Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. 296-303 (doi:10.1542/peds.2006-0790)
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Pediatric Fireworks-Related Injuries in the United States: 1990–2003

Rachel J. Witsaman, BAa, R. Dawn Comstock, PhDa,b and Gary A. Smith, MD, DrPHa,b

a Center for Injury Research and Policy, Columbus Children's Research Institute, Children's Hospital, Columbus, Ohio
b Department of Pediatrics, College of Medicine and Public Health, The Ohio State University, Columbus, Ohio

OBJECTIVE. Our goal was to describe the epidemiology of pediatric fireworks-related injuries among children aged 19 years and younger by using a nationally representative sample.

DESIGN. We performed a retrospective analysis of data from the US Consumer Product Safety Commission's National Electronic Injury Surveillance System from 1990–2003.

RESULTS. An estimated 85800 pediatric fireworks-related injuries were treated in US emergency departments during the 14-year study period. Injured children had a mean age of 10.8 years, and 77.9% were male. Fireworks users accounted for 49.5% of the injuries, whereas 22.2% of the injuries were to bystanders; however, user status could not be determined in 28.3% of cases. The overall fireworks-related injury rate decreased significantly during the study period, but subgroup analysis did not indicate consistent declines among all ages and types of fireworks. Injuries were most commonly caused by firecrackers (29.6%), sparklers/novelty devices (20.5%), and aerial devices (17.6%). The most commonly injured body sites were the eyeball (20.8%), face (20.0%), and hands (19.8%), and the most common injury type was burns (60.3%). Approximately 91.6% of all children with fireworks-related injuries were treated and released from hospital emergency departments, 5.3% were admitted, and 2.3% were transferred to another institution. Bystanders accounted for 13.3% of admitted cases and 20.6% of transferred cases.

CONCLUSIONS. Consumer fireworks cause serious preventable injuries among pediatric fireworks users and bystanders in the United States. Parents should be advised to take their children to safer public fireworks displays rather than allowing consumer fireworks to be used by or near their children. A national restriction of consumer fireworks, in accordance with the policy recommendations of the American Academy of Pediatrics, should be implemented to reduce the burden of fireworks-related injuries among children.

Key Words: fireworks • pediatric • injury prevention • burns • trauma

Abbreviations: ED—emergency department • NEISS—National Electronic Injury Surveillance System • CPSC—Consumer Product Safety Commission • RR—relative risk • CI—confidence interval

Accepted Mar 4, 2006.


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