Epidemiology of Fireworks Injuries: The National Electronic Injury Surveillance System, 1980-1989,☆☆,

https://doi.org/10.1016/S0196-0644(94)70161-XGet rights and content

Abstract

Study objectives: To estimate the annual fireworks injury rates in the United States over the past decade (1980 through 1989) and to describe the epidemiology of fireworks-related trauma.

Design: Retrospective analysis of fireworks-related injuries reported from the National Electronic Injury Surveillance System of the Consumer Product Safety Commission. Results: During the study period, nearly 10,000 Americans were injured annually by fireworks. The rates were highest in the young, with a peak of 22.3 per 100,000 persons per year for males age 10 to 14. Males outnumbered females by 2.5:1. Half of the fireworks injuries occurred around the week of July 4. The hand was the most frequently injured body part, followed by the eyes and the face. Active participants consistently were the major victims in all "personal-use" fireworks and had more severe injuries than bystanders. Rockets were the most dangerous device among class C fireworks. Conclusion: Fireworks injuries are a health hazard to the public. Young persons are at the highest risk to suffer injuries, mainly due to personal-use fireworks. A majority of victims are injured during the week of July 4. Class B fireworks and rockets appear to be very dangerous. [See L-C, Lo SK: Epidemiology of fireworks injuries: The National Electronic Injury Surveillance System, 1980 -1989. Ann Emerg Med July 1994;24:46-50.]

Section snippets

INTRODUCTION

Although the dangers of fireworks have long been recognized,1, 2, 3, 4, 5, 6, 7, 8, 9 they still are not appreciated by the public. Under current federal law, fireworks are categorized into three classes: classes A and B (more than 50 mg of gunpowder) and class C (50 mg or less of gunpowder).2 Class A and B fireworks are illegal for sale to the general public, and the sale of specific types of class C fireworks is under state control.10

Most of the research on fireworks injuries has been

MATERIALS AND METHODS

NEISS, which was set up by the Consumer Product Safety Commission (CPSC) in 1972, is a surveillance network that monitors patients with acute product-related injuries who are treated in hospital emergency departments. It comprises a sample of hospitals that are statistically representative of hospitals with EDs in the United States and US territories.11 The sampling frame was updated in 1978 and 1990 to reflect changes in the number of hospitals and in hospital size.12, 13 Data used in this

RESULTS

From 1980 through 1989, there were 1,703 fireworks-related injuries on records in NEISS; based on statistical probability, this number corresponds to a projected 99,300 actual accidents (95% CI, 72,300 to 127,670). In other words, approximately 10,000 Americans were injured annually by fireworks in the 1980s. Although there were some year-to-year fluctuations, no trend was obvious during this time period (Table 1). For all 10 years, the occurrence of fireworks injuries peaked in July (61%), and

DISCUSSION

It is clear that fireworks are a health hazard to the public. As shown in the NEISS database, fireworks injury rates in the United States remained essentially unchanged for the 1980s, with approximately 10,000 persons injured annually. The rates reported here are lower than those quoted in other studies,1, 2 but a direct comparison of rates may not be appropriate as this NEISS data set contains hospitals that are located in states with or without fireworks regulation, whereas other studies

CONCLUSION

Fireworks are an important preventable cause of burns and eye injuries, responsible for 10,000 injuries annually in the United States. More than half of the victims were injured during the week of July 4. Boys, especially those 10 to 14 years old, are at the highest risk. Injuries from personal-use fireworks were predominant in the NEISS data. Active participants were injured more often and had more severe injuries than bystanders.

Acknowledgements

We are grateful to the CPSC for providing the NEISS data and to Drs Andrew Dannenberg, Harry Quigley, Gordon Smith, and Sheila West for advice. Dr Joanne Klopfer, who edited this paper, also deserves our sincere thanks.

References (17)

  • RS Wilson

    Ocular fireworks injuries and blindness: An analysis of 154 cases and a three-state survey comparing the effectiveness of model law regulation

    Ophthalmology

    (1982)
  • LV McFarland et al.

    Risk factors for fireworks-related injury in Washington state

    JAMA

    (1984)
  • Bureau of Epidemiology, Texas Department of Health

    Fireworks-related injuries, July 1-5, 1983, Austin, Texas

    Texas Preventable Disease News

    (June 16, 1984)
  • SA Vernon

    Survey of ocular injuries due to fireworks in the United Kingdom

    J Roy Soc Med

    (1988)
  • Eye Injury Registry of Alabama

    Fact Sheet of Ocular Fireworks Trauma in Alabama

    (1991)
  • LR Berger et al.

    Injuries from fireworks

    Pediatrics

    (1985)
  • RL McCauley et al.

    Class C firework injuries in a pediatric population

    J Trauma

    (1991)
  • WA Zamboni et al.

    Management of acute facial powder burns

    Ann Plastic Surg

    (1987)
There are more references available in the full text version of this article.

Cited by (36)

  • Firework injuries at a major trauma and burn center: A five-year prospective study

    2014, Burns
    Citation Excerpt :

    Fireworks are used globally to celebrate religious and cultural festivals and holidays. These include the Fourth of July and New Year's Eve in the United States [9,33,34], Diwali in India [35], Hari Raya Festival in Malaysia [36], Halloween in Northern Ireland [23], Guy Fawkes Day in Great Britain [37], Greek Orthodox Easter in Greece [11], and New Year's Day in Denmark [38], Austria [15], South Africa [39], Italy [23,40], Iran [7], and the Philippines [24], among others. Yet fireworks are clearly a health hazard to the public.

  • Serious fireworks-related eye injuries in Alsace (France)

    2010, Journal Francais d'Ophtalmologie
  • The health and economic impact of fireworks-related injuries in Iran: A household survey following the New Year's Festival in Tehran

    2010, Injury
    Citation Excerpt :

    Bottle rockets were another type of firework used by those surveyed in this study. Bottle rockets are known for their high risk for injury.6,21,32,35,40,41 They are rockets attached to a stick, which is used to stand them in a soda bottle for ignition (hence the name “bottle rocket”).

View all citing articles on Scopus

From the Chang Gung College of Medicine and Technology, Taiwan, Republic of China.

☆☆

Address for reprints: Ms Lai-Chu See, Department of Public Health, Chang Gung College of Medicine and Technology, 259, Wen-Hwa I Road, Kwei-San, Tao-Yuan 333, Taiwan, Republic of China, 03-328-3016, ext 5056, Fax 03-328-3031

Reprint no. 47/1/56264

View full text