. This article is lacking sources and detail, so I'm a bit skeptical...
4. American Society for Testing and Materials. Standard specification for eye protective devices for paintball sports (Standard No F1776–01). West Conshohocken, PA: ASTM, 2001.
5. Fineman MS, Fischer DH, Jeffers JB, Buerger DG, Repke C. Changing Trends in Paintball Sport–Related Ocular Injuries. Arch Ophthalmol. 2000;118(1):60–64. doi:10.1001/archopht.118.1.60

A source I'm very skeptical of that I did not include

• Lindner, J. Must-Know Paintball Injuries Statistics [Current Data]. Gitnux Marketdata Report. 2024. https://gitnux.org/paintball-injuries-statistics/
  • The reference list includes 6 very common scholarly search engines and publication sources and "nytimes.com", making them too ambiguous to be verifiable. It reminded me of what a high school freshman would add to the end of a report that was due in 1 hour. The findings also contradict other findings from more reputable sources (e.g. a claim that "eye injuries account for up to 85% of all paintball-related injuries")

Disclosure: I am not affiliated with or sponsored by any paintball companies or fields and have no financial conflicts of interest. I was procrastinating today and wanted to use my research + teaching background to think of ways to grow the sport of paintball!

[Pyrate Jim]

You might want to look into the 300 fps rule and how it came to be.
I don't have the documentation on hand, but from old memory it involved Bud Orr and several Court Judges with demonstrations. Like the Judges were at the field wearing protective gear because they couldn't do the demonstration in a courtroom.

[jetenginekyle]

I wonder how the decline of paintball gear being sold at walmart and similar box stores effects the number of injuries. Due to unattractive in-store offerings vs airsoft

For example last time I went to bass pro the only pb gear there were cronus and 98 starter packs and a couple of shitty mask while the airsoft section had m16's, ak47's and even an all metal mp40. Since most of the customers the products in these stores are competing for are 11-16 year olds that want to have back yard games. The cool factor of realistic markers (lets be real a cronus looks like a joke when its on the shelf next to a badass mp40 or ak) combined with the advantages airsoft has in backyard games it's no wonder kids are playing more unsupervised airsoft in comparison to paintball.

And don't even get me started on how lax eye protection is in airsoft compared to paintball, at least from what I've seen in airsoft rage vids on youtube.

[redsquirrel]

This is a really good point.

[HalfThank]

Clarification since original post: By definition, air guns fire metal projectiles (e.g. BB guns or pellet guns) and therefore do not include airsoft guns.

That's to say that I agree with your point and suspect that airsoft guns looking cooler and being more playable in unsupervised settings could result more hospital visits! (My write-up just doesn't have the data to corroborate that atm)

[Siress]

this kind of research is very difficult... without the source data, it's difficult to tell if the same data is being represented across multiple studies being referenced.

Some more:
https://www.tandfonline.com/doi/abs/...8.2022.2107400

https://www.aaojournal.org/article/S...112-4/abstract

[ejacksophoto]

I reffed for years and the worst injury I saw on the field was not paintball marker or eye related at all. Kid tripped running through the woods and cut his leg on a branch. The cut on his shin was so deep you could see the bone.

Other than that, only a few close calls with dumb renters removing their masks in the middle of the game. Doesn't help that most fields buy cheap masks that will fog up. When a first-time player is in the heat of the moment and they can't see - their first instinct seems to be to flip the mask up.

[loveaboveall]

No sources or data to cite however, I would also argue airsoft is bigger than paintball due to it's ease and cost of entry. As stated above the safety alone is much cheaper not to mention the cost of paint vs BBS. Air is a hassle compared to charging a battery.

I remember playing spring only airsoft with my friends. We can play almost anywhere and we could afford to play as jr high age.

Great post BTW. I wish I could participate with the research.

[HalfThank]

Clarification since original post: By definition, air guns fire metal projectiles (e.g. BB guns or pellet guns) and therefore do not include airsoft guns.

That's to say that I agree with your point and suspect that airsoft guns are more popular than PB guns b/c they're cheaper and its easier to play in unsupervised settings! (My write-up just doesn't have the data to speak to these claims rn)

I'll keep you in the loop if I end up diving deeper down this rabbit hole!

[Grendel]

Several of your "questions"/topics are covered in the ASTM documentation around paintball goggles/safety/first strike. When that was a hot topic on here there were a lot of us who went down this rabbit hole but I believe that was on the previous site you might look at the Wayback Machine for some of that discussion (First Strike, Goggles and Safety Standards). uv_halo IIRC was the member directly involved in these discussions and was the member who attended some of these ASTM meetings (please correct me if I am wrong time and age are catching up with me ). I would reach out to him and pick his brain on some of this.

[Grendel]

Some links that will help with your research unfortunately digging in ANSI requires significant capitol investment unless you can find a member who will share with you:

https://pubmed.ncbi.nlm.nih.gov/10548462/

https://pubmed.ncbi.nlm.nih.gov/?term=Paintball

https://www.jabfm.org/content/25/1/124

https://gitnux.org/paintball-injuries-statistics/ (references at the bottom)

https://www.aao.org/eye-health/news/combating-eye-injuries-from-air-guns

https://injuryfacts.nsc.org/home-and...onal-injuries/ (non-powder Gun at the bottom of the data that will include paintball)

https://aspe.hhs.gov/reports/common-sports-injuries-incidence-average-charges-0

https://webstore.ansi.org/standards/astm/astmf227223

https://webstore.ansi.org/standards/astm/astmf280111

https://webstore.ansi.org/standards/astm/astmf204100

https://webstore.ansi.org/standards/astm/astmf177702

[cellophane]

I reffed for years and the worst injury I saw on the field was not paintball marker or eye related at all. Kid tripped running through the woods and cut his leg on a branch. The cut on his shin was so deep you could see the bone.

