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Have a Blast (Carefully) on the Fourth

From the WebMD Archives

July 3, 2000 -- Last Fourth of July, 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., tells WebMD she saw the dismal aftermath of what started out as a fun day. "The older children felt terrible," says Clem. "But by then the damage had been done."

Something strange 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.

Too often, these amateur pyrotechnic efforts leave someone with a serious eye injury, hearing loss, burns, or even dead -- even if they weren't the one striking the match. But with precautions, most such injuries can be prevented, experts say.

During the month-long period bracketing the Fourth of July last year, fireworks caused 6,300 visits to emergency rooms, according to the U.S. Consumer Product Safety Commission. About 40% of these injuries were to children 10-14 years old, according to the American College of Emergency Physicians.

Fireworks are illegal in only a handful of states: Connecticut, Delaware, Georgia, Massachusetts, Minnesota, New York, New Jersey, Rhode Island, and Vermont. Polices in other states range from giving consumers limited access to fireworks to having virtually no restrictions.

The National Council on Fireworks Safety defines consumer fireworks as cone fountains, cylindrical fountains, Roman candles, skyrockets, firecrackers, mines and shells, helicopter-type rockets, certain sparklers, and revolving wheels. The National Center for Injury Prevention and Control says the most severe injuries are typically caused by "class B" fireworks, such as rockets, cherry bombs, and M-80s -- which are federally banned from public sale but often find their way into consumers' hands nonetheless.

The American Academy of Ophthalmology, the American College of Emergency Physicians, and the National Association of State Fire Marshals have gathered the following facts:

  • Nineteen people died in the first 10 months of 1999 from fireworks-related injuries.
  • More than 6,000 such injuries occurred between June 23 and July 23 of last year. Some 30% of these injuries were to hands, wrists, or arms, and 20% were to the eyes. Many of those injured were bystanders.
  • Ten percent of children injured by fireworks suffer permanent damage, such as loss of an eye, finger, or hand.
  • Bottle rockets account for two-thirds of all fireworks-related injuries and over half of fireworks-related eye injuries.
  • Sparklers, often given to young children, can burn at up to 2,000 degrees Fahrenheit and cause serious eye injuries.

Ophthalmologist Louis Pizzarello, MD, tells WebMD he has seen more than his share of fireworks-related tragedies. Pizzarello, who is affiliated with Southampton and New York Presbyterian Hospitals, says the most common culprit for eye injuries are bottle rockets. "I have seen eyes damaged beyond repair, [leading to] removal of the eye."

Since 40% of all fireworks injuries happen to children, Clem says it's important to recognize that this means most 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.

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.

"All firework injuries are preventable," says Arthur Kellermann, MD, an emergency physician and a leading researcher in injury prevention,

The American College of Emergency Physicians and the Consumer Product Safety Commission provide the following safety tips:

  • 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. "Always wear safety goggles or unbreakable glasses while shooting fireworks," says Kellermann.
  • 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.
  • Only light fireworks on a smooth, flat surface away from houses, dry leaves, and flammable materials.

Clem 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."