Increases in Firework-Related Upper Extremity Injuries Correspond to Increasing Firework Sales: An Analysis of 41,195 Injuries Across 10 Years

Abstract

Introduction: Between 2008 and 2017, the American Pyrotechnics Association reported a 41% increase in revenue from firework sales, with 2017 showing $885 million US dollars in consumer sales. We sought to evaluate the epidemiology of firework-related upper extremity injuries during this 10-year period, hypothesizing that hand/upper extremity injuries from fireworks were increasing in the United States. Methods: Observational epidemiologic assessment of a weighted cohort of patients via the National Electronic Injury Surveillance System from 2008 to 2017. The National Electronic Injury Surveillance System provides a nationwide probability sample of injuries related to consumer products based on emergency department visits collected from a cohort of about 100 US hospitals. Results: A total of 1,079 patients representing an estimated 41,195 firework-related upper extremity injuries presented to US emergency departments from 2008 to 2017. The number of injuries increased significantly from 2,576 in 2008 to 5,101 in 2017 (R2 = 0.85, R = 0.92, P < 0.001). A Spearman rank-order correlation determined that there was a strong, positive correlation between the increase in firework sales and the increase in injuries (rs = 0.939, P < 0.01). The overwhelming majority of firework-related injuries were seen in males (77%) aged 11 to 29 years (48%). The hand and fingers accounted for 85.8% of injuries, with the thumb being the most commonly injured body part (51.3%). Burns were the most common injury across all body sites except the wrist, where fractures were most common. Conclusion: Ten-year firework-related upper extremity injuries increased, corresponding to increased consumer sales across the same period. This study provides previously absent population-level data to provide a framework for discussion among policy makers and physicians alike in an attempt to mitigate the use of fireworks and their associated upper extremity injuries. Level of Evidence: Level III

Occurrence and outcome of firework-related ocular injuries in Switzerland: A descriptive retrospective study

“…There is a relevant economical aspect of firework sales: in 2017, a total of 885 million US dollars was generated with consumer sales of fireworks in the United States showing an increase of 41% compared to 2008 [ 37 ]. On the other hand, the number of firework-related injuries increased accordingly from 2,576 in 2008 to 5,101 in 2017 [ 37 ]. This also results in an increased financial burden to health systems due to the need for medical visits, hospitalizations, and surgeries.…”

Patterns and trends of firework-related adult burns in New South Wales, Australia

“…In Australia, the most prevalent time for firework burns was summer during festive celebrations from the Christmas season to New Year's Day. In other countries, firework burns during celebratory events have been linked to Spring festival [11], Guy Fawkes [12], Diwali [13], Eid [3], and Independence Day [14].…”