HomeMy WebLinkAbout20051198.tiff 1998 Fireworks-Related Injuries
A Study of Fireworks-Related Injuries Treated in Hospital Emergency Rooms between June 23 and July
23, 1998
June 1999
Michael A.Greene
Hazard Analysis Division
Directorate for Epidemiology and Health Sciences
U.S. Consumer Product Safety Commission
E inajT
- z 1A
2005-1198
TABLE OF CONTENTS
EXECUTIVE SUMMARY 1
I. INTRODUCTION 2
II. METHODOLOGY 2
III. RESULTS 3
A.Deaths 3
B.National Injury Estimates for 1998 4
C. 1998 Special Study 5
1. Fireworks Type and Injury Dispositions 5
2. Age and Sex of Injured Persons 7
3. Age of the Injured Person by Type of Fireworks 8
4. Injury Diagnosis and Body Part Injured 9
5. Type of Fireworks and Body Part Injured 10
III. DISCUSSION 11
REFERENCES 12
APPENDIX 13
Executive Summary
This report provides the results of a CPSC staff analysis of
1998 data on fireworks-related injuries . Annual estimates are
derived from the National Electronic Injury Surveillance System
(1998) . Estimates for the July 4" period are based on a one-
month special survey (June 23 to July 23 , 1998) of fireworks-
related injuries treated in hospital emergency rooms reporting to
NEISS. Highlights are as follows :
• Fireworks devices were involved in an estimated 8, 500 injuries
treated in U. S . hospital emergency rooms during calendar year
1998 . This estimate is significantly lower than estimates for
the years 1992 through 1994 (12 , 500) .
• There were thirteen deaths from fireworks in 1998 . Seven of
these deaths occurred from an explosion in a fireworks
factory.
• An estimated 5, 000 injuries, directly involving fireworks,
were treated in U.S . hospital emergency rooms during the cne-
month period surrounding the Fourth of July, 1998 . The
highest injury estimates were for firecrackers (1, 900) ,
rockets (800) , and sparklers (500) .
• Over 40 percent of the injuries were to children under age 15 .
The estimated number of injuries to males (3 , 700) was
approximately three times the number of injuries to females
(1, 300) .
• The parts of the body most often injured were the hands
(1, 800) , eyes (1, 100) ,and head/face (1, 000) . Over half the
injuries involved burns . Burns were the most frequent injury
received by all parts of the body except the eye, where
contusions and lacerations were the most frequent injuries .
I. Introduction
The U.S . Consumer Product Safety Commission (CPSC) has
maintained an active interest in consumer fireworks safety since
the early 1970s . CPSC regulations include a 50 milligram powder
limit on firecrackers, fuse burn time limits, requirements to
prevent tip-over and blowout, and cautionary labeling
requirements . The most recent regulations involve the October
1991 ban on reloadable tube aerial shell fireworks devices with
shells larger than a 1 . 75-inch outer diameter and a March 1996
static stability requirement for multiple tube devices with tubes
greater than or equal to an inner diameter of 1. 5 inches .
II. Methodology
Fireworks deaths were obtained from the CPSC Death
Certificate file, and the IPII (Injury and Potential Injury
Incident) file. Because it takes up to two years to receive
reports of deaths from all the states, the number of fireworks
deaths for 1998 may actually be greater than reported here.
Total estimated fireworks injuries for 1998 were obtained
from the National Electronic Injury Surveillance System (NEISS) .
NEISS is a probability sample of U. S. hospitals that have
emergency departments . All estimates for the number of injuries
in this report were obtained using the hospital totals and the
sampling weights in NEISS . These weights were adjusted for non
reporting. The variance calculations and associated confidence
intervals used the standard procedure for a stratified sample
(Cochran, 1977, Chapter 5) . Estimates were rounded to the
nearest 100 injuries . Estimates less than 50 injuries are shown
as an asterisk (*) . Percentages were rounded to the nearest 5% .
In addition, from June 23 through July 23 , 1998, CPSC
conducted a special study that identified 147 fireworks-related
injuries treated in hospital emergency rooms . The 1998 special
study focused on the types of fireworks involved in injuries and
the injuries associated with their use. Victims were asked to
identify the fireworks type from illustrations shown to them at
the hospital emergency room.
Although estimates are provided in this report for many
subsets of the data, such as gender or body part injured,
interpretation of estimates for these subsets should be made with
caution since estimates based on small sample sizes generally
have large amounts of sampling variability. Also the assumption
that the sampled injury data follow a normal distribution, which
is required for valid confidence intervals, is less plausible for
2
small samples than large samples. In particular, this means that
when comparing subsets of the data, it is not possible to
determine how much of the difference is due to sampling
variability and how much comes from real differences in national
injuries . Because of the large number of different possible
comparisons, variances or confidence intervals are not provided
in this report except for total injuries .
NEISS data for 1998 are based on a revised sampling frame
that first went into effect in 1997 (Kessler and Schroeder,
1998) . The new frame reflects changes that have occurred in the
population of injuries occurring at U.S . hospital emergency
departments . Estimates for total fireworks injuries for years
before 1997 have been adjusted to take these changes into
account . These estimates are different from the estimates in 1996
and earlier CPSC publications .
Ill. Results
A. Deaths
CPSC files contain entries for thirteen deaths that occurred
from fireworks during 1998 . Below are synopses of the cases :
• Six women and one man between 25 and 52 years old died in an
explosion in a fireworks factory in Jefferson Township,
Michigan.
• Two girls, 9 and 13 years old, died from smoke inhalation in a
mobile home fire in Ellsinore, Missouri that was started by
sparks from smoldering fireworks.
• A 12-year-old female was killed in Cleveland, Ohio, when she
was struck in the head by a mortar shell at a neighborhood
park.
• A 17-year-old man died in Navarino, Wisconsin after being
struck by shrapnel from a mailbox where he had placed a
lighted firecracker.
• A 29-year-old man drowned in Fox Lake, Illinois after he blew
a hole in the bottom of his boat with a large firecracker.
• A 56-year-old Connecticut man was launching fireworks out of a
plastic tube in Block Island, Rhode Island. He peered inside
the tube when one firework failed. The firework went off and
struck him in the head.
3
B. National Injury Estimates for 1998
Table 1 and Figure 1 present the estimated number of
fireworks-related injuries for 1988 through 1998 treated in U.S .
hospital emergency rooms both annually and during the one-month
period for the special study surrounding the Fourth of July.
In 1998, there were an estimated 8, 500 fireworks injuries
for the calendar year (95 percent confidence interval 6 , 000 -
11, 000) . Annual estimates were highest in the years 1992-1994 ,
declining to lower levels in 1996-1998 . From a statistical
point of view, estimated total injuries for 1996 , 1997 and 1998
were not significantly different from each other. Estimates for
1996-1998 were significantly lower than the peak years of 1992-
1994 .
In 1998, 65 percent of fireworks injuries occurred during
the July 4th holiday period (June 23 - July 23) . Historically,
about 60 tc 75 percent of fireworks-related injuries occurred
during that period.
Table 1
Estimated Fireworks-Related Injuries
Estimated Injuries Estimated Injuries
Year June 23-July 23 Calendar Year
1998 5, 400 8, 500
1997 6, 200 8 , 300
1996 4 , 900 7, 300
1995 7, 900 10, 900
1994 8 , 800 12, 500
1993 9, 100 12 , 300
1992 9,200 12 , 600
1991 7, 900 11, 000
1990 7, 900 12 , 000
1989 6,200 9, 600
1988 7, 000 10, 100
Source: NEISS, U.S. Consumer Product Safety Commission/EHHA. Estimates for
1988-1996 were revised to adjust for a new sampling frame and do not match
values published in 1997 or earlier.
4
Fireworks Injuries 1988-1998
14,000
12000 ry � : ,�i
10,000 W. � Entire Year
d 8 000 Yi��
a 6 000 iiji -» —July 4 Period
E 4 000 . .:. . .:!
2000
1
7
0� gib O� 0^ °��" �� Acb
a 0y c CS‘ °��
Year
C. 1998 Special Study
The remainder of this report presents the results of the
1998 special study of hospital emergency department treated
injuries associated with fireworks that occurred during the July
4 holiday season from the special study perioc410(:):1.
June 23 to July
23 . As indicated in Table 1, an estimated 5, njuries
occurred during the study period (n=147) . Howev , an estimated
400 of these injuries (n=9) were marginally related to a
fireworks device and are excluded from the remainder of this
analysis . An example of such an excluded injury is a punctured
foot suffered by a 12 year old male who stepped on a nail
protruding from a rocket launcher pedestal .
This leaves a total of 5, 000 injuries directly related to
fireworks. The 95 percent confidence interval for this estimate
is 3 , 000 - 7, 100 .
1. Fireworks Type and Injury Dispositions
Table 2 categorizes July 1998 holiday season fireworks
injuries by device type (see illustrations in Appendix) •
Firecrackers accounted for about 40 percent (1, 900) of all
estimated fireworks injuries that occurred during this period. Of
these, illegal, large firecrackers, such as 15%
80 ' s, were involved
in 800 estimated injuries . This was about 15% of the total
injuries . Among legal consumer devices, rockets (800 injuries) ,
sparklers (500 injuries) , and Roman candles (300 injuries) were
5
the major contributors to injuries . Bottle rockets accounted for
600 of the 800 rocket-related injuries .
Table 2
Estimated Fireworks-Related Injuries,
by Type and Disposition, June 23-July 23, 1998
n=138
Fireworks Type Estimated Injuries
Total 5, 000
Firecrackers 1, 900
Small 500
Illegal 800
Unknown 700
Rockets 800
Bottle Rockets 600
Other, Unspecified 100
Other Consumer Devices 1, 100
Sparklers 500
Fountains 100
Novelties 200
Multiple Tube and Shell 100
Roman Candles 300
Homemade/Altered 100
Public Display 300
Unknown 800
Source: NEISS, U.S. Consumer Product Safety Commission/EHHA. Totals may not
add due to rounding. Caution is recommended when using the estimates in this
table because of the relatively small sample sizes from which these estimates
were derived.
