Fireworks fun fizzles into injury for thousands of holiday celebrants every year

Firecrackers. Bottle rockets. Roman candles.

All bring to mind the flashy fun associated with the Fourth of July.

But to physicians and firefighters, the crackly combustion of fireworks signals the potential for an explosion of accidents, injuries, and fires.

"Fireworks send over 11,000 people to the emergency room during the Fourth of July period each year," said Tom Weingeist, M.D., head of ophthalmology at University of Iowa Hospitals and Clinics. "Most victims are children and young adults."

Of these injuries, the hands (40 percent), eyes (20 percent), and head and face (20 percent) are the body areas most often involved. About one-third of eye injuries from fireworks result in permanent blindness. Burns account for more than half of fireworks-related injuries, and lacerations, contusions, and abrasions are also common.

H. Culver Boldt, M.D., a retina specialist at UI Hospitals and Clinics, said he and his colleagues have seen a variety of fireworks-related eye injuries over the years.

"We do our best and have successfully helped some patients recover from fireworks-related eye injuries," he said. "But the truth is that severe, permanent damage often occurs at the moment of impact, and surgical repair may not salvage useful vision."

Injuries typically happen when people--often young people--assume a fuse isn't lit, he said. "They lean over a bottle rocket after it seems to have fizzled and it goes off." Bottle rockets fly an unpredictable path and can hit bystanders hundreds of feet away.

Even seemingly harmless fireworks, such as sparklers, can cause thermal or chemical injuries to the eye, Boldt said.

"Fireworks are unpredictable so the risk of injury exists no matter how many precautions are taken. The best and safest way to enjoy fireworks is to attend public displays produced by professionals."

 At a Glance

• · About 15 percent of fireworks-related injuries are severe enough to rupture the eye. Even injuries that do not rupture the eye often cause permanent blindness.
• · Bottle rockets are responsible for about 80 percent of eye injuries. Many bottle rocket injuries occur during what would be considered to be appropriate and safe bottle rocket use.
• · Being young and male are risk factors. People under 20 years are nearly five times more likely to sustain fireworks-related injuries than those over 24 years. The risk for males is nearly four times higher than for females.
• · Even after patients seek appropriate medical treatment, at least 40 percent of the eyes with fireworks-related trauma recorded in the U.S. Eye Injury Registry remain legally blind.