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Firework injuries remain high in years after legalisation: its impact on children
  1. Colette Galet1,
  2. Isaac Slagel1,
  3. Adam Froehlich2,
  4. Morgan Bobb3,
  5. Michele Lilienthal1,
  6. Elizabeth Fuchsen4,
  7. Karisa K Harland2,5,
  8. Carlos A Pelaez4,
  9. Dionne A Skeete1,
  10. Michael E Takacs5
  1. 1Department of Surgery, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
  2. 2Injury Prevention Research Center, The University of Iowa, Iowa City, Iowa, USA
  3. 3The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
  4. 4Department of Surgery, UnityPoint Health, Des Moines, Iowa, USA
  5. 5Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
  1. Correspondence to Dr Colette Galet, Department of Surgery, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA; colette-galet{at}uiowa.edu

Abstract

Purpose We evaluated the impact of Senate Bill 489 passed in May 2017, allowing the sale and use of fireworks in Iowa 1 June to 8 July and 10 December to 3 January, on hospital presentations for firework injuries in the state. To identify the public health implications of this law, we conducted a detailed subanalysis of hospital presentations to the two level I trauma centres.

Methods Hospital presentations for firework injuries from 1 June 2014 to 31 July 2019 were identified using the Iowa Hospital Admission database and registries and medical records of Iowa’s two level 1 trauma centres. Trauma centres’ data were reviewed to obtain demographics, injury information and hospital course. Prefirework and postfirework legalisation state data were compared using negative binomial regression analysis. Trauma centre data detailing injuries were compared using χ2 and Mann-Whitney U tests as appropriate.

Results Emergency department (ED) visits and hospital admissions for firework injuries increased in Iowa post-legalisation (B-estimate=0.598±0.073, p<0.001 and B-estimate=0.612±0.322, p=0.058, respectively). ED visits increased postlegalisation in July (73.6% vs 64.5%; p=0.008), reflecting an increase in paediatric admissions (81.8% vs 62.5%; p=0.006). Trauma centres’ data showed similar trends. The most common injury site across both study periods was the hands (48.5%), followed by the eyes (34.3%) and face (28.3%). Amputations increased from 0 prelegalisation to 16.2% postlegalisation.

Conclusion Firework legalisation led to an increase in the number of admissions and more severe injuries.

  • Injury Diagnosis
  • Burn
  • Hand Injury
  • Child

Data availability statement

Data are available on reasonable request. Data are available on reasonable requests.

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Data availability statement

Data are available on reasonable request. Data are available on reasonable requests.

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Footnotes

  • Twitter @ColetteGalet, @Iowa_EM

  • Contributors Conceptualisation: KKH, CG, MET, AF and DAS; methodology: CG, KKH and MB; formal analysis: CG, KKH, MB and IS; data collection: AF, EF, CAP, CG and ML; data curation: CG, MB and KKH; writing—original draft: CG, AF and IS; writing—review and editing: AF, MB, IS, ML, EF, CAP, KKH, DAS, MET and CG; visualisation: IS and CG; supervision: CG, KKH, DAS and MET.

    Drs Takacs, Harland and Galet are the authors responsible for the overall content as guarantors

  • Funding This research was funded by the Iowa Department of Public Safety, State Fire Marshal (project #1227892). Research reported in this publication was partially supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002537.

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  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.