Fireworks Injuries to the Head and Neck: A Retrospective Analysis Between 2008 and 2017

This study examines firework-associated head and neck injuries in the United States from 2008 to 2017 obtained from a single epidemiology source. The National Electronic Injury Surveillance System (NEISS) was used to collect epidemiologic data and retrospectively analyze firework-associated injuries from 2008 to 2017. Injury types included burns, concussions, contusions, foreign bodies, hematomas, internal organ injury, lacerations, and puncture wounds. Four hundred and thirty-one individuals were originally included; however, 14 participants were excluded due to inadequate injury information. Chi-squared analyses were performed between the following categorical variables: gender vs body part injured, patient age vs injury type, and patient age vs body part injured. About 417 injuries to the head and neck (67.4% male, 32.6% female) were treated in NEISS-reporting emergency departments during the 10-year period. Sixty-nine percent of the injuries occurred in July. Body parts injured included the ear (10.6%), face (61.6%), head (13.0%), mouth (4.8%), and neck (10.0%). Chi-squared analysis demonstrated an association between gender and body part injured (P = .0001). Patient age (P = .066) was independent of injury type. Children aged 0 to 12 years had the highest probability of being injured (40.2%), then adults 22 and older (33.1%) and adolescents 13 to 21 years (26.9%). Given that the preponderance of injuries caused by fireworks occurred primarily in minors, pediatricians should screen for any household firework use during the anticipatory guidance portion of well-child checks, which we believe would improve patient safety and decrease injury rates.