Although most of these fireworks-related injuries were
treated at the emergency room and then released, an estimated 300
cases or 6 percent required hospital admission or transfer to
another hospital for treatment . This was somewhat higher than
the hospitalization and treat and transfer rate of 4 . 5 percent
for all consumer products .
Among the eleven people in the sample who were hospitalized,
there were four injuries from firecrackers, two from rockets, two
6
from Roman candles, two from homemade firecrackers and one record
did not specify the type of device. Seven cases involved burns,
two were amputations (one an amputation of the hand, the other
injury involved the loss of three fingers) , one was multiple
facial trauma and the last was severe lacerations to the hand.
Ten of the victims were male and one was female. The youngest
victim was a 2-year-old female and the oldest was a 54-year-old
male. Five of the victims were between 5 and 14 years of age.
2. Age and Sex of Injured Persons
About seven percent (400 estimated injuries) of all
estimated fireworks injuries were to children younger than age 5
(Table 3) . These children, along with children in the 5 to 14
age group, accounted for about 40 percent (2 , 100 injuries) of all
injuries . The age group 15 to 24 (1, 600) had 35 percent of
injuries and 25 to 44 (1, 000) had 20 percent of the injuries.
Injury rates per 100, 000 population were highest among those
between the ages of 5 and 24 years (4 .4 - 4 . 5) Rates were lowest
among victims over age 45 . There was one recorded injury of a
male 65 and over (representing 6 .25 estimated injuries) .
In general, most (75%) fireworks injuries were to males.
Overall, the estimated number of injuries to males (3 , 700) was
2 . 9 times the number of injuries to females (1, 300) .
7
Table 3
Estimated Fireworks-Related Injuries,
By Age and Sex, June 23-July 23, 1997
n=138
Injuries per
Age Group Male Female Total 100, 000
(years)
Total 3, 700 1, 300 5, 000 1 . 9
Less than 5 300 100 400 1. 9
5 to 14 1, 400 300 1, 700 4 .4
15 to 24 1, 200 400 1, 600 4 . 5
25 to 44 700 300 1, 000 1 .3
45 to 64 100 200 300 0 .4
65+
Source: NEISS, U.S. Consumer Product Safety Commission/EHHA. Population
rates were based on 1998 U.S. population estimates by age and sex, U.S. Bureau
of the Census. Totals may not add due to rounding. Estimated injuries less
than S0 shown by * .
3. Age of the Injured Person by Type of Fireworks
Table 4 presents the ages of those injured by the type of
fireworks device involved in the injury. Among the 600 estimated
bottle rocket-related injuries, most were sustained by persons
between the ages of 5 and 24 years old. Children between the
ages of 5 and 14 sustained 300 bottle rocket-related injuries .
Among firecracker-related injuries, children between ages 5 and
14 accounted for about one-third (600) . Sparklers were the
primary source of injuries among children under 5 years old, with
an estimated 300 injuries .
8
Table 4
Estimated Fireworks-Related Injuries,
by Device Type and Age Group
June 23-July 23, 1998
n=138
Age Group (Years)
Fireworks Type Totals c 5 5-14 15-24 25-44 45-64
Total 5, 000 400 1, 700 1, 600 1, 000 300
Firecrackers 1, 900 * 600 800 300 200
Small 500 * 300 100 100 *
Illegal 800 * 100 400 200 100
Unspecified 700 * 200 300 100 100
Rockets 800 * 300 300 100 *
Bottle 600 * 300 200 100 *
Other 100 * * 100 * *
Other Devices 1, 100 300 200 400 200 *
Sparklers 500 300 100 * 200 *
Homemade/Altered 100 * 100 100 * *
Public Display 300 * 100 * 100 100
Unspecified 800 * 400 100 200 *
Source: NEISS, U.S. Consumer Product Safety Commission/EHHA. Totals may not
add due to rounding. Estimated injuries less than 50 shown by *. Other
devices included Fountains, Novelties, Multiple Tube and Shell and Roman
Candles in addition to Sparklers.
4. Injury Diagnosis and Body Part Injured
Table 5 presents the types of injuries sustained to specific
parts of the body. Most injuries (75%) were to the hands, head,
and eyes . Hands and fingers with an estimated 1, 800 injuries,
accounted for 35% of the total injuries . Eye injuries with 1, 100
injuries accounted for 20% of the total . Injuries to the head
and face at 1, 000 injuries were also about 20% of the total .
Among diagnoses, burns, with 2, 800 injuries and 55% of the
total, was the most frequent . Contusions and lacerations, at
1, 300 injuries and 25% of the total, was the second most frequent
9
diagnosis . Except for the eyes, burns were the most frequent
injury to most parts of the body. Contusions or lacerations were
the most common injuries to the eye . Head and facial injuries
involved both burns and contusions or lacerations .
Table 5
Estimated Fireworks-Related Injuries,
By Body Part and Diagnosis
June 23-July 23, 1998
n=138
Diagnosis
Body Part Total Burn Contusion, Fracture, Other
Laceration Sprain
Total 5, 000 2, 800 1, 300 200 700
Hand/Finger 1, 800 1, 100 300 200 200
Head/Face 1, 000 700 100 * 100
Eye 1, 100 200 500 * 400
Leg 400 300 100
Trunk 100 * 100
Arm 200 100 100 * *
Foot/Toe 500 400 100
Source: NEISS, U.S. Consumer Product Safety Commission/EHHA. Totals may not
add due to rounding. Estimated injuries less than 50 shown by *. Fracture,
Sprain includes dislocations. Other includes all other injury categories.
Head/Face injuries include the NEISS codes for face, including eyelid, eye
area and nose; head; neck; mouth, including lips, tongue and teeth; and ear.
Leg includes NEISS codes for upper leg, knee, lower leg, and ankle. Trunk
includes NEISS codes for lower trunk, upper trunk (not including shoulders)
and pubic region. Arm includes lower arm, elbow, upper arm, shoulder, and
wrist.
5. Type of Fireworks and Body Part Injured
Table 6 presents estimated injuries by the fireworks device
and body part involved. Firecracker injuries occurred most often
to the hand (1, 000) and the eye (400) . Victims sustained injuries
from firecrackers while holding the device, or attempting to
release it after an ignition. Rockets were represented in more
injuries to the eye than any other part of the body (200) . Many
of these victims sustained injuries from erratic rocket flight
patterns, or burning debris from the rocket . Sometimes these
scenarios involved a rocket placed on the ground or thrown into
the air. Sparkler-related injuries most frequently involved
hands (300) . A typical sparkler injury occurred when the user
touched the glowing end, or inadvertently poked himself or a
10
bystander with the ignited device .
Table 6
Estimated Fireworks-Related Injuries
By Type of Device and Body Part
June 23-July 23, 1998
n=138
Body Part
Head Arm
Fireworks Type Total Hand Face Eye Leg Other
Total 5, 000 1, 800 1, 000 1, 100 1, 100 100
Firecrackers 1, 900 1, 000 200 400 300
Sparklers 500 300 100 * 100
Rockets 600 100 100 200 100
Other Devices 2, 000 400 500 400 500 100
Source: U.S. Consumer Product Safety Commission/EHHA. Totals may not add due
to rounding. Estimated injuries less than 50 shown by •. Other devices
included fountains, novelties, multiple tube and shell, Roman candles, public
display, homemade/altered and unspecified devices.
lit Discussion
Estimated fireworks-related injuries for 1998 were
significantly lower than estimates for the years 1992 through
1994 and about the same as 96-97 . One can be reasonably
confident at this point that there has been a substantial
decrease in the number of injuries since the early 1990s .
As in previous years, injuries to children were a major
component of fireworks-related injuries in 1998, with children
under age 15 accounting for 40 percent of all fireworks-related
injuries . The disproportionate involvement of children is
further illustrated by the high rate of injury for the 5 to 14
age group, compared to the rate for the population as a whole
(4 .4 vs 1 . 9 injuries per 100, 000 people) .
It should be noted that while estimates are presented by
type of fireworks device, evaluation of relative hazard by type
requires data on the number of products on the market . Such data
11
are not available at this time.
References
Cochran, W. (1977) , Sampling Techniques, 3rd edition. John Wiley
and Sons, NY.
Kessler, E. and Schroeder, T. (1998) , "The NEISS Sample (Design
and Implementation) , " U.S . Consumer Product Safety Commission,
Washington, DC.
12
(ht4
1/44TE5 .
1999 Fireworks Annual Report
Fireworks-Related Deaths, Emergency Department'Ireated Injuries,
and Enforcement Activities During 1999
June 2000
Michael A. Greene
Division of Hazard Analysis
Directorate for Epidemiology
U.S. Consumer Product Safety Commission
Patrick M. Race
Office of Compliance
U.S. Consumer Product Safety Commission
I. EXHIBIT
Executive Summary
This report provides the results of the U. S. Consumer Product Safety
Commission (CPSC) staff analysis of 1999 data on fireworks-related injuries and deaths.
The report also includes a summary of CPSC enforcement activities during 1999.
We obtained information on fireworks deaths primarily from news clips in
CPSC's Injury and Potential Injury Incident(IPII) database. We estimated fireworks
injuries from CPSC's National Electronic Injury Surveillance System (NEISS). More
detailed analyses of injuries including the type of injury and the firework involved were
based on a special study conducted between June 23 and July 23, 1999.
Highlights of the report are as follows:
• CPSC has reports of 16 deaths from fireworks in 1999. There were 13 deaths
reported in 1998.
• Fireworks devices were involved in an estimated 8,500 injuries treated in U. S.
hospital emergency departments during calendar year 1999. CPSC estimated the
same number of injuries in 1998.
