3 Fireworks-Related Injuries That Land People In The Emergency Room

Nothing says Fourth of July like fireworks. The technicolor explosives are every kid’s favorite part of the celebration — and many adults’ favorite, too. They’re mesmerizing to watch from a safe distance, but pose a serious danger if you stand too close or misuse them.

According to the Consumer Product Safety Commission, 9,700 people were sent to emergency rooms in the U.S. due to injuries sustained from fireworks in 2023, and eight people died. The number of fireworks-related injuries has risen overall between 2008 and 2023, and peaked in 2020, when the pandemic caused the cancellations of many public professional fireworks displays.

The most injured body parts in 2023 were hands and fingers (35%), the head, face and ears (22%) and eyes (19%), according to the CPSC. The age groups most likely to be seen in the ER for fireworks injuries were teens ages 15-19 and children ages 5-9.

We spoke to two doctors about the most common injuries they see caused by fireworks and how to prevent them.

Burns

The CPSC report found that 42% of ER visits for firework-related injuries involved burns.

“Burns typically are on the hands or the face,” Dr. Nick Poulos, trauma director and chief of pediatric surgery at Nemours Children’s Hospital in Orlando, told HuffPost.

“Burn injuries are usually flash injuries and are usually not terribly severe,” he said, although that doesn’t mean they aren’t painful. If your child gets a burn that doesn’t seem severe, Poulos recommends cooling it off with cold water.

“Then, if the if the pain is persistent, that would be the time to head to the emergency room.”

Blast injuries

Blast injuries, which involve tissue damage, “can be very severe and debilitating,” Poulos said.

“Explosives get much more dangerous the more compact they are pressed,” he said. So if a child holds on tightly to a firework that then explodes, “the tissue can’t get away very fast, and so it makes the exposure much worse.”

Blast injuries will require a trip to the emergency room.

But not all types of fireworks are capable of causing them. Sparklers “don’t have any explosive component,” Poulos said. They’re on the end of a stick, giving you a buffer, and “the amount of gunpowder is much, much smaller,” he added.

While any kind of firework can cause injury, kids are less likely to get hurt by sparklers. The CPSC report says there were about 700 injuries caused by sparklers brought to the ER in 2023, out of the 9,700 total injuries. Bottle rockets caused another 800 injuries. Other kinds of explosive firewords were responsible for the remaining majority of the injuries. Any kind of projectile, or a firework that shoots into the air, can injure either the person igniting it or a spectator.

Eye injuries

Eye injuries are a major concern when it comes to fireworks, as they can cause vision damage — sometimes permanently.

Eye injuries vary in their severity, Dr. Brian Boxer Wachler, a Los Angeles-based ophthalmologist, told HuffPost. But any significant injury to the eye requires medical attention.

A common, less-serious injury involves damage to the outer portion of the eye called the cornea. Boxer Wechler said that even a minor abrasion or scratch can still cause a lot of discomfort.

“Even though it’s really small, there’s so many nerves, it’s just incredibly painful,” he said of the cornea. While these injuries often heal within a couple of days, it’s important to see a specialist because of the possibility of infection and scarring. The impact of scarring can range from “a little vision distortion to a really high degree of vision impairment, depending on the scar,” Boxer Wechler said.

In more serious injuries, a firework penetrates the cornea and damages deeper layers of the eye.

“That can cause a cataract, it can cause a retina detachment. And those could be really high degrees of vision impairment, or even blindness, possibly,” Boxer Wechler said. Depending on the severity of the injury, he said, treatment might involve a “Band-Aid-type contact lens,” antibiotic drops, steroids or even surgery.

Boxer Wechler noted that all of these injuries can be prevented by using protective eye wear.

If you plan to use fireworks, here’s what you should know

The doctors recommended the following safety precautions when using fireworks with children in order to prevent injury.

1. Supervision by an adult who is not drinking. Poulos said that kids who are ready to be left alone in the house are likely ready to use fireworks with supervision, around ages 12 or 13. “Every child lighting a firework should have adult supervision,” Boxer Wachler said. Calling alcohol and fireworks “a bad mix,” Poulos said it’s important that the supervising adult remain sober.
2. Protective eyewear. “The most protective types of lenses are polycarbonate lenses,” Boxer Wechler said. “Some material that’s shatterproof.” Think of the safety goggles you wore in chemistry class. If you don’t have these on hand, a pair of sunglasses is a decent second option, even though they are not shatterproof. While it’s uncommon to see people wearing protective eyewear when lighting fireworks, Boxer Wechler noted that it used to be rare to find seatbelts in cars, and a change in norms is always possible.
3. A safe distance. With any fireworks that explode in the sky, “everybody ought to be back at least 50 feet away from where this is going off, because the risk is also for the audience as well as the person lighting it,” Poulos said. He added that a person should never hold this type of firework in their hand, but use a smoldering stick, or “punk,” that will give you some distance. The firework “needs to be in a stable position, and it needs to be lit with one of those punks, so that you are nowhere near the firework when it actually takes off,” Poulos said. To avoid starting a fire, he added, fireworks should be set off on an asphalt or cement surface, and not aimed toward anyone’s home or a wooded area.
4. A bucket of water or garden hose. Sparklers can be dropped into a bucket of water to be extinguished. Water should be immediately available in case anything catches flame. If a firework doesn’t light or go off correctly, do not handle it or attempt to light it again.