Fireworks-related Injuries
Indiana Epidemiology Newsletter
September 2006
Charlene Graves, MD
Susan Perkins, RN
Tracy Powell, MPH
Through the passage of House Enrolled Act 1131, the Indiana State Department of Health (ISDH) received injury reports resulting from fireworks and/or pyrotechnics during 2003 and 2004. No reporting occurred in 2005 due to the expiration of this law. The passage of Public Law 187 in 2006 reinstated reporting of fireworks-related injuries, with identical reporting requirements as those in the previous statute. This report presents fireworks injuries data compiled from March 31-July 31, 2006.
Highlights for 2006
- As of July 31, 2006, 251 unduplicated cases of fireworks-related injuries were reported to the ISDH.
- 55 percent of all reported fireworks-related injuries involved children and adolescents, who represent one fourth of Indiana’s population (as of July 1, 2004).
- 73 percent of cases reported burn injuries, with burns to the hands being the most common type of injury.
- 25 percent of reported injuries involved the eyes, with 97 percent of those with eye injuries not using any method of eye protection.
- 23 percent of injured persons required either hospital admission or specialized care for burns or eye injuries.
11 percent (28 cases) of injured persons were admitted to a hospital in 2006, compared to 6 percent in 2004.
- Sparklers, rockets, and firecrackers were associated with 58 percent of all reported injuries.
- Mishandling, malfunction, or errant path of fireworks accounted for 70 percent of all those injured.
- Fireworks used on private property accounted for 86 percent of reported injuries.
- 70 percent (175 cases) of reported injuries involved males, and 30 percent (76 cases) involved females. Across all age groups, males accounted for more fireworks-related injuries than females.
- 82 percent (205 cases) of reported injuries occurred among Whites, and Black/African Americans accounted for 13 percent (33 cases) of all injuries.
- The median age of those injured was 17 years. The average age of all injured persons was 21 years, with an age range from 11 months to 67 years.
- 85 percent (213 cases) of all reported injuries occurred between June 30 and July 9, 2006 (Figure 1), with 47 percent (118 cases) on July 4, 2006.
- Sparklers, rockets, and firecrackers accounted for 58 percent of reported injuries. Many other types of fireworks were reported to have caused injury, including mortars, smoke bombs, spinners, missiles, Roman candles, and fountains. Although 29 percent (72 cases) of the reports noted that the injury resulted from mishandling fireworks, 41 percent (104 cases) reported that the injury resulted from fireworks malfunction or an errant path of a rocket.
- 73 percent (182 cases) of reported cases experienced burn injuries. Of these, 121 cases (48%) reported second-degree burns, and 17 cases reported third-degree burns. Other types of injuries included contusions/lacerations/abrasions (57 cases), penetrating foreign body/missiles (13 cases), puncture wounds (10 cases), and sprains/fractures (4 cases).
- 52 percent (164 cases) of all reported injuries involved the hands or eyes (Figure 2). Injuries to the face, ears, and head accounted for 18 percent of all reported injuries.
- 63 percent (159 cases) of reported injuries occurred at the injured person’s private home, yard, or property. A friend/neighbor/relative’s home or property was involved in 22 percent (56 cases) of injuries; public or school property was involved in 8 percent (21 cases).
- 91 percent of all reports did not provide information on alcohol consumption; 23 cases (9%) stated alcohol was related to the injury, and 15 of these cases reported alcohol use within three hours of the injury. Seven cases reported alcohol use by other people at the scene.
- 17 percent (42 cases) of all people injured were bystanders.
- Among those injured who were less than 18 years of age, 64 percent (83 cases) of reported injuries occurred while in the presence of an adult.
Year Comparisons (2003, 2004, and 2006)
For all three years, the most frequently reported fireworks-related injury was burns, accounting for over 60 percent of all injuries (Table 3). Although burns increased slightly from 67 percent in 2004 to 73 percent in 2006, the increase was not significant (p=0.22). After hand injuries, eyes were the second most reported area of the body harmed by fireworks. The proportion of reported eye injuries increased significantly from 17 percent in 2003 to 25 percent in 2004 (p=0.01); however from 2004 to 2006, the slight increase (to 29%) was not statistically significant (p=0.53).
