Sparking the Debate: Facial Injury Patterns from Fireworks

The objective of this article is to estimate the incidence, injury patterns, and demographics of patients presenting to emergency departments (EDs) for facial injury sustained from fireworks. This was an analysis of a nationwide database. The National Electronic Injury Surveillance System (NEISS) was evaluated for facial injuries from fireworks from 2013 to 2017. Relevant entries were examined for incidence, patient characteristics, location of injury, and type of injury. There were 509 NEISS entries, extrapolating to an estimated 19,816 ED visits for head and neck injuries due to fireworks from 2013 to 2017. The number of visits per year due to fireworks has been relatively stable over the past 5 years with an average of 3,963 cases per year. Greater than 90% of injuries occurred in July. Males comprised the majority of patients (67%), with the median age of 16 years. Most common sites of injury were the eyeballs (41%), followed by midface including eyelids, periorbita, and nose (31%), ears (12%), and only minor incidence of oral injuries (2%). After burns, contusions were the second most common injury from fireworks, followed by lacerations and foreign body injuries. The majority of firework injuries occurred in teenagers, reinforcing the importance of greater safety regulations and age limits for purchasing fireworks. Nearly half the incidents were eye injuries, necessitating greater public education in protective eyewear and mandating their use during festive holidays. Furthermore, injury patterns reported in this analysis may serve as a valuable adjunct for enhancing clinical history taking and physical examination to look for concurrent injuries.