Fatal and near-fatal asthma in children exposed to fireworks

Fireworks accounted for an estimated 8,300 emergency department visits during 1997 in the United States. Firecrackers, bottle rockets, roman candles, and sparklers contribute to the most hospitalizations. Burns account for the majority of these injuries Fireworks are manufactured from a variety of chemicals, which include the known irritant, sulfur dioxide, as one of the products of combustion. We are reporting one fatal and one near fatal asthma exacerbation after use of fireworks.

We are reporting two patients who had severe asthma exacerbation shortly after having exposure to different types of fireworks.

Patient data were collected from patients that presented the week of July 4, 1998 to our institution. Information was also obtained from the Consumer Product Safety Commission and the National Weather Service.

The patients presented to our institution within hours of their exposure from the fireworks. One patient had a respiratory arrest and was resuscitated, but subsequently expire. The second patient was able to treated aggressively and avoided intubation.

These cases demonstrate risks that fireworks may present to the asthmatic child and that patient's with asthma should exercise caution when observing or participating in fireworks demonstrations.