Facial Plast Surg 2020; 36(05): 659-664
DOI: 10.1055/s-0040-1714116
Original Research

Sparking the Debate: Facial Injury Patterns from Fireworks

Neil Ketan Mehta
1   Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
,
Brandon Cowan
1   Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
,
Houmehr Hojjat
1   Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
,
Jared Johnson
1   Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
,
1   Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
,
Michael Carron*
1   Department of Otolaryngology - Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan
› Author Affiliations

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.

* Michael Thomas Chung and Michael Adelard Carron are co-senior authors.




Publication History

Article published online:
27 July 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Tadisina KK, Abcarian A, Omi E. Facial firework injury: a case series. West J Emerg Med 2014; 15 (04) 387-393
  • 2 Haseen MA, Mahmud AA, Huda F, Beg MH. Temporal artery rupture following firework rocket injury. Indian J Plast Surg 2015; 48 (02) 225-226
  • 3 Fogarty BJ, Gordon DJ. Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland. Burns 1999; 25 (01) 53-56
  • 4 Molendijk J, Vervloet B, Wolvius EB, Koudstaal MJ. The big bang: facial trauma caused by recreational fireworks. Craniomaxillofac Trauma Reconstr 2016; 9 (02) 175-180
  • 5 Puodžiuvienė E, Jokūbauskienė G, Vieversytė M, Asselineau K. A five-year retrospective study of the epidemiological characteristics and visual outcomes of pediatric ocular trauma. BMC Ophthalmol 2018; 18 (01) 10
  • 6 Moore JX, McGwin Jr G, Griffin RL. The epidemiology of firework-related injuries in the United States: 2000-2010. Injury 2014; 45 (11) 1704-1709
  • 7 Centers for Disease Control and Prevention (CDC). Injuries associated with homemade fireworks-- selected states, 1993-2004. MMWR Morb Mortal Wkly Rep 2004; 53 (25) 562-563
  • 8 Billock RM, Chounthirath T, Smith GA. Pediatric firework-related injuries presenting to United States emergency departments, 1990-2014. Clin Pediatr (Phila) 2017; 56 (06) 535-544
  • 9 Wang C, Zhao R, Du WL, Ning FG, Zhang GA. Firework injuries at a major trauma and burn center: a five-year prospective study. Burns 2014; 40 (02) 305-310
  • 10 Sandvall BK, Jacobson L, Miller EA. et al. Fireworks type, injury pattern, and permanent impairment following severe fireworks-related injuries. Am J Emerg Med 2017; 35 (10) 1469-1473
  • 11 Bresler AY, Hanba C, Svider P, Carron MA, Hsueh WD, Paskhover B. Craniofacial injuries related to motorized scooter use: a rising epidemic. Am J Otolaryngol 2019; 40 (05) 662-666
  • 12 DeFroda SF, Lemme N, Kleiner J, Gil J, Owens BD. Incidence and mechanism of injury of clavicle fractures in the NEISS database: Athletic and non athletic injuries. J Clin Orthop Trauma 2019; 10 (05) 954-958
  • 13 Shields WC, McDonald EM, Pfisterer K, Gielen AC. Scald burns in children under 3 years: an analysis of NEISS narratives to inform a scald burn prevention program. Inj Prev 2015; 21 (05) 296-300
  • 14 Association AP. U.S. Fireworks Industry Revenue Figures Breakdown by Industry Segment 1998–2018. 2019 ; Available at: Accessed April 30, 2020 https://pyro.memberclicks.net/assets/docs/FactsandFigures/Fireworks%20Revenue%20by%20Industry%20Segment%201998-18.pdf
  • 15 Chang IT, Prendes MA, Tarbet KJ, Amadi AJ, Chang SH, Shaftel SS. Ocular injuries from fireworks: the 11-year experience of a US level I trauma center. Eye (Lond) 2016; 30 (10) 1324-1330
  • 16 Demissie Z, Everett Jones S, Clayton HB, King BA. Adolescent risk behaviors and use of electronic vapor products and cigarettes. Pediatrics 2017; 139 (02) e20162921
  • 17 Scott-Parker B, Oviedo-Trespalacios O. Young driver risky behaviour and predictors of crash risk in Australia, New Zealand and Colombia: same but different?. Accid Anal Prev 2017; 99 (Pt A): 30-38
  • 18 Myers J, Lehna C. Effect of fireworks laws on pediatric fireworks-related burn injuries. J Burn Care Res 2017; 38 (01) e79-e82