Sparking the Debate: Facial Injury Patterns from Fireworks

Abstract

The objective of this article is to estimate the incidence, injury patterns, and demographics of patients presenting to emergency departments (EDs) for facial injury sustained from fireworks. This was an analysis of a nationwide database. The National Electronic Injury Surveillance System (NEISS) was evaluated for facial injuries from fireworks from 2013 to 2017. Relevant entries were examined for incidence, patient characteristics, location of injury, and type of injury. There were 509 NEISS entries, extrapolating to an estimated 19,816 ED visits for head and neck injuries due to fireworks from 2013 to 2017. The number of visits per year due to fireworks has been relatively stable over the past 5 years with an average of 3,963 cases per year. Greater than 90% of injuries occurred in July. Males comprised the majority of patients (67%), with the median age of 16 years. Most common sites of injury were the eyeballs (41%), followed by midface including eyelids, periorbita, and nose (31%), ears (12%), and only minor incidence of oral injuries (2%). After burns, contusions were the second most common injury from fireworks, followed by lacerations and foreign body injuries. The majority of firework injuries occurred in teenagers, reinforcing the importance of greater safety regulations and age limits for purchasing fireworks. Nearly half the incidents were eye injuries, necessitating greater public education in protective eyewear and mandating their use during festive holidays. Furthermore, injury patterns reported in this analysis may serve as a valuable adjunct for enhancing clinical history taking and physical examination to look for concurrent injuries.

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

“…The NEISS database was selected because it has served as a public health research tool for other similar epidemiological studies. 10,11 Approximately 100 urban, suburban, and rural hospitals, including eight children's hospitals, report data to the NEISS. Thus, this database represents a stratified probability sample of more than 6000 hospitals in the United States which have six or more beds and an ED that is always open.…”

“…Population estimates from the U.S. Census Bureau were used to determine injury rates per 1 million people. [10][11][12][13]…”

CT Findings of Firework Injuries to the Head and Neck

“…Fireworks are used worldwide for recreational purposes and are a direct cause of significant morbidity in the United States [1][2][3] and other parts of the world including Asia 4,5 and Europe. 6,7 Males, young adults, and children are disproportionately affected by fireworks injuries.…”

“…6,7 Males, young adults, and children are disproportionately affected by fireworks injuries. [1][2][3] Common types of fireworks that cause injuries include firecrackers, sparklers, bottle rockets, mortar, and roman candles. [1][2][3] In the United States, an estimated 97 562 fireworks-related injuries were treated in the emergency departments from 2000 to 2010, with 42% of these injuries involving the head and neck area.…”

“…[1][2][3] Common types of fireworks that cause injuries include firecrackers, sparklers, bottle rockets, mortar, and roman candles. [1][2][3] In the United States, an estimated 97 562 fireworks-related injuries were treated in the emergency departments from 2000 to 2010, with 42% of these injuries involving the head and neck area. 2 The US Consumer Product Safety Commission estimated that 10 000 fireworksrelated injuries were seen and treated in the United States hospital emergency departments during 2019 alone, with 16% of the injuries involving the head/face/ear and 15% affecting the eye.…”