The grammatical (in)correctness of the title aside, the 4th of July is marked by the use of fireworks by amateurs across the US. Fortunately the number of injuries had declined in recent years – until a spike was seen in 2011, when according to the National Fire Protection Association (NFPA) 9,600 fireworks-related injuries were treated in U.S. hospital emergency rooms. One quarter of the injuries are seen in children younger than 15 years. As expected, males account for nearly 70%. By body part the breakdown is as follows:

  • 61% – extremities: hand or finger (46%), leg (11%), and arm, shoulder, or wrist (4%)
  • 34% – head, including the eye (17% of total)
  • 5% – Other parts of the body

 

One-third of these eye injuries results in permanent blindness with bottle rockets carrying the greatest risk for injuring the eye. A 1999 CPSC study found that one third of the fireworks-related injuries were caused by firecrackers, approximately 10% of which were illegal. Approximately 20% of the injuries were from rockets. Sparklers which are presumed safe (but really aren’t) caused 10% of these fireworks-related injuries. Though most injuries caused by sparklers are minor burns and corneal abrasions they can exceed 1000°F at the tip and can ignite clothing. One study found that 2/3 of injuries from sparklers were in children <5 years of age. Illegal (homemade) fireworks increase the risk of hospitalization.

Many children are injured because they are bystanders with inadequate adult supervision

Consumer fireworks include fountains and candles that shoot out sparks or flaming balls, rockets with sticks (bottle rockets), other rockets, firecrackers, sparklers, and smoke devices. These are permitted under federal regulations, and their sale is regulated by state and local authorities. A minority of states ban all fireworks  and a select few ban all consumer fireworks except sparklers, “snakes,” or other novelty items.

State by state firework regulations

You should also be aware that fireworks cause unintended fires as well. Nearly 18,000 were reported in 2011 with only 40 injuries and no deaths but $32 million in property damage. Most of these fires were outdoors and associated with grass or brush. Per the NFPA “using 2000-2010 data, the risk of fire death relative to hours of usage is higher for fireworks than for cigarettes. On Independence Day in a typical year, fireworks account for two out of five of all reported fires, more than any other cause of fire.”

Per the AAP states that ban all consumer fireworks have significantly lower rates of fireworks-related injuries and fires. They recommend the following:

  • Pediatricians should educate parents, children, community leaders, and others about the dangers of fireworks. Children and their families should be counseled to attend public fireworks displays rather than purchase fireworks for home use.
  • Public sales, including those by mail or Internet order, of all fireworks should be prohibited. Ideally, this should be done on a national level by federal law or CPSC regulation. International importation of fireworks for private use should also be banned. Sales to professional pyrotechnicians for the purpose of creating public displays would be exempt.
  • The private use of fireworks should be banned. Pediatricians should work to increase the number of communities and states that ban the private use of all fireworks.
  • Accurate surveillance and reporting of fireworks-related injuries, deaths, and fires must be continued.
  • Additional research should be conducted to identify factors that have contributed to the recent decrease in the number of fireworks-related injuries. This information would be helpful in efforts to promote continued improvement in this and perhaps other injury problems.