Severe Fireworks-Related Injuries: Demographic Characteristics, Injury Patterns, and Firework Types in 294 Consecutive Patients

Pediatr Emerg Care. 2021 Jan 1;37(1):e32-e36. doi: 10.1097/PEC.0000000000002302.


Objectives: The relationship between fireworks and patient characteristics is not known. Our objective was to examine how severe fireworks-related injuries in children and teens compare to adults.

Methods: We conducted a retrospective case series (2005-2015) study of patients who sustained consumer fireworks-related injuries requiring hospital admission and/or operation at a single level 1 trauma/burn center. The distribution of race, use behavior, injury type, body region injured, and firework type was examined by age groups, 1 to 10 years, 11 to 17 years, and 18 years or older.

Results: Data from 294 patients 1 to 61 years of age (mean, 24 years) were examined. The majority (91%) were male. The proportion of injuries from different firework types varied by age, with rockets causing the highest proportion in children aged 1 to 10 years, homemade fireworks in those aged 11 to 17 years, and shells/mortars in adults 18 years or older. Compared with adults, children aged 1 to 10 years were more frequently American Indian/Alaska Native, Hispanic, or Asian than White. Compared with adults, children aged 1 to 10 years and 11 to 17 years were more frequently bystanders than active users. Compared with adults, children aged 1 to 10 years and 11 to 17 years had a greater proportion of burn and face injuries. Children aged 1 to 10 years had a decreased proportion of hand injuries. Three patients, 2 adults and 1 child aged 11 to 17 years, died.

Conclusions: Children, teens, and adults experience severe fireworks-related injuries differently, by demographic characteristics, injury patterns, and firework types. Tailored public health interventions could target safety messaging and injury prevention outreach efforts to reduce firework injuries among children and adolescents.

MeSH terms

  • Accident Prevention / methods
  • Adolescent
  • Adult
  • Age Factors
  • Blast Injuries / epidemiology*
  • Blast Injuries / etiology
  • Blast Injuries / mortality
  • Blast Injuries / prevention & control
  • Burns / epidemiology*
  • Burns / etiology
  • Burns / prevention & control
  • Child
  • Child, Preschool
  • Emergency Service, Hospital
  • Explosive Agents / adverse effects*
  • Eye Injuries / epidemiology
  • Facial Injuries / epidemiology
  • Female
  • Hand Injuries / epidemiology
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Retrospective Studies
  • Trauma Centers
  • Young Adult


  • Explosive Agents