Other than that, only a few close calls with dumb renters removing their masks in the middle of the game. Doesn't help that most fields buy cheap masks that will fog up. When a first-time player is in the heat of the moment and they can't see - their first instinct seems to be to flip the mask up.

I can corroborate this from experience (and I'm sure most here can.) I've never seen an injury resulting from a paintball beyond some cuts from the shell and some wicked contusions / bruising (other than the injury at NXL that led to mandatory chin strap rule [I'm blanking on the player's name].) I have seen several people go to the hospital because they hit a rock or bunker spike, took a bad dive and broke a bone, hyper-extended their knee, overheated, etc.

I found a couple articles relating to eye injuries, but they were all medical articles and focused on the diagnosis more than what led to the injury. Most also seemed to be related more towards the random drive-by type assaults rather than people actually at a field.

You can get a little information from the Consumer Product Safety Commission: https://www.cpsc.gov/Research--Stati...ine-Query-Tool
What I managed to find had 61 reports related to gas, air or spring operated guns, only 2 of those specifically mentioned paintball, and the injuries/reports were equipment related. It is a bit depressing to read through this 😟 Most injuries in the reports I found are related to BBs (doesn't specify airsoft or metal/pellet gun) or are related to something in the air system failing.

Also found references to some studies but haven't found the studies yet

https://www.paint-ball.org/paintball/safety_report.htm

SGMA Extract 2003
While membership in the Extreme Sports category implies a whiff of danger, only paintball is handicapped by a huge injury taboo, one that exists in the public mind, but not in the statistics. The industry has long maintained that the rare (but highly publicized) eye injury almost always occurs in an unsupervised, unprotected, often illegal setting; and that paintball is a very safe activity, a claim substantiated by the current research, as the sport reflected only 0.2 injuries per 1,000 exposures, the lowest injury rate of any Extreme Sport. Put another way, the average player will suffer a paintball injury about once every 500 years.

It may surprise you to know that a 2003 study by the National Injury Information Clearinghouse (U. S. Consumer Product Safety Commission), stated that paintball is safer than bowling, running, and almost every other popular sport.

The U.S. Agency for Healthcare Research and Quality (ARHQ) studies, among other things, healthcare usage. One of the things they track is Emergency Department (ED) usage including the diagnosis for each person who comes into the ED as part of the Hospital Cost and Utilization (H-CUP) project.
… In 2008, they released a statistical brief on the injuries arising from airguns - both BB guns and paintball guns. …
This data paints an interesting picture of paintball:
Only 614 people ended up in EDs as a result of paintball injuries.
Of those, only 12% (or approximately 74 people) were admitted to the hospital.
This means that the vast majority were treated and released, implying that the injury wasn’t overly serious.

both of the above from https://www.liveabout.com/paintball-injuries-2565966 (I know nothing about the site or it's authors)

[uv_halo]

Several of your "questions"/topics are covered in the ANSI documentation around paintball goggles/safety/first strike. When that was a hot topic on here there were a lot of us who went down this rabbit hole but I believe that was on the previous site you might look at the Wayback Machine for some of that discussion (First Strike, Goggles and Safety Standards). uv_halo IIRC was the member directly involved in these discussions and was the member who attended some of these ANSI meetings (please correct me if I am wrong time and age are catching up with me ). I would reach out to him and pick his brain on some of this.

You got it at least mostly right. I participated in several teleconferences with the ASTM and, they were all centered on the safety of First Strikes, and how they compared to regular paint.

One thing I'm interested in is the fact that the goggle format we have today (eye, Ear, Temple, mouth coverage) was well established and standard (at least on commercially operated fields) by 2006. I believe it was standard at least by 2001, when JT introduced their Gen 2 Spectra system, the Proteus. If this decline in injury rates was only observed post 2006, it would seem to me that something else was at play, possibly another related standard like netting, or mandatory chronoing, etc.

[Grendel]

Thanks for the clarification and I love you Tom K. quote

[HalfThank]

The articles I read reflected regrettably piecewise data (once study from 1997-2001 with a stratified random sample of 100 US hospitals, another looking at data from 2006-2008). That is to say I can't say that the decline in injury rates _only_ occurred post 2006. What I can say is that there is strong evidence that injury rates decreased from 2006-2008, and weaker evidence to say that it decreased in 2006-2008 compared to 1997-2001 in the US.

Aside, I learned tons reading your r/paintball post on ASTM standards!

[uv_halo]

HalfThank Information for paintball impact stuff largely came up with the First Strike submissions to the ASTM. The standard is/was based on how many projectiles will break on a board at a given distance. Not scientific in the least. That being said, when First Strikes came up for discussion, there was comparison testing between the two projectiles (Maximum impact forces, damage to bare ballistic gel, damage to 'clothed' ballistic gel). Data from this testing can be found here. I have no idea if anything like that has been done for airsoft. Given the solid nature of the projectiles, they may simply have assigned a size / weight limit to the projectiles and, a speed limit.

If it's not the goggles that are responsible for the change. I suspect it was something else. It was around this time when at least one major paintball-related youtube channel, recommended a quality goggle purchase before a gun (in other words, keep renting a gun after you buy your own mask). This may have had an effect on less fogging and, less lifting of goggles. Around this time, HPA was becoming more standard that may have had an effect on reducing goggle defeats due to hot shots.