PEDIATRICS Vol. 98 No. 1 July 1996, pp. 1-9
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The Rockets' Red Glare, the Bombs Bursting in Air: Fireworks-related Injuries to Children

Gary A. Smith MD, DrPH1, Jane F. Knapp MD2, Theodore M. Barnett MD2, and Brenda J. Shields MS1

1 Ohio State University College of Medicine, Department of Pediatrics, Columbus
2 University of Missouri at Kansas City School of Medicine, Department of Pediatrics, Children's Mercy Hospital, Kansas City

Objective. To describe the epidemiology of fireworks-related injuries to children treated in a pediatric emergency department.

Design. A descriptive study of a consecutive series of patients.

Setting. The emergency department of a large urban children's hospital.

Participants. Children treated for injuries associated with fireworks during the 22-year period from 1972 through 1993.

Results. Three hundred sixteen children were treated for fireworks-related injuries. Ninety-five percent of patients were injured during the 3-week period of June 22 to July 14 during the study years. Seventy-one percent of patients were male, and the average age was 8.5 years, with a range of 1 month to 17 years. The child was a bystander in 26% of cases, and adult supervision was present in 54% of cases. One patient died, and 11% of children required admission to the hospital, with an average length of stay of 7.8 days (range, 1 to 37 days). Fifteen children (5%) went to the operating room for treatment of injuries. Thirty-three patients (10%) had permanent sequelae from their injuries, including 7 children (2%) with complete or partial loss of vision in one eye. The eyes were injured in 29% of cases, followed by hands and fingers (22%), other head and face sites (18%), and lower extremities (16%). The primary injury was a burn in 72% of cases. Firecrackers were associated with 42% of injuries, followed by bottle rockets (12%), other types of rockets (7%), Roman candles (11%), sparklers (7%), fountains (5%), jumping jacks (4%), and class B (illegal) fireworks (4%). Sixty-seven percent of sparklerrelated injuries occurred among children 5 years and younger (Fisher's exact test, P = .000002; odds ratio [OR] = 10.00, 95% confidence interval 3.52 < OR < 29.24).

Submitted on February 6, 1996
Accepted on April 2, 1996




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