• There was no increase in injuries in 1999 despite a 20 percent increase in the dollar
value of fireworks imported into the United States. Some of the increase in imports
was for the additional fireworks activity associated with millennium celebrations.
• Estimated emergency department treated injuries for the period 1997-1999 were
significantly lower than the estimates for 1992 through 1994, when the average was
almost 12,500 injuries per year.
• An estimated 5,700 fireworks-related injuries were treated in U. S. hospital
emergency departments during the one month special study period surrounding the
Fourth of July, 1999 (June 23, 1999—July 23, 1999). The highest injury estimates
were for firecrackers (1,800), rockets (1,000), and sparklers (600). These were about
the same levels as 1998.
• During this one-month period, as in previous years, injuries to children were a major
component of fireworks-related injuries with children under 15 accounting for 45
percent of the injuries.
• About 35 percent of the injuries to children under age 15 involved firecrackers.
Rockets accounted for about 20 percent of the injuries and sparklers accounted for
about 15 percent of the injuries. About three times as many males were injured as
females.
• Also during this period, the parts of the body most often injured were the hands
(estimated 2,300 cases), eyes (1,000) and head/face (1,200). Over half the injuries
involved bums. Bums were the most frequent injury to all parts of the body except
the eyes, where contusions, lacerations, and foreign bodies in the eyes were the most
frequent.
• A review of NEISS in-depth investigations of injuries during the special study period,
showed that some serious injuries were associated with (1) fireworks explosions that
were earlier or later than expected by the user, (2) rockets with errant flight patterns
or(3) inappropriate use of fireworks by children.
• During 1999, CPSC has participated in multi-state fireworks investigations. As a
result, several fireworks retailers and distributors of illegal fireworks were shut down
and tens of thousands of illegal explosive devices were seized. Following a separate
investigation, a large fireworks importer was permanently enjoined from selling
violative fireworks.
• CPSC and the U.S. Customs Service have continued to sample shipments and to seize
shipments that violate CPSC's mandatory safety requirements.
• During 1999, these surveillance operations were stepped-up in anticipation of
increased fireworks usage and also to cover an extended sales season associated with
the millennium celebrations.
• In criminal cases, five defendants pled guilty to violations of Federal explosives laws
and violations of the Federal Hazardous Substances Act. The courts imposed prison
sentences, fines and forfeitures.
r
Table of Contents
Introduction 1
Death and Injury Estimates 2
Fireworks-related Deaths for 1999 2
National Injury Estimates for 1999 and Comparison with Prior Years 3
Injury Estimates for the 1999 Special Study 4
Fireworks Types and Injury Dispositions 4
Age and Sex of Injured Persons 6
Age of the Injured Person by Type of Fireworks 7
Injury Diagnosis and Body Part Injured 8
Type of Fireworks and Body Part Injured 9
In-depth Investigations of Fireworks Deaths and Injuries 10
Enforcement Activities 11
Discussion 12
References 13
Appendix: In-depth Investigations 14
Introduction
This report describes injuries and deaths associated with fireworks during 1999.
The report also describes CPSC enforcement activities for 1999.
Fireworks deaths were obtained from the CPSC Death Certificate file and the IPII
(Injury or Potential Injury Incident) file. There may be up to a two-year lag between
when a death occurs and when the death is reported in the Death Certificate file, so
reporting for 1999 may not be complete. Data for the IPII file come from news clips,
consumer complaints and reports from government agencies. Because reporting is
voluntary, there may have been fireworks deaths that were not reported to any of these
sources, and are not included among the deaths in this report. Therefore, the number of
deaths from fireworks-related injuries might be greater than reported here.
Total estimated emergency department treated injuries for fireworks in 1999 were
obtained from CPSC's National Electronic Injury Surveillance System(NEISS). NEISS
is a probability sample of U. S. hospitals that have emergency departments.1 All estimates
for the number of injuries in this report were obtained using the hospital totals and the
sampling weights in NEISS. These estimates reflect emergency department treated
injuries for the entire country.
The detailed analysis of injuries in hospital emergency departments in this report
is based on a special study of fireworks injuries treated between June 23, 1999 and July
23, 1999. This special study focused on the types of fireworks involved in these injuries.
Victims were shown illustrations of fireworks at emergency departments to help them
identify the device associated with the injury. The type of fireworks device was not
usually recorded during other periods of the year.
Also, during the special study period, CPSC completed in-depth investigations of
38 fireworks injuries. These in-depth investigations were limited to injuries involving
amputation, eye injuries, or injuries requiring admission to the hospital. There were also
some investigations where it was suspected that the fireworks device was illegal or that
the device was illegally purchased. In most cases, victims were telephoned and read a
questionnaire. These investigations were intended to determine how the most serious
injuries occurred. Victims were asked about the circumstances of the incident, where the
device was obtained and future medical treatment required for the injury.
In this report, injury estimates derived from NEISS are rounded to the nearest 100
injuries and percentages are rounded to the nearest 5 percent. Estimates of less than 50
injuries are shown with an asterisk(*). Values may not add to totals because of
rounding.
For a description of NEISS,including the revised sampling frame,see Kessler and Schroeder(1998).
Procedures used for variance and confidence interval calculations,and adjustments for the sampling frame
change in 1997 are found in Marker,Lo, Brick,and Davis(1999). SAS statistical software for trend and
confidence intervals is documented in Schroeder(2000).
1
Although a number of different analyses are provided in this report for different
categories of injuries, including the age distribution of victims and the types of fireworks
involved in the injury, interpretation of these estimates should be made with caution.
This is because estimates based on small sample sizes have relatively large amounts of
sampling variability. For example, when comparing subsets of the data, say between
injuries associated with two different types of fireworks, or between two different years,
it is difficult to determine how much of the difference between estimates is associated
with sampling variability and how much comes from real differences in national injury
totals.
Information about enforcement activities was provided by CPSC's Office of
Compliance.
Death and Injury Estimates
Fireworks-related Deaths for 1999
CPSC has reports of 16 deaths that occurred from fireworks during 1999. Brief
descriptions are found below.
• Five people in Gardendale, Alabama were killed when smoldering fireworks
remains in a trash can adjacent to a house ignited. The fire spread to the house.
The victims were a 43 year-old male, 41 year-old female and 3 male children, 10,
10 and 6 years old.
• A house fire that started from smoldering fireworks debris in a trash can, killed 5
people in Salem, Wisconsin. This included a 31 year-old female, a 9 year-old
male, a 4 year-old male, and two female children, one 2 years old and the other 1
year old.
• Three teenagers were killed in Centerville, Arizona, when a shell exploded in a
trailer that contained fireworks. The ages of the victims were not disclosed in the
newspaper account of this incident.
• A 5 year-old male in the San Diego area was killed from burns when sparklers
ignited in his pocket.
• A 15 year-old male was killed in Kanorado, Kansas. He placed fireworks in a
partially buried pipe. When he lit them, he was killed by the explosion.
• A 13 year-old male in Lake Roesiger, Washington was killed when he placed a
shell inside a tube. The shell struck him in the head when it exploded.
2 This incident was also in CPSC's Death Certificate File.
2
National Injury Estimates for 1999 and Comparison with Prior Years
Table 1 and Figure 1 present the estimated number of fireworks-related injuries
for 1988 through 1999 treated in U. S. hospital emergency departments annually.
Table 1
Estimated Fireworks-Related Injuries 1988-1999
Estimated
Year Injuries
1999 8,500
1998 8,500
1997 8,300
1996 7,300
1995 10,900
1994 12,500
1993 12,000
1992 12,500
1991 10,900
1990 12,000
1989 9,600
1988 10,100
Source: NEISS,U. S.Consumer Product Safety Commission/EPHA. Estimates for 1988-1996 were
revised to adjust for the new sampling frame and do not match values published in reports for 1997 or
earlier.
In 1999, there were an estimated 8,500 fireworks injuries for the calendar year.3
This was the same value as the estimate reported for 1998 and was slightly greater than
the values reported for 1996 and 1997 (Greene, 1999). None of the totals for 1996-1999
were statistically significantly different from each other.4 However, the difference
between 1999 and the high value in 1994 of 12,500 injuries was significant.5 Also, the
difference between the three-year average for 1997-1999 and the three-year average for
the historic high period between 1992 and 1994 was statistically significant.6
3 95 percent confidence interval 6,000 to 11,000.
4 P-values as follows: for 1998 and 1999,p=0.9849;for 1999 and 1997,p=0.8576.
5 p=0.0411,one tail.
6p<0.01,one tail.
3
Figure 1. Fireworks Injuries 1988-1999
NNNN
W S_
1988 1990 1992 1994 1996 1998
Year
In 1999, 75 percent of fireworks injuries occurred during the July 4th holiday
period (June 23 -July 23). In the last decade, about 60 to 80 percent of fireworks-related
injuries occurred during this period.
There was no increase in injuries in 1999 despite an increase of about 20 percent
in shipments of fireworks to the United States from 1998 to 1999, based on dollar
values.7 Some of the increase in imports was prcbably associated with the additional
fireworks activity for the millennium celebrations.
Injury Estimates for the 1999 Special Study
The remainder of the injury analysis in this report presents the results of the 1999
special study of hospital emergency department treated fireworks injuries that occurred
between June 23 and July 23, 1999. During this period, there were an estimated 5,700
fireworks-related injuries for the special study period.8 This estimate was based on 179
emergency department cases.
Fireworks Types and Injury Dispositions
Table 2 below shows the distribution of July 1999 holiday season fireworks
injuries by type of device.
Data from the USITC Trade Database-Web Access.Included was U.S.imports at Customs value for
HTS8 36041010 and HTS8 36041090.
895 percent confidence interval: 4,000 to 7,500.