The proportion of people with fireworks-related injuries admitted to the hospital increased in 2006, when compared to 2003 and 2004. The increase from 5 percent in 2004 to 11 percent (28 people) in 2006 was significant (p<0.05).
Across all three years, the types of fireworks causing most injuries (sparklers, rockets, and firecrackers) and the reasons for injury (mishandling, errant path, and malfunctioning) did not change significantly (p>0.05).
Table 1 compares percentage of fireworks-related injury categories by year.
| Category | 2003 (n=261) | 2004 (n=233) | 2006 (n=251) |
|---|---|---|---|
| Demographics | |||
| Median Age/Range | 18 (0-74 yrs) |
18 (0-72 yrs) |
17 (0-67 yrs) |
| Children/Adolescents | 53% | 52% | 55% |
| Males | 73% | 76% | 70% |
| Females | 27% | 24% | 30% |
| White | 84% | 87% | 82% |
| Black or African American | 10% | 8% | 13% |
| Injury Type | |||
| Burns | 76% | 67% | 73% |
| Body Part Injured | |||
| Hand | 34% | 32% | 36% |
| Eye | 17% | 25% | 29% |
| Injury Circumstances | |||
| Injured on Private Property | 83% | 89% | 86% |
| Cases with No Eye Protection | 82% | 88% | 97% |
| Children Injured with Adults Present | 60% | 50% | 64% |
| Received Specialized Care for Burn or Eye Injuries | 8% | 19% | 12% |
| Hospitalized | 3% | 6% | 11% |
| Fireworks Circumstances | |||
| Injuries from Sparklers, Rocket, or Firecrackers | 63% | 64% | 58% |
| Injuries from Mishandling Fireworks | 27% | 23% | 29% |
| Errant Path or Malfunctioning Fireworks | 21% | 37% | 41% |
Summary of 2006 Data
For the 251 cases of fireworks-related injuries that comprise this report, 85 percent (213 cases) occurred during a 10-day period surrounding July 4, 2006, including 47 percent (118 cases) of injuries that took place on Independence Day. While those injured ranged in age from 11 months to 67 years, children and adolescents comprised more than one half
(55 percent) of the reported cases. According to the 2004 U.S. Census population estimates for Indiana, persons under 18 years of age represent one fourth of the population. Adults were present 64 percent (83 cases) of the time for reported injuries in children and adolescents. Males were involved in 70 percent of all reported cases, which is a common finding for many traumatic injuries. The racial distribution of those injured was similar to that of the population of Indiana.
As expected, the most frequently reported type of injury was burns, involving 73 percent (182 cases) of all cases and 59 percent of all injuries. While the hands were the part of the body most commonly injured (36 percent), injuries to the eye (29 percent) were also common.
Bystanders were injured in 17 percent (42 cases) of reported cases. Hospital admission was needed for 11 percent of those injured, with an additional 12 percent requiring specialized care for either burn or eye injuries. There were no reported deaths resulting from fireworks injuries during the time period of this report.
For cases who noted where they used fireworks, 86 percent (215 cases) of reported cases occurred at private homes, yards, or properties (self-owned, friend, neighbor, or relative). The type of fireworks involved in injuries varied somewhat by age. Sparklers caused the most injuries in young children, rockets caused the most injuries in adolescents, and sparklers, closely followed by firecrackers and aerials, caused the most injuries in adults.
Mishandling, malfunction, or errant path of fireworks was the most frequent mechanism reported for fireworks-related injuries, accounting for 70 percent of all those injured. Alcohol use was not stated for 91 percent of the reported cases. Of the 9 percent reporting use of alcohol, 96 percent reported alcohol use at activities affecting injured adults.
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