- Knowledgebase: Child Safety, Injury Prevention and Treatment
- Questions about child safety and injury prevention, as well as treatment for minor injuries.
- 47. AAP: Statement on Children and Fireworks - Top
- Children and Fireworks (RE9218)
Every year, Americans express their patriotism on Independence Day and celebrate other festive occasions with fireworks. As a result, approximately 12 446 individuals, more than half of them children, have fireworks-related injuries that require hospital treatment. [1] In 1988, it is estimated that 20 people died as a direct result of injuries caused by fireworks or by the fires they caused. [2] The hands (32%), head (18%), legs (15%), and eyes (14%) are the body parts most often involved, accounting for about 80% of all fireworks-related injuries. [3] About one third of the eye injuries result in permanent blindness. [4] Hand and finger injuries require 120 estimated amputations annually. [3] Burns are the most common type of fireworks-related injury: lacerations, contusions, and abrasions are also frequent. [2,5,6]
Under current federal regulations issued by the Consumer Products Safety Commission (CPSC) in 1976, any firecracker containing more than 50 mg of explosive material is banned, although aerial devices still may contain up to 130 mg of powder. The CPSC classifies explosive devices into three categories: Class A, which are solid explosives such as TNT and dynamite; Class B, which includes large firecrackers, cherry bombs, and M-80s; and Class C, the common, or so-called "safe and sane" devices. Class B devices are banned from public sale but are used for professional displays. Class C fireworks include fountains and candles, which shoot out sparks or flaming balls, rockets with sticks (called "bottle rockets" because it is customary to stand them in a soda bottle for ignition), other rockets, sparklers, and smoke devices. These are permitted under federal law, and their sale is regulated by state and local authorities. [5] At present, only 12 states ban all Class C fireworks, while 7 additional states ban all except sparklers and/or "snakes." [2]
A recent Consumer Product Safety Commission report based on 1989 National Electronic Injury Surveillance System (NEISS) data found that about two thirds of the fireworks-related injuries involved products permitted under CPSC regulations and presumed to contain no more than the legally allowed amount of powder. However, it was not possible to know from the data collected whether the fireworks actually met the CPSC-specified design and performance criteria. The CPSC report found that 16% of the fireworks-related injuries were from small firecrackers and 50% were from other common fireworks regularly sold to the public. Notably, sparklers, which were widely believed to be quite safe, cause 19% of the injuries. [3] Although most sparkler injuries are minor burns and corneal abrasions, sparklers can reach temperatures greater than 1000 deg.F at the tip and can cause serious burns by igniting clothing. [4,6] A case-control study designed to control for the popularity of various devices found firecrackers and aerial devices to be associated with the greatest risk of injury. It also found that the highest chance of severe injury (that requiring hospitalization) occurred with illegal and homemade devices. [5] Half of the eye injuries and an even higher percentage of those eye injuries resulting in permanent blindness or enucleation are caused by bottle rockets. [4]
Injuries resulting from public fireworks displays are extremely rare, and malfunctions of fireworks devices account for only a small percentage of injuries. Misuse of fireworks, either by adults who have been drinking or by unsupervised children, accounts for the majority of fireworks injuries; and about 15% of the time, the injured party is a bystander. [5]
In a 1984 study it was reported that in King's County, Washington, the mean dollar charge for care for all injured persons was $562 and that 7% of the people required hospitalization for an average of 7 days. The mean cost per hospitalized patient was $5431. Patients who were not hospitalized accrued an average of $191 in direct costs. [5] Using these figures (understanding that 1991 current costs would certainly be greater) and the NEISS estimate of 10 000 fireworks-related injuries annually, the immediate direct costs of these injuries is approximately $5.6 million. Other costs, such as lifetime medical care, time lost from work, and decreased productivity, cannot be measured. In 1985, 51 600 fires, which resulted in $36.4 million in direct property damage, were caused by fireworks. [2] These considerable losses of life, health, and money are almost entirely preventable by the removal of all fireworks from the hands of everyone but professional pyrotechnicians. States that ban all Class C devices have significantly lower rates of fireworks-related injuries and fires. [4,6] Where local regulations ban fireworks, there is frequent crossover to nearby communities that permit them, so the effectiveness of such local regulation is limited. Education does not appear to decrease injuries in states where fireworks are permitted. [5]
The American Academy of Pediatrics recommends the following actions:
1. Encourage accurate reporting of fireworks-related injuries, death, and fires.
2. Prohibit public sales, including those by mail order, of all fireworks, even the presently legal Class C "safe and sane" devices. Ideally this would be done on a federal level, either by federal law or by Consumer Product Safety Commission regulations. Sales to professional pyrotechnicians for the purpose of creating public displays should, of course, be exempted. It may be necessary, however, to initiate a licensing mechanism for such purchasers. International import of Class C devices for private use should also be banned.
3. The Academy should work with national government agencies to achieve a ban on all fireworks, and support the model state fireworks law proposed by the National Fire Protection Association. Individual pediatricians and state chapters should work to increase the number of communities and states that ban fireworks entirely.
4. Pediatricians should educate parents and community leaders about the dangers of the so-called "safe and sane" fireworks. Parents should be encouraged to attend public fireworks displays rather than to purchase fireworks for home use. When families feel they must have home fireworks despite the well-documented risks involved, children should never be allowed to ignite them, nor should they be around any devices without adult supervision. Pediatricians should also emphasize the increased dangers of fireworks use by persons who have been consuming alcoholic beverages.
- Updated: March 5, 2001
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