4
•
Table 2
Estimated Fireworks-Related Injuries
By Type of Firework
June 23-July 23, 1999
Fireworks Type Estimated Injuries
Total 5,700
Firecrackers 1,800
Small 100
Illegal 500
Unknown 1,200
Rockets 1,000
Bottle Rockets 700
Other, Unspecified 300
Other Consumer Devices 1,900
Sparklers 600
Fountains
Novelties 200
Multiple Tube and Shell 400
Roman Candles 600
Helicopters
Homemade/Altered
Public Display 100
Unknown 900
Source: NEISS,U.S. Consumer Product Safety Commission/EPHA. Based on 179 reported emergency
department visits between June 23, 1999 and July 23, 1999. Cases were weighted by the NEISS sampling
weights. Frequencies reported in the table were rounded to the nearest 100. Totals may not add due to
rounding. Estimates of less than 50 injuries are shown as an asterisk(*). Caution is recommended in
comparing estimates in this table because of the relatively small number of injuries from which each
estimate was derived.
5
As shown in Table 2, firecrackers accounted for about 30 percent (1,800) of all
injuries that occurred during this period. Among firecrackers, illegal, large firecrackers,
such as M-80's were involved in 500 estimated injuries. This was less than 10 percent of
the total injuries. Among legal consumer devices, rockets (1,000 injuries), sparklers (600
injuries), and Roman candles (600 injuries) were the major contributors. Bottle rockets
accounted for 700 of the 1,000 rocket-related injuries
Although most of these fireworks-related injuries were treated at emergency
departments and then released, an estimated 7 percent (400 cases)required hospital
admission or transfer to another hospital for treatment. This was somewhat highef than
the hospitalization and treat/transfer rate of 4.5 percent for all consumer products.
Age and Sex of Injured Persons
Less than 10 percent (400 injuries) of all fireworks-related injuries were to
children under 5 years of age as shown in Table 3. Children in the 5 to 14 age group
accounted for about 35 percent (estimated 2,100) fireworks-related injuries. Together,
children under 15 experienced 45 percent of the fireworks injuries.
The age group 15 to 24 had 30 percent of the injuries (1,800) and the 25 to 44 age
group had 20 percent of the injuries (1,100;. There were no recorded fireworks-related
injuries to people 65 years of age and over in the NEISS sample.
Injury rates per 100,000 population were highest among people aged 5 to 24
years. Children between 5 and 14 years of age had 5.3 injuries per 100,000 people, while
young adults 15 to 24 had 4.8 injuries per 100,000 people.
In general, most injuries were to males, accounting for 4,200 incidents. About
three times as many males were injured as females.
6
Table 3
Estimated Fireworks-Related Injuries
By Age and Sex
June 23-July 23, 1999
Age Group Total Male Female Injuries per
(years) 100,000 people
Total 5,700 4,200 1,500 2.1
Less than 5 400 300 200 2.1
5 to 14 2,100 1,600 500 5.3
15 to 24 1,800 1,200 500 4.8
25 to 44 1,100 1,000 200 1.3
45 to 64 300 100 100 0.5
Source: NEISS,U. S.Consumer Product Safety Commission/EPHA. Notes: See Table 2. US population
from www.census.gov/population/estimates/nation/intfile2-l.txt
Age of the Injured Person by Type of Fireworks
Table 4 presents the ages of those injured by the type of fireworks device
involved in the injury. Injuries to the youngest children, under 5, were associated with
sparklers, firecrackers, and bottle rockets. For 5-14 year olds and for 15-24 year olds,
firecrackers, other devices (including sparklers) and rockets were the source of injuries.
7
Table 4
Estimates Fireworks-Related Injuries
By Device Type and Age Group
June 23-July 23, 1999
Age Group (Years)
Fireworks Type Totals <5 5-14 15-24 25-44 45-64
Total 5,700 400 2,100 1,800 1,100 300
Firecrackers 1,800 100 800 700 200 *
Small 100 * 100 * * *
Illegal 500 * * 400 100 *
Unspecified 1,200 100 700 300 100 *
Rockets 1,000 100 400 200 200 *
Bottle 700 100 300 100 100 *
'.--. Other 300 * 100 100 100 *
Other Devices 1,900 300 600 400 400 100
Sparklers 600 100 300 * 100 100
Various 1,200 100 300 400 300 100
Homemade/Altered * * * * * *
Public Display 100 * * * 100 *
Unspecified 900 200 400 200 100
Source: NEISS,U. S.Consumer Product Safety Commission/EPHA. Notes: See Table 2. Various Other
Devices include multiple tube devices,novelties,reloadable aerial shell devices,Roman candles,fountains,
and novelties.
Injury Diagnosis and Body Part Injured
Table 5 presents the types of injuries sustained to specific parts of the body.
Eighty percent of injuries (4,500) were to the hands,head/face, and eyes. Hands and
fingers with an estimated 2,300 injuries, accounted for 40 percent of the total injuries.
Injuries to the head and face at 1,200 total injuries were about 20 percent of the total.
r--
8
Among diagnoses, bums with 3,200 estimated injuries and 55 percent of the total,
were the most frequent. Contusions and lacerations, at 1,300 injuries and 25 percent of
the total were the second most frequent. Contusions, lacerations, and foreign bodies (in
other diagnoses) were the most common eye injuries. Head and facial injuries primarily
involved burns and contusions or lacerations.
Table 5
Estimated Fireworks-Related Injuries
By Body Part and Diagnosis
June 23-July 23, 1999
Body Part Total Burns Contusions Fractures Other
Lacerations Sprains Diagnoses
Total 5,700 3,200 1,300 300 900
Hands/Fingers 2,300 1,300 500 200 300
Head/Face 1,200 600 400 * 200
Eyes 1,000 300 300 * 400
Legs 300 300
Trunk 200 100 * * 100
Arms 500 400 * 100
Feet/Toes 100 100
Source: NEISS,U. S.Consumer Product Safety Commission/EPHA. Notes: See Table 2. Fractures and
sprains also included dislocations. Other diagnoses included all other injury categories. Head/Face injuries
include the NEISS codes for face,eyelid,eye area and nose,head,neck,mouth,lips,tongue,teeth and ear.
The category for legs includes codes for upper leg,knee,lower leg,and ankle. Trunk includes NEISS
codes for lower trunk,upper trunk(not including shoulders),and pubic region. The arms category includes
lower ann,elbow,upper arm,shoulder,and wrist.
Type of Fireworks and Body Part Injured
Table 6 below presents estimated injuries by the fireworks device and body part
involved. Firecracker injuries occurred most frequently to the hand(900 injuries).
Typically, victims sustained injuries from firecrackers while holding the device, or
attempting to release it after ignition. Rockets were represented in injuries to me eye,
head/face, and arm/leg region. Victims sustained injuries from erratic rocket flight
9
patterns, or burning debris from the rocket. Sparkler injuries typically involved the
hands. Sparklers burn at a high temperature.
Table 6
Estimated Fireworks-Related Injuries
By Type of Firework and Body Part Injured
June 23-July 23, 1999
Type of Hands Head Arms
Fireworks Total Fingers Face Eyes Legs Trunk
Total 5,700 2,300 1,200 1,000 900 200
Firecrackers 1,800 900 400 300 100 100
Sparklers 600 400 100 100 - -
Rockets 1,000 100 300 300 300 -
Other Devices 2,200 900 400 300 600 100
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. Notes: See Table 2. The arms and
legs category includes feet and toes. The other body regions are definea in the note under Table 5. Other
devices included fountains,novelties,multiple tube and shell,Roman candles,public display,
homemade/altered and unspecified.
In-depth Investigations of Fireworks Deaths and Injuries
CPSC conducted in-depth investigations of the more serious injuries associated
with fireworks that occurred during the month surrounding the July 4 holiday. Injuries
were selected when they involved the eye, or amputations, or when the victim was either
admitted to the hospital or transferred to another facility for treatment. These injuries
were selected for investigation to develop information on potential long term effects.
Investigations were also conducted because the injury was suspected to result from the
use of illegal fireworks.
Most of these investigations were conducted by telephone. Either the victim was
the source of information or the victim's guardian, when the victim was under 18.
Thirty-eight completed investigations were reviewed. A summary of these
investigations is in the appendix. Typical causes of injuries shown in these reports
included the following:
10
• Fireworks that exploded earlier or later than the victim expected. Often the
device exploded after the victim thought it was not operating and the victim
retrieved it to light it again. For example, in the Appendix, see task numbers
990708HEP9008 and 990722HEP9007.
• Errant flight paths for rockets and mortars, injuring bystanders. In some
cases, the rocket had blown off its stand, or the flight path had been affected
by the wind. For example, see Appendix task numbers 990713HEP9013 and
990714HEP9003.
• Inappropriate usage of fireworks devices, especially by children. This
includes cutting open fireworks, using them near flammable liquids, using
devices indoors or in cars,burying devices in pipes, etc. See Appendix task
numbers 990706HEP9001 and 990713HEP9007.
The review of the investigations showed that victims, for the most part, expected
a full recovery. Some eye injuries, however, involved surgery for cornea or lens
replacement. (An example was in task number 990722HEP9018 in the Appendix.) Also,
some hand injuries resulted in severe burns and lacerations. One victim reported some
loss of function with full recovery uncertain (task number 990723HEP9007). A second
victim had part of his thumb amputated. He reported that partial recovery was expected
after prolonged physical therapy (task number 990804HEP9010).
r
Enforcement Activities
As part of its focus on reducing fireworks injuries, CPSC is working to ensure
that imported fireworks meet CPSC's regulations. CPSC works with the U. S. Customs
Service on surveillance of fireworks imports. Surveillance operations were stepped-up in
1999 in anticipation of increased fireworks usage, and also to cover an extended sales
season associated with the millennium celebrations. As part of these activities, CPSC
and Customs selectively sampled 522 shipments of fireworks to ascertain the level of
compliance with fireworks regulations. About 31 percent of these shipments were found
to violate fireworks regulations. These shipments accounted for more than 6 million
units presenting violations serious enough to warrant seizure or other actions by the U.S.
