The incidence of acoustic trauma due to New Year's firecrackers

While occupational noise is tightly regulated by various noise protection programs, some kinds of leisure noise have been poorly addressed. The aim of this study was to estimate prospectively the incidence of blast and explosion trauma due to the use of New Year's firecrackers in a western industrialized society. The results are based on 562 centers in Germany, including the otorhinolaryngology departments of 31 university hospitals and of 87 city hospitals as well as a random sample of specialized otorhinolaryngology private practices (n=444). After extrapolation of the number of reported cases to the number of hospitals and practices on duty, a total of 8,160 cases (95% confidence interval 7,515-8,805) was estimated giving an incidence of 9.9 per 100,000 inhabitants. There were three times as many men affected as woman. The incidence for the age group of 6 to 25 years was much higher: 28 per 100,000 with a maximum of 107 per 100,000 for 19-year-old men. These incidences suggest that firecrackers may pose a momentous public health risk. Because of the medical and economic importance of incurable sensorineural hearing loss, it is the task of public health services to promote the effective prevention of irreversible damage to the hearing organ.