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Abstract
Objectives State laws dictate firework access in the USA, and the association between state laws and paediatric firework injuries has not been investigated. We hypothesise that states with fewer firework restrictions will have a higher incidence of paediatric firework injuries.
Methods A retrospective review (2012–2020) of paediatric patients who sustained a fireworks-related injury was conducted using the Pediatric Health Information System. Inclusion criteria were age less than 18 years and International Classification of Diseases code for fireworks-related injury. States were classified as ‘unrestrictive’ or ‘restrictive’ based on permitted fireworks. Case number, demographics and injury severity were evaluated. A negative binomial regression was used to evaluate independent variables predictive of firework injuries, with the dependent variable being the number of injuries. Independent variables that were predictive of number of injuries were subsequently evaluated with a Mann-Whitney test to determine the significance of the differences between ‘unrestrictive’ and ‘restrictive’ states.
Results During the study period, 2299 fireworks-related injuries were reported. Mean age was 9.2±4.8 years (range 0–17). Most injuries, based on raw numbers, were in ‘unrestrictive’ states (72.6%). When normalised measures were used for comparison, based on paediatric state population, there was a statistically significant difference with a higher percentage of injuries in unrestricted states (p=0.002). The mean number of cases per million pediatric-aged individuals was higher in the ‘unrestrictive’ states versus the ‘restrictive’ states (p=0.003).
Conclusions States with fewer firework restrictions had a higher incidence of fireworks-related injuries in children. Restricting fireworks may protect children from fireworks-related injuries.
- Blast/Explosion
- Child
- Burn
Data availability statement
Data are available upon reasonable request.
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Data availability statement
Data are available upon reasonable request.
Footnotes
Contributors Dr. Sara Van Nortwick (SVN) is the guarantor for this manuscript and its related data.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests RM receives consulting fees from Stryker and serves on committees for the Scoliosis Research Society and Pediatric Spine Study Group. For the remaining authors, none were declared. No funding was secured for this study.
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.
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