Customs Service (CPSC, 2000).
Also during 1999, CPSC collected and tested more than three times as many
domestic fireworks samples than in previous years.
CPSC has also initiated or participated in multi-state criminal investigations of
illegal fireworks. These investigations have led to more than a dozen criminal search
warrants and the seizure of tens of thousands of illegal explosive devices, tons of
professional display fireworks being illegally sold or distributed to consumers, and
components used to manufacture illegal fireworks. Several fireworks retailers and
distributors have either been permanently or temporarily shut down. In addition, a recent
11
CPSC investigation led to a permanent injunction in a civil case against Midwest
Fireworks Manufacturing Co., Inc. of Ohio, a large fireworks importer. This order
enjoined the firm from distributing and selling violative fireworks.
Also, five defendants in criminal cases pled guilty to felony violations of Federal
explosives laws as well as violations of the Federal Hazardous Substances Act. Four
defendants were sentenced to federal prison terms of 8 to 30 months. Fines ranging from
$6,000 to $60,000 were imposed. One defendant also forfeited $300,000 in illegal
proceeds to the federal government.
Discussion
The total number of estimated fireworks injuries for 1999 was the same as for
1998, 8,500. Despite a 20 percent increase in imports this year, there were no changes in
the number of injuries. Also, the injuries for recent years continue to he significantly
lower than the estimates for the years 1992 through 1994.
Injuries during the 1999 one-month special study period at 5,700 were higher than
1998's estimate of 5,000, but the difference was not statististically significant. For 1999,
the types of fireworks associated with the injuries, the age and gender distribution,
hospital dispositions and diagnoses, all were within the range of what was reported for
1998.
As in previous years, in 1999, injuries to children were a major component of
fireworks-related injuries with children under 15 accounting for 45 percent of the
injuries. The disproportionate involvement of children is further illustrated by the high
rate of injury for the 5 to 14 age group, compared to the rate for the population as a
whole. Children in this age group experienced 5.3 emergency department treated
fireworks injuries per 100,000 people as compared with the general population rate of 2.1
per 100,000 people.
A review of in-depth investigations of serious fireworks injuries showed that
typical causes of injuries included (1) fireworks exploding earlier or later than expected
by the user, (2) errant flight paths or tipping over of rockets, and (3) inappropriate use.
During 1999, CPSC's Office of Compliance increased its investigation of the sale
of illegal fireworks. Compliance was involved in seizures of illegal devices, injunctions
against manufacture of illegal devices and criminal cases for violation of the Federal
Hazardous Substances Act.
12
References
Greene MA (1999), "1998 Fireworks-Related Injuries," U. S. Consumer Product Safety
Commission, Washington, DC.
Kessler E and Schroeder T (1998), "The NEISS Sample(Design and Implementation),"
U. S. Consumer Product Safety Commission, Washington, DC.
Marker D, Lo A, Brick M and Davis W(1999), "Comparison of National Estimates from
Different Samples and Different Sampling Frames of the National Electronic Injury
Surveillance System (NEISS)," Final Report prepared for the U. S. Consumer Product
Safety Commission, Westat. Rockville, MD.
Schroeder T (2000), "Trend Analysis of NEISS Data." U. S. Consumer Product Safety
Commission, Washington, D. C.
U.S. Consumer Product Safety Commission (2000), "Saving Lives and Keeping Families
Safe," 1999 Performance Report. Washington, D. C.;
www.cpsc.gov/about/gpra/gpra.html.
13
) )
Appendix
In-Depth Investigations
Task Number Age Sex Treatment Disposition Diagnosis Body Part Type of Apparent Cause Medical Treatment and
Date Fireworks Prognosis
990706HEP9001 9 Male 990624 TRANSF BURNS, FACE Cracker/size Victim throwing fireworks into 1st and 2nd degree burns to
THERMAL unk a septic tank that ignited. face,victim will recover.
990708HEP9007 43 Male 990705 HOSP OTHER EYEBALL Bottle Rockets NA NA
990708HEP9008 33 Male 990704 HOSP BURNS, HAND Cracker/size Relit firework that exploded in NA
THERMAL unk his hand.
990713HEP9007 15 Male 990703 HOSP BURNS, IIAND Cracker/large Victim cut open an M-100 and Victim will recover From
THERMAL ignited the powder. Bums.
990713HEP9008 22 Male 990702 HOSP LACERATION HAND Large Victim ignited an M-80 inside a Severe lacerations to the
Firecrackers mobile home hand.
990713HEP9009 9 Male 990630 HOSP BURNS, UPPER LEG Bottle Rockets NA NA
THERMAL
990713HEP9010 39 Male 990705 HOSP BURNS, EYEBALL Reloadable Homemade mortar firework NA
TIIERMAL Shells exploded while hand)^_d.
990713HEP9013 18 Male 990704 HOSP LACERATION EYEBALL Bottle Rockets Victim injured by off course Victim needs lens and
Texas Pop Rocket corneal replacement. Return
of full vision not expected.
990714HEP5361 12 Male 990707 1IOSP BURNS, LOWER Sparklers Brother poured alcohol on Complete recovery expected.
THERMAL TRUNK victim's shirt and ignited with
firework.
990714HEP8213 10 Male 990707 HOSP BURNS, 25-50%OF Cracker/size Victim lit fireworks in his Full recovery expected.
THERMAL BODY unk pocket,which ignited his pants.
990714HE1'9003 2 Male 990703 TRANSF BURNS, LOWER Relradable Firework ignited by victim's Full recovery expected.
THERMAL TRUNK Shells father. Tipped over and struck
victim.
Task Number Age Sex Treatment Disposition Diagnosis Body Part Type of Apparent Cause Medical Treatment and
Date Fireworks Prognosis
990719CEP9004 33 Male 990703 TRANSF LACERATION LOWER Cracker/size NA NA
TRUNK unk
990722HEP7812 10 Male 990701 TR/REL BURNS, UPPER LEG Cracker/size NA NA
TIIERMAL unk
990722HEP9007 17 Male 990703 TR/REL FRACTURE FINGER Large Victim picked up a lit M-80 that Full recovery expected.
Firecrackers exploded in his hand
990722HEP9008 17 Female 990704 TR/REL BURNS, IIAND Cracker/size NA NA
THERMAL unk
990722IIEP9012 17 Male 990704 TR/REL CRUSHING HAND Large M-80 exploded in victim's hand. Full recovery expected.
Firecrackers
990722HEP9013 13 Male 990704 TR/REL OTHER EYEBALL Unknown Victim injured by debris from Loss of vision in one eye
fireworks. from injury. Recovery
uncertain.
990722f IEP9014 25 Male 990704 TR/REL CRUSHING HAND Reloadable Mortar fuse burned quicker than Full recovery expected.
Shells expected by victim.
990722HEP9015 20 Male 990704 TR/REL FRACTURE FINGER Unknown Firework exploded in victim's Full recovery expected.
hand
990722IlEP9016 36 Female 990623 TR/REL FRACTURE FINGER Large NA NA
Firecrackers
990722HEP9017 41 Male 990704 TR/REL FRACTURE FINGER Reloadable Mortar fuse burned quicker than Full recovery expected.
Shells expected by victim.
9907221IEP9018 40 Male 990705 TR/REL BURNS, EYEBALL Other Rockets Spark from rocket went into Victim has had laser surgery
TIIERMAL victim's eye. and a cornea transplant. Full
recovery uncertain.
990722HEP9019 26 Male 990705 TR/REL FRACTURE ELBOW Other Rockets NA NA
990722I1EP9020 21 Female 990705 TR/REL BURNS, IIAND Roman Candles Firework exploded in victim's Full recovery expected.
THERMAL hand
990723IIEP9006 4 Male 990704 IIOSP BURNS, FACE Unknown NA NA
TIIERMAL
Task Number Age Sex Treatment Disposition Diagnosis Body Part Type of Apparent Cause Medical Treatment and
Date Fireworks Prognosis
990723HEP9007 18 Male 990701 TR/REL LACERATION FINGER Large M-80 exploded in victim's hand, Scarring and limited motion
Firecrackers when he attempted to relight it. likely. Full recovery
uncertain.
990723HEP9008 14 Male 990705 TR/REL BURNS, FACE Reloadable Victim bent over to relight a Bums to the cheek and face.
THERMAL Shells firework,which exploded before Full recovery expected.
he could light it.
990723HEP9009 14 Female 990704 TR/REL BURNS, UPPER LEG Reloadable Wind blew over a lit rocket that Full recovery expected.
TIIERMAL Shells hit the victim.
990723HEP9010 10 Female 990704 TR/REL CONTUSIONS, FACE Bottle Rockets Errant bottle rocket hit victim in Full recovery expected.
ABR. the face.
99072311EP9011 24 Female 990705 TR/REL BURNS, SIIOULDER Other Rockets NA NA
THERMAL
990726HEP9005 9 Male 990721 TR/REL LACERATION FINGER Reloadable Victim's finger was cut by Full recovery expected.
Shells already exploded mortar shell
990728HEP9005 12 Male 990718 TR/REL CONTUSIONS, EYEBALL Bottle Rockets Pebble hit victim's eye while Full recovery expected.
ABR. firing a bottle rocket
990728HEP9006 36 Male 990704 TR/REL BURNS, HAND Reloadable Patient struck in the chest by a Full recovery expected.
THERMAL Shells mortar type firework,burning
chest,hand,face and arm.
990728HEP9007 39 Male 990705 TRANSF AMPUTATION FINGER Reloadable Explosion of mortar shell NA
Shells resulted in partial thumb
amputation and burn to cornea.
990728HEP9008 18 Male 990704 TR/REL OTHER EYEBALL Large NA NA
Firecrackers
9907291 IEP901 I 16 Male 990714 IlOSP AMPUTATION FINGER Large M-80 exploded before victim NA
Firecrackers could throw. Partial amputation
of thumb and two other fingers.
) ) )
Task Number Age Sex Treatment Disposition Diagnosis Body Part Type of Apparent Cause Medical Treatment and
Date Fireworks Prognosis
99080411EP9006 19 Male 990705 TR/REL BURNS, IIAND Ground Victim lighting spinning wheel Full recovery expected.
THERMAL Spinners and firework in a moving vehicle
Novelties which exploded in his hand.
990804HEP90I0 20 Male 990718 HOSP AMPUTATION FINGER Large M-80 exploded in hand before Partial recovery expected
Firecrackers he could throw it.Partial after prolonged physical
amputation of thumb. therapy.
. � .
2001 Fireworks Annual Report
Fireworks-Related Deaths, Emergency Department Treated Injuries,
and Enforcement Activities During 2001
June 2002
Michael A. Greene
Division of Hazard Analysis
Directorate for Epidemiology
U.S. Consumer Product Safety Commission
Patrick M. Race
Office of Compliance
U.S. Consumer Product Safety Commission
EXHIBIT
1
Executive Summary
This report provides the results of the U. S. Consumer Product Safety
Commission(CPSC) staff analysis of data on fireworks-related injuries and deaths during
2001. The report also includes a summary of CPSC enforcement activities during that
year.
We obtained information on fireworks deaths primarily from news clips in
CPSC's Injury/Potential Injury Incident(IPII) database. We estimated fireworks injuries
from CPSC's National Electronic Injury Surveillance System (NEISS). More detailed
analyses of injuries including the type of injury and the firework involved were based on
a special study conducted between June 22 and July 22, 2001.
Highlights of the report are as follows:
• CPSC has reports of 4 deaths from fireworks in 2001. CPSC received reports of 10
deaths in 2000.
• Fireworks devices were involved in an estimated 9,500 injuries treated in U. S.
hospital emergency departments during calendar year 2001. CPSC estimated that
there were 11,000 injuries in 2000. The year 2000 had the highest annual injury
totals since 1994, most likely related to increased fireworks sales associated with the
millennium celebrations.
• An estimated 5,700 fireworks-related injuries were treated in U. S. hospital
emergency departments during the one month special study period surrounding the
Fourth of July, 2001 (June 22, 2001 —July 22, 2001). This was 900 fewer injuries
than the year 2000 for the same period. Highlights of the special study were as
follows:
Firecrackers were associated with the greatest number of injuries at 1,500,
followed by rockets at 1,200.
About three times as many males were injured as females.
Injuries to children were a major component of total fireworks-related injuries
with children under 15 accounting for about half the number of injuries.
In terms of per capita injuries, children 10-14 had the highest risk of injury at 6.5
emergency department treated injuries per 100,000 people, followed by children
15-19 (5.1 injuries) and 5-9 (4.0 injuries).
Sparklers accounted for about one third of the injuries to children under 5.
Children 5-14 were injured about equally by firecrackers, rockets and other
devices.
The parts of the body most often injured were hands (estimated 1,800 emergency
department visits), eyes (1,600 visits), and the head/face/ear region(900 visits).
Over half the injuries involved burns. Bums were the most frequent injury to all
parts of the body except the eyes,where contusions, lacerations, and foreign
bodies were the most frequent types of injuries.
• CPSC conducted telephone follow-up investigations of some of the more serious
fireworks injuries that occurred during the month surrounding the July 4`h holiday.
Findings from these investigations included the following:
Some of the causes of injuries included delayed or early fireworks explosions,
errant flight paths of rockets, debris from aerial fireworks and mishandling of
sparklers.
While most victims had recovered from their injuries before the telephone survey,
a few injuries may have resulted in permanent loss of function. Some of these
injuries led to blindness and blurring of vision, while another injury involved
partial finger amputation.
Most victims who knew where the fireworks were obtained, reported that they
came from a stand,rather than a store. No victims reported obtaining fireworks
from mail order or over the intemet.
• During 2001, CPSC's Office of Compliance and U. S. Customs Service surveillance
ran at a high level due to the volume of fireworks entering the country for the July 4`h
holiday celebrations. About 400 shipments that were suspected to be in violation of
CPSC's regulations were sampled. We found more than one-third of these shipments
representing more than 1.7 million units were in violation of CPSC's fireworks
regulations.
• CPSC staff also initiated and participated in several multi-state criminal
investigations. These investigations led to the execution of several search warrants
and the indictments of at least five people. As a result of these investigations, several
criminal defendants will be prosecuted during 2002.
Table of Contents
Introduction 1
Fireworks-related Deaths for 2001 2
National Injury Estimates for 2001 3
Injury Estimates for the 2001 Special Study 5
Fireworks Device Types and Injury Dispositions 5
Age and Sex of Injured Persons 7
Agc of the Injured Person by Type of Fireworks Device 8
Injury Diagnosis and Body Part Injured 10
Type of Fireworks Device and Body Part Injured 10
Hospital Disposition 11
Investigations of Fireworks Injuries 12
Hazard Patterns 12
Long Term Consequences of Fireworks-related Injuries 13
Where Were Fireworks Obtained? 13
Enforcement Activities 14
Discussion 14
References 16
Appendix Al
Introduction
This report describes injuries and deaths associated with fireworks during 2001.
The report also describes CPSC enforcement activities for 2001.
Fireworks deaths were obtained from the CPSC Injury/Potential Injury Incident
file (IPII). Data for the IPII file come from news clips, consumer complaints and reports
from government agencies. Because reporting is voluntary, there may have been
fireworks deaths that were not reported to any of these sources, and are not included
among the deaths in this report. As a result,the number of deaths from fireworks-related
injuries might be greater than reported here.
Emergency department treated injuries for fireworks in 2001 were obtained from
CPSC's National Electronic Injury Surveillance System(NEISS). NEISS is a probability
sample of U. S. hospitals with emergency departments.' All estimates for the number of
injuries in this report were obtained using the hospital totals and the sampling weights in
NEISS. These estimates reflect emergency department treated injuries for the entire
country.
The detailed analysis of injuries in hospital emergency departments in this report
is based on a special study of fireworks injuries treated between June 22, 2001 and July
22, 2001. This special study focused on the types of fireworks involved in these injuries.
Victims were shown illustrations of fireworks at emergency departments to help them
identify the device associated with the injury. The type of fireworks device was not
usually recorded during the rest of the year.
Also, during the special study period, CPSC initiated in-depth investigations of 62
fireworks injuries from the injuries treated at NEISS hospitals. These investigations
focussed on injuries involving amputations, eye injuries, or injuries requiring hospital
admissions. Victims were telephoned and read a questionnaire. These investigations
were intended to determine how the most serious injuries occurred, the medical treatment
involved and the long-term consequences of the injuries. Victims were also asked where
the device was obtained.
In this report, injury estimates derived from NEISS are rounded to the nearest 100
injuries. Estimates of less than 50 injuries are shown with an asterisk (*). Totals may not
add due to rounding.
Although a number of different analyses are provided in this report for different
categories of injuries, including the age distribution of victims and the types of fireworks
involved in the injury, interpretation of these estimates should be made with caution.
This is because estimates based on small sample sizes have relatively large amounts of
For a description of NEISS,including the revised sampling frame,see Kessler and Schroeder(1998).
Procedures used for variance and confidence interval calculations,and adjustments for the sampling frame
change in 1997 are found in Marker,Lo, Brick,and Davis(1999). SAS statistical software for trend and
confidence intervals is documented in Schroeder(2000).
1
sampling variability. For example, when comparing subsets of the data, say between
injuries associated with two different types of fireworks, or between two different years,
it is difficult to determine how much of the difference between estimates is associated
with sampling variability and how much comes from real differences in national injury
totals.
Fireworks-related Deaths for 2001
CPSC has reports of 4 non-work related deaths that occurred from fireworks
during 2001.2 This compares with reports of 10 deaths that occurred from fireworks
during 2000.3 Brief descriptions of the 2001 incidents are as follows:
• A 36 year old Indiana man was killed from shrapnel when a firework that he had
made exploded.
• Another Indiana man,46 years old, sustained severe injuries to his face and neck
when a lit aerial firework exploded while he was looking in the launching tube. His
wife told CPSC investigators that he died from those injuries.
• A 30 year old Pennsylvania man twisted several fuses from explosive sticks together
and lit them. He was killed from the blast.
• A Texas woman, 33 years old, died in a mobile home fire. Fireworks landing on a
sofa outside her mobile home may have ignited the sofa and then the home, according
to a newspaper article.
According to the Centers for Disease Control and Prevention, there were an average of
6.1 deaths per year from fireworks incidents between 1988 and 1999.4
2 We originally reported 8 fireworks deaths for 2001 which included four deaths in a house fire in Texas.
New information,gathered since CPSC's initial report,found that the cause of these deaths had been
erroneously reported in the newspaper as fireworks.
3 See Greene MA and Race PM(2001),"2000 Fireworks Annual Report:Fireworks-Related Deaths,
Emergency Department Treated Injuries, and Enforcement Activities During 2000," US Consumer Product
Safety Commission,Washington,DC.
4 Data from Center for Disease Control and Prevention,CDC Wonder Compressed Mortality file for 1988-
^ 1999,for ICD 9 code 923.0 and ICD 10 code W39. See www.cdc.gov/wonder.
2
National Injury Estimates for 2001
Table 1 and Figure 1 present the estimated number of fireworks-related injuries
for 1991 through 2001 that were treated in U. S. hospital emergency departments.
Table 1
Estimated Fireworks-Related Injuries 1991-2001
Year Estimated Injuries Injuries per 100,000 people
2001 9,500 3.3
2000 11,000 3.9
1999 8,500 3.0
1998 8,500 3.1
1997 8,300 3.0
1996 7,300 2.7
1995 10,900 4.1
1994 12,500 4.8
1993 12,000 4.7
1992 12,500 4.9
1991 10,900 4.3
Source: NEISS,U. S.Consumer Product Safety Commission/EPHA. There were 291 fireworks-related
injuries recorded in NEISS hospital emergency departments during 2001. Estimates for 1991-1996 were
revised to adjust for the new sampling frame and do not match values published in reports for 1997 or
earlier.Injury estimates rounded to nearest 100 injuries.Cases were weighted by the NEISS sampling
weights. U. S.Population estimates from eire.census.gov/popest/data/counties/tables/CO-EST2001-
12/CO-EST2001-I2-00.php for 1991-2000 and from eire.census.gov/popest/data/national/tables/NA-
EST2001-01.php for 2001.
3
Figure 1. Fireworks Injuries 1991-2001
0
0
o —
to
0
0
o -
N
0
O
0 -
O
L O
N O -
O
f0
E
N
W O
o —
O
rn
O
O —
O
- O
O _
O
r I
1992 1994 1996 1998 2000
Year
In 2001,there were an estimated 9,500 fireworks injuries for the calendar year
(95% confidence interval 7,100— 11,900 injuries).
Total emergency department treated injuries and per capita injuries declined in
2001 from the higher levels experienced during the millennium year of 2000. Table 2
shows that much of the difference in total injuries resulted from differences in the months
of January and July. In typical years, there are relatively few injuries in January. The
year 2000 with celebrations marking the millennium was not typical.
4
Table 2
Comparison of 2001 Fireworks Injuries with 2000 Fireworks Injuries by Month
Month 2001 2000 Changes
Total Injuries 9,500 11,000 -1,600
January 400 1,400 -1,000
February 100 * 100
March 200 100 100
April 200 200 0
May 100 100 -100
June 1,000 1,000 0
July 6,000 6,900 -800
August 200 400 -200
September 300 300 0
October 200 200 0
November 400 100 300
December 300 400 0
Source: NEISS,U. S.Consumer Product Safety Commission/EPHA. Estimates rounded to the
nearest 100 injuries. Totals may not add due to rounding.
Injury Estimates for the 2001 Special Study
The remainder of the injury analysis in this report presents the results of the 2001
study of hospital emergency department treated fireworks injuries that occurred between
June 22 and July 22, 2001. During this period, there were an estimated 5,700 fireworks-
related injuries (95%confidence interval 3,800-7,500). Estimates are derived from the
actual number of visits and sampling weights. There were 177 visits to NEISS hospital
emergency rooms for fireworks related injuries during the special study period.
Fireworks Device Types and Injury Dispositions
Table 3 shows the number of injuries by fireworks device type.
5 Both 2001 and 2000 monthly totals and the change in injuries are rounded to the nearest 100 injuries.
This makes the change column look wrong for May,July and December. Unrounded estimates for May are
126(2001),73(2000)and 53 (Change). All these numbers round to 100. Rounding also produces the
apparent addition mistakes in July and December.
5
Table 3
Estimated Fireworks-Related Injuries
By Type of Fireworks Device
June 22-July 22, 2001
Fireworks Device Type Estimated Injuries
Total 5,700
Firecrackers 1,500
Small 600
Illegal 200
Unspecified 700
Rockets 1,200
Bottle Rockets 1,000
Other,Unspecified 200
Other Consumer Devices 1,300
Sparklers 60C
Fountains 100
Reloadable Aerial Shells 200
Roman Candles 300
Helicopters 100
Homemade/Altered 100
Unspecified 1,600
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. Based on 177 reported emergency
department visits between June 22,2001 and July 22,2001. See notes for table 1. Totals may not add due
to rounding. Estimates rounded to nearest 100 injuries.
As shown in Table 3, firecrackers accounted for about 25 percent(1,500) of all
injuries that occurred during this period. Among firecrackers, illegal, large firecrackers,
such as M-80's were involved in 200 estimated injuries. This was less than 5 percent of
the total injuries. Among legal consumer devices, rockets (1,200 injuries) and sparklers
(600 injuries)were most often found as the fireworks type. Bottle rockets accounted for
1,000 of the 1,200 rocket injuries.
6
Age and Sex of Injured Persons
Children under 5 experienced 10 percent (600 injuries) of all fireworks-related
injuries as shown in Table 4. Children in the 5 to 14 age group accounted for 35 percent
(estimated 2,100) of the fireworks-related injuries. Together, children under 15
accounted for about half the fireworks injuries.
The age groups 15 to 24 had 25 percent of the injuries (1,300) as did the 25 to 44
age group (1,400 injuries). People over 45 experienced about 5 percent of the injuries.
Males had 4,400 injuries,representing about 75% of the total.
The injury rates per 100,000 population were highest among children aged 10 to
14 with 6.5 injuries per 100,000 people. Children between 5 and 14 years of age had 5.3
injuries per 100,000 people, followed by children under 5 with 3.0 injuries per 100,000
people. Young adults 15 to 19 had 5.1 irjuries per 100,000 people.
7
Table 4
Estimated Fireworks-Related Injuries
By Age and Sex
June 22-July 22,2001
Age Group Total Male Female Injuries per
(years) 100,000 people
Total 5,700 4,400 1,300 2.0
Less Than 5 600 500 100 3.0
5 To 14 2,100 1,700 400 5.3
5 To 9 800 700 100 4.0
10 To 14 1,300 1,000 300 6.5
15 To 24 1,300 1,200 '00 3.3
15 To 19 1,000 1,000 * 5.1
20 To 24 300 200 100 1.4
25 To 44 1,400 1,000 400 1.9
45 To 64 300 100 200 0.5
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. Notes: See Table 3.US population
from www.census.gov/population/projections/nation/summary/np-t3-b.txt. People over 65 had less than 50
injuries. That row is not shown in the table,but the injuries are counted in totals.
Age of the Injured Person by Type of Fireworks Device
Table 5 presents the ages of those injured by the type of fireworks device
involved in the injury. Sparklers were associated with the most injuries for children
under 5. For 5-14 year olds and for 15-24 year olds, firecrackers, other devices
(including sparklers) and rockets were the source of injuries. Young adults, 15-24 years
old were more likely to be injured by firecrackers than any other device.
8
Table 5
Estimated Fireworks-Related Injuries
By Device Type and Age Group
June 22-July 22, 2001
Age Group (Years)
Fireworks Type Totals <5 5-14 15-24 25-44 45-64
Total 5,700 600 2,100 1,300 1,400 300
Firecrackers 1,500 100 500 600 300 *
Small 600 100 300 200 * *
Illegal 200 * * 200 * *
Unspecified 700 * 200 200 300 *
Rockets 1,200 * 500 300 400 100
Bottle 1,000 * 400 200 300 100
Other 200 * 100 * 100 *
Other Devices 1,300 300 500 100 500 100
Sparklers 600 200 200 * 100 100
Fountains 100 * 100 * * *
Various 600 100 100 100 300 *
Homemade/Altered 100 * * * * *
Public Display * * * * * *
Unspecified 1,600 200 600 400 300 100
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. Notes: See Table 3. Other Devices:
Various include fountains,novelties, multiple tube and shells,reloadable shells and Roman candles.
People over 65 had less than 50 injuries. That column is not shown in the table,but the injuries are counted
in totals.
9
Injury Diagnosis and Body Part Injured
Table 6 presents the types of injuries sustained to specific parts of the body.
Hands and fingers with an estimated 1,800 injuries, accounted for 30 percent of the total
injuries. There were almost as many eye injuries, at 1,600, as hand and finger injuries.
With 900 total injuries, head and face injuries were about 15 percent of the total.
Burns with 3,300 estimated injuries and 60 percent of the total,were the most
frequent diagnosis. Contusions and lacerations, at 1,100 injuries and 20 percent of the
total were the second most frequent. Also, contusions/lacerations, and foreign bodies
(the latter counted in other diagnoses) were the most common eye injuries. Head and
facial injuries involved more burns than contusions or lacerations.
Table 6
Estimated Fireworks-Related Injuries
By Body Part and Diagnosis
June 22-July 22, 2001
Body Part Total Burns Contusions Fractures Other
Lacerations Sprains Diagnoses
Total 5,700 3,300 1,100 100 1,100
Arm 400 100 100 100 100
Eye 1,600 400 500 * 600
Hand/Finger 1,800 1,600 100 * 100
Head/Face/Ear 900 400 300 * 200
Leg 600 500 * * 100
Trunk 500 300 100 100
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. Notes: See Table 3. Fractures and
sprains also included dislocations. Other diagnoses included all other injury categories. Arm includes
NEISS codes for upper arm, elbow,lower arm,shoulder and wrist. Head,Face,Ear includes eyelid,eye
area,nose,neck,and mouth. Leg includes upper leg,knee,lower leg,ankle,foot and toe. Trunk includes
lower trunk,upper trunk,pubic region,all parts of body,internal and 25-50%of body.
Type of Fireworks Device and Body Part Injured
Table 7 below presents estimated injuries by the fireworks device and body part
involved. Firecracker injuries occurred most frequently to the hand(500 injuries) or the
10
head/face/ear region(also 500 injuries). Typically,victims sustained injuries from
firecrackers while holding the device, or attempting to release it after ignition. Rockets
were associated mainly with eye and hand injuries. Victims sustained injuries from
erratic rocket flight patterns, or burning debris from the rocket. Sparkler injuries
typically involved bums to the hands or sparks getting into the eyes.
Table 7
Estimated Fireworks-Related Injuries
By Type of Fireworks Device and Body Part Injured
June 22-July 22, 2001
Type of Hands Head
Fireworks Device Total Arm Eye Fingers Face/Ear Leg Trunk
Total 5,700 400 1,600 1,800 900 600 500
Firecrackers 1,500 * 200 500 500 100 200
Rockets 1,200 100 400 300 200 200
Sparklers 600 * 200 300 * 100 100
Homemade/Altered 100 * * * * * *
Public Display
Other 700 * 300 300
Unspecified 1,600 200 500 400 100 200 200
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. Notes: See Table 3.Body parts are
defined in table 6. Firecrackers include small,illegal and unspecified firecrackers;rockets include missiles,
bottle rockets,stick rockets and unspecified rockets,other includes helicopters,Roman candles,reloadable
aerial shells and fountains.
Hospital Disposition
Although most of these fireworks-related injuries were characterized as "treat and
release," an estimated 12 percent required hospital admission or transfer to another
hospital for treatment. This was somewhat higher than the hospitalization and
treat/transfer rate of 4 percent for all consumer product related injuries for 2001.
The 12 percent admit or transfer rate was consistent for all age groups except
children under 5 who were admitted or transferred 5 percent of the time. People injured
by rockets and unspecified fireworks types were admitted or transferred at higher rates (at
20 and 14 percent respectively) than other victims. People with a diagnosis of eye injuries
also were admitted or transferred at 14 percent. These findings are connected because as
shown in table 7, about one quarter of eye injuries were caused by rockets and about one
11
third were caused by unspecified types of fireworks. However,the number of cases with
dispositions other than treat and release is relatively small so these conclusions are
somewhat tenuous.
Investigations of Fireworks Injuries
CPSC conducted telephone investigations of the more serious fireworks injuries
that occurred during the month surrounding the July 4 holiday. Injuries were selected for
follow-up when they involved the eye, amputations, or when the victim was either
admitted to the hospital or transferred to another facility for treatment. These injuries
were selected to develop information on potential long-term health effects of the injury
and on how serious incidents occurred. Investigations were also conducted when the
injury was suspected to result from the use of illegal fireworks.
Victims were asked about the hazard patterns associated with the injury, their
medical care following the emergency department treatment, and about long term
consequences of the injury. They were also asked about the source of the fireworks that
caused the injury.
There were 30 completed investigations and 32 other cases with investigations
assigned that could not be completed. The main reasons for the incomplete investigations
were that the victim could not be contacted or refused to cooperate.
Summaries of the investigations are found in the Appendix to this report. The
investigations are organized in order of emergency department disposition: "Admit to
Hospital" followed by"Treat and Transfer" followed by"Treat and Release."Within
disposition, cases are sorted by sex and increasing age. CPSC Task numbers are given in
parentheses following the discussion of the case.
Hazard Patterns
Among investigated cases, errant flight paths for rockets were implicated in six
cases (C10712HEP9014, 010712HEP9001, 010713HEP9010, 010717HEP9002,
010720HEP9013 and 010829HEP5921). Other rocket-related injuries were associated
with misaiming (010720HEP9014, 10720HEP9021, 10709HEP9025, and
010717HEP9017), a wick that flew off(10720HEP9017) and a bottle rocket that bent
back after ignition(10729HEP9018). All these events resulted in eye or face injuries
Fireworks exploding earlier or later than expected by the victim also were
associated with injuries. A ground spinner flashed back at a victim burning his face and
hand (010905HEP9002), an unknown firework exploded in a victim's hand resulting in
finger amputation(010807HEP9001), sparks from a Roman candle burned another
victim's eyes (010706HEP9015), a firecracker of unknown type blew up while the victim
12
was trying to light it (010706HEP9013), and another exploded while the victim was
holding it (010706HEP9014). Two similar injuries occurred with fountains. One
fountain flashed when lit(010713HEP9011) and another fountain exploded while a man
was lighting it(010709HEP9019).
Victims also experienced eye injuries from aerial fireworks in two cases
(010731HEP9001 and 010717HEP9014).
Finally, mishandling of sparklers resulted in three injuries. Two young males got
sparks in their eyes (010720HEP9011 and 010713HEP9009),while a teen-ager was
injured when he lit a bag containing a number of sparklers that subsequently exploded
(010717HEP9016).
Long Term Consequences of Fireworks-related Injuries
Victims were asked if there were any long term consequences of their injuries.
Three of 30 victims told telephone investigators that full recovery was not expected. A 9
year old victim of a badly aimed bottle rocket suffered damage to the optical nerve and
will be permanently blind in one eye(010720HEP9014). A 14 year old male who was
struck by a bottle rocket, experienced a torn retina and will be legally blind in that eye
(10720HEP9013). Finally, a 19 year old male who picked up a firework of unknown
type experienced amputation of the tip of his index finger. The fractured bones in his
index finger and thumb will heal (10807HEP9001).
For other victims, recovery is not certain or the victim could not estimate the time
to recovery. One example was a 10 year old male with a lacerated cornea and bruised
retina from the impact from a bottle rocket. He was treated by an eye specialist and
might be partially blind(010712HEP9014). In another case, a 29 year old female had a
firecracker blow up when trying to throw it. Her vision is expected to return,but the time
period is uncertain(010706HEP9013). Also, a 13 year old male was injured when a
fountain flashed when lit. Full recovery is expected but the time to recovery is uncertain
(10713HEP9011).
Where Were Fireworks Obtained?
In the telephone interview, victims were asked where the fireworks that caused
the is juries were obtained. Of the 30 victims with telephone interviews,the largest
number, 16, did not know where the fireworks were acquired. In most cases, this is
because the victim was not the person who lit or acquired the fireworks.
For the 14 victims who were aware of the source of the fireworks, most(9)
reported that the fireworks came from a stand. Often the stand was on a highway or main
road and was reported to be open only for the 4`h of July season. Three other respondents
said that fireworks were obtained from a store. Two respondents said that friends or
13
relatives gave them the fireworks,but they did not know further where the friends
obtained the fireworks.
Enforcement Activities
CPSC's Office of Compliance took a multifaceted approach in its enforcement
activities regarding fireworks in 2001. It used a variety of enforcement techniques and
initiatives to keep dangerous and unsafe fireworks from consumers.
As part of this approach, the CPSC staff continued its work with the U.S.
Customs Service to conduct surveillance on imported shipments of fireworks to ensure
that those shipments met CPSC's regulations. From the thousands of fireworks
shipments entering the U. S., CPSC and Customs sampled approximately 400 shipments,
to determine if they complied with regulations. We found more than one-third of the
shipments we sampled to contain fireworks that violated CPSC fireworks regulations.
These shipments accounted for more than 1.7 million units with violations serious
enough to warrant seizure or other actions by the U.S. Customs Service.
Another enforcement activity that was assigned priority was investigation into
firms and individuals that offer kits and components used to make illegal and dangerous
firecracker type explosives such as M80's and Quartersticks. Also, CPSC staff initiated
investigations into pest control devices for sale via mail order or over the internet. These
devices are offered as agricultural or wildlife control devices but are frequently sold in
violation of Federal law. CPSC staff initiated several investigations into firms engaged in
this business.
The Office of Compliance also initiated and participated in several multi-state
criminal investigations. These investigations led to several search warrants during 2001
and the indictment of at least five individuals. CPSC staff worked cooperatively with
other Federal agencies such as the Bureau of Alcohol, Tobacco and Firearms and state
and local law enforcement agencies. CPSC staff provided legal, field and technical
support in several cases involving the large-scale distribution of illegal explosive devices
and illegal diversion of professional display fireworks to consumers. These criminal
investigations led to the seizure of thousands of illegal firecracker-type explosive devices
and illegally diverted professional fireworks. Several of the individuals who were the
subjects of these investigations will be prosecuted in 2002.
Discussion
Both injuries and deaths decreased from 2000. There were 4 fireworks deaths
reported in 2001, six fewer than reported in 2000. The total number of estimated
fireworks injuries for 2001 was 9,500. This was 1,500 injuries less than in 2000,the
year with the highest number of injuries since 1995. The per capita injury rate decreased
14
to 3.3 injuries per 100,000 people in 2001 from the 2000 rate of 3.9 injuries per 100,000
people.
During the one-month special study period of June 22 to July 22, there were an
estimated 5,700 injuries, about 900 fewer than in 2000 and the same number as estimated
in 1999. Children under 15 years old accounted for about half the number of injuries.
Children aged 10-14 were at highest risk of injury(6.5 injuries per 100,000 people),
followed by young adults 15-19 (5.1) and children 5-9 (4.0). Males were three times
more likely to be injured as females.
Firecrackers caused the most injuries, followed by bottle rockets and sparklers.
Sparklers were associated with about one third of the injuries to children under 5.
Children 5-14 were injured about equally by firecrackers, rockets and other devices.
Over half the injuries involved burns. Parts of the body most often injured were
the hands, eyes and head/face/ear region.
A review of data from a telephone follow up survey of people injured by
fireworks showed that typical causes of injuries included(1) fireworks exploding earlier
or later than expected by the user, (2) badly aimed rockets or rockets with errant flight
paths, (3)mishandling of sparklers and (4) debris from aerial fireworks. We also
discovered from the telephone survey that most victims already had or will recover from
their fireworks injuries. But several victims experienced severe eye injuries that could
result in permanent blindness.
Enforcement activities remained at a high level. CPSC's Office of Compliance
worked with U.S. Customs to sample imported fireworks and seize illegal shipments.
CPSC staff also initiated investigations of firms and individuals who offered kits and
components to make illegal and dangerous firecrackers. Several of these sales involved
use of the internet.
Also during 2001, CPSC staff provided legal, field and technical support in cases
involving large-scale distribution of illegal explosive devices and illegal diversion of
professional display fireworks to consumers. These investigations have led to seizures of
tons of fireworks and will lead to prosecution of several individuals.
15
References
Greene MA (1999), "1998 Fireworks-Related Injuries,"U. S. Consumer Product Safety
Commission,Washington, DC.
Greene MA and Race P (2000), "1999 Fireworks Annual Report: Fireworks-Related
Deaths, Emergency Department Treated