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Pediatric Firework Injuries Increase at EDs as States Relax Regulations

LOUISVILLE, KY – The number of children — and the severity of their injuries — presenting to emergency departments with fireworks-related burns is on the upswing, according to a new study that points out the trend appears to track the loosening of state laws regulating pyrotechnics.

The research was presented recently at the Pediatric Academic Societies 2016 Meeting in Baltimore. For the study, researchers reviewed the National Inpatient Sample, with data on 8 million hospital stays each year, and the Nationwide Emergency Department Sample, which annually compiles information on 30 million discharges from emergency medicine facilities.

Although they found the number of patients younger than age 21 treated and released by EDs for fireworks injuries went up modestly from 2006 and 2012, much larger increases were identified for injuries requiring inpatient hospital admission, which rose from 29% of cases in 2006 to 50% in 2012.

"The increase in fireworks-related injuries and the severity of these injuries in children since 2006 are very concerning," said co-author Charles Woods, MD, associate chair of pediatrics at the University of Louisville. "Although our findings do not prove a direct link to relaxations in state laws governing fireworks sales, it may be time for lawmakers to reassess this issue. Parents and caregivers of children also should be aware of these increasingly serious injuries and the potential dangers involved in allowing young children to handle and play with fireworks.”

Background information in the study notes that changes in U.S. fireworks laws have allowed younger children to purchase fireworks, as well as allowing individuals to purchase more powerful ones.

Results of the study indicate that the 3,193 injuries reviewed represented an estimated 90,257 firework-related burn injuries treated in the United States from 2006 to 2012.

Most of the injuries, 62.9%, were managed in EDs, with incidence increasing over time from 4.28 per 100,000 in 2006 to 5.12 per 100,000 in 2012.

In addition to the increase in the proportion of injuries requiring inpatient admission, researchers also documented longer lengths of stay, from 3.12 days in 2006 to 7.35 days in 2012. At the same time, the average age of the injured decreased from 12.1 years old in 2006 to 11.4 years old in 2012.

“Pediatric fireworks-related burn injuries have increased in incidence, apparent severity of injury, the proportion requiring hospitalization and LOS (in the hospital) in a time period of relaxed fireworks laws in the U.S.,” study authors conclude. “Fireworks laws may need to be revisited by policy-makers.”

PDMR and PTC2 - Pediatric Emergency Medicine Reports-hz