Fireworks Injuries to the Head and Neck: A Retrospective Analysis Between 2008 and 2017

Abstract

Background This study examines firework-associated head and neck injuries in the United States from 2008 to 2017 obtained from a single epidemiology source. Methods The National Electronic Surveillance System was used to collect epidemiologic data and retrospectively analyze firework-associated injuries from 2008 to 2017. Injury types included burns, concussions, contusions, foreign bodies, hematomas, internal organ injury, lacerations, and puncture wounds. 431 individuals were originally included, however, 14 participants were excluded due to inadequate injury information. Chi-squared analyses were performed between the following categorical variables: gender versus body part injured, patient age versus injury type, and patient age versus body part injured. Results 417 injuries to the head and neck (67.4% male, 32.6% female) were treated in National Electronic Surveillance System-reporting emergency departments during the 10-year period. 69% of the injuries occurred in July. Body parts injured included the ear (10.6%), face (61.6%), head (13.0%), mouth (4.8%), and neck (10.0%). Chi-squared analysis demonstrated an association between gender and body part injured (p=0.0001). Patient age (p=0.066) was independent of injury type. Children aged 0-12 years had the highest probability of being injured (40.2%), then adults 22+ (33.1%) and adolescents 13-21 years (26.9%). Conclusions Given that the preponderance of injuries caused by fireworks occurred primarily in minors, pediatricians should screen for any household firework use during the anticipatory guidance portion of well-child checks, which we believe would improve patient safety and decrease injury rates.

Thunder and lightning—a report on firework-associated acoustic trauma at New Year 2021/2022

“…The 2020 Fireworks Annual Report of the United States of America Consumer Product Safety Commission stated that the highest risk for firework-associated injury is for people between 20 and 24 years of age and that after the hand and fingers, ears are the second most commonly affected by firework-associated trauma along with face and head injuries [ 17 ]. Similar results were found in an analysis by the National Electronic Injury Surveillance System in the United States that registered 2641 firework-related injuries during a period from 2008 to 2017: In this analysis, ears were the third most commonly affected (11%) by firework-related injuries after facial (62%) and head (13%) injuries [ 16 ]. Strikingly, the authors found the highest probability of being injured in children up to 12 years of age (40%), followed by adults over 22 years of age (33%) and adolescents from 13 to 21 years of age (27%, [ 16 ]).…”

“…Similar results were found in an analysis by the National Electronic Injury Surveillance System in the United States that registered 2641 firework-related injuries during a period from 2008 to 2017: In this analysis, ears were the third most commonly affected (11%) by firework-related injuries after facial (62%) and head (13%) injuries [16]. Strikingly, the authors found the highest probability of being injured in children up to 12 years of age (40%), followed by adults over 22 years of age (33%) and adolescents from 13 to 21 years of age (27%, [16]). Similar to this finding and to the numbers reported by the ophthalmological Feuerwerks-Verletzungen-Studiengruppe [5] concerning only eye injuries, children and adolescents (defined as persons below legal age, 40% in [5]) are overrepresented in our study with 24% compared to 16.7% in the normal population [15].…”

“…Are these injuries avoidable and if so, how? Based on the data presented in this manuscript, these questions can be answered as follows in our opinion: Injuries caused by fireworks are also relevant for the individual, since they disproportionately often affect particularly vulnerable groups: children and uninvolved bystanders [ 5 , 16 ]. Although access to category two pyrotechnics is restricted to adults—thus representing a restriction for children [ 2 ]—half of the children and adolescents reported here were injured while actively lighting fireworks.…”

Schlag auf Schlag – Bericht über feuerwerksbedingte Knalltraumata zum Jahreswechsel 2021/2022

“…Die Ohren waren nach Verletzungen im Gesicht (62 %) sowie am übrigen Kopf (13 %) am dritthäufigsten (11 %) betroffen. Auffallend ist, dass in dieser Erhebung die Wahrscheinlichkeit einer Verletzung bei Kindern bis zum zwölften Lebensjahr am höchsten war (40 %), gefolgt von Erwachsenen über 22 Jahren (33 %) und Jugendlichen von 13–21 Jahren (27 %, [ 16 ]). Analog hierzu und zu den Zahlen von Pfisterer et al.…”

“…Sind sie vermeidbar und wenn ja, wie? Diese Fragen kann man anhand der hier zusammengetragenen Daten wie folgt beantworten: Verletzungen durch Feuerwerk sind auch für den Einzelnen relevant, treffen sie doch überproportional häufig besonders schutzbedürftige Personengruppen: Kinder und unbeteiligte Zuschauer [ 5 , 16 ]. Obwohl Ersteren gemäß Sprengstoffgesetz kein Zugang zu Pyrotechnikartikeln der Kategorie 2 erlaubt ist [ 2 ], wurde die Hälfte der hier gemeldeten Kinder und Jugendlichen beim aktiven Zünden von Feuerwerk verletzt.…”