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Have a Blast (Carefully) on the 4th

Medically Reviewed by Jacqueline Brooks, MBBCH, MRCPsych
From the WebMD Archives

July 3, 2001 -- Guess what happened around this time last year?

According to the Consumer Product Safety Commission (CPSC), there were about 6,600 fireworks-related injuries. Whether firecrackers, bottle rockets, Roman candles, or even the seemingly harmless sparklers were at fault, from June 23 to July 23, 2000, thousands of Americans found their festivities surrounding "the 4th" interrupted by trips to a hospital's emergency department.

Firecrackers led the casualty-causing list, with 1,600 injuries. But rockets and sparklers -- which can burn at temperatures of 2,000 degrees Fahrenheit -- were not far behind.

"Detonating these devices is best left to the professionals," CPSC chairwoman Ann Brown said in an annual presentation about fireworks safety held June 28.

But Americans have become do-it-yourselfers, and such accidents are a disturbing summertime tradition. Two years ago, for example, a 2-year-old was rushed to Duke Medical Center with severe burns and ligament damage to his hands. Older children had lit a firecracker, handed it to him, and shouted for him to throw it. Instead, he clutched it, and it exploded in his hands.

Kathleen Clem, MD, chief of emergency medicine at the hospital in Durham, N.C., told WebMD she saw the dismal aftermath. "The older children felt terrible," said Clem. "But by then the damage had been done."

According to the CPSC, children under 5 accounted for nearly 15% of fireworks injuries last year -- 900 of them in all. Add up all the children hurt by fireworks this time last year, and nearly half were under age 15.

This week, the American Academy of Pediatrics, or AAP, released its recommendations to help lower the injury toll.

The physician group called on pediatricians to warn parents, kids, and communities about fireworks dangers and urge people to go to the professional displays instead of lighting up the dangerous products themselves.

The academy went so far as to call for a national ban on all fireworks sales and use by anyone except professionals. The announcement added that parental supervision and forbidding kids from lighting fireworks don't protect children from the possibility of accidents. They cited a study that found an adult was present in more than half of the cases where a child was hurt. More than a quarter of the accidents happened to a young bystander.

Still, despite all the warnings, something unusual seems to happen to many otherwise sensible, law-abiding citizens around the Fourth of July. Some parents, who wouldn't dream of allowing their young teens to fire a gun in a crowd, buy fireworks and hand them over to their children. Perhaps just as dangerous are the adults -- who may have had too much to drink or who tend to ignore directions -- who try to create their own fireworks displays.

Clem says it's important to recognize how many of these injuries involve adults. "We think it's primarily a problem with kids, but it's not," she says.

She says that while adults have been programmed to turn over their car keys if they've had too much too drink, they may think they can still handle fireworks -- which are, in effect, explosives. "Because of the party atmosphere, they take risks and show more bravado than they normally would if they weren't under the influence," she says.

That occasional recklessness, among adults and children, has led to sometimes-tragic results:

  • The CPSC knows of 10 deaths from fireworks accidents during 2000.
  • In 75% of the injuries, fireworks damaged the victim's hands, head or face, and eyes.
  • In the 700 hand injuries, the product exploded before the handler could throw it.
  • Two people had to have a hand amputated when homemade sparkler bombs exploded before they could be thrown.
  • Sparkler injuries usually damaged the user's hands or shot sparks into the user's eyes. Unpredictably flying rockets were another major cause of eye injury.

The National Council on Fireworks Safety, an organization that includes firework manufacturers, says that legal fireworks, used properly, are not the problem. They say that over the past 10 years, 30-33% of the injuries associated with fireworks have typically been caused by illegal explosives or homemade fireworks.

The council also notes that Public Service Commission statistics show most injuries are minor, and that more often than not, the injuries involved misuse rather than a malfunction of the fireworks.

If you do choose to use fireworks this 4th, though, at least abide by the following safety tips provided by The American College of Emergency Physicians and the CPSC:

  • Read the labels and follow all warnings and instructions. Most injuries occur due to improper use. If the device is not marked with the contents, warning label, and directions, it is most likely illegal or hazardous.
  • Check the amount of gunpowder on the contents. Fireworks must contain less than 50 mg of gunpowder, according to U.S. law. Any firework containing more than that (such as cherry bombs) may not be legally sold to the general public.
  • Protect your eyes by wearing safety goggles or unbreakable glasses.
  • Stand in a safe place and make sure other people are out of range before lighting fireworks.
  • Never investigate why a firework didn't go off, or try to relight fireworks that haven't fully combusted.
  • Never allow children to play with fireworks.
  • Keep a bucket of water nearby in case of accident or fire.
  • Light fireworks only on a smooth, flat surface, away from houses, dry leaves, and flammable materials.

Clem, in agreement with the CPSC, and the AAP, offers one final, fail-proof tip. "The safest way to enjoy fireworks is to attend an professional fireworks display," she says. "The effects are better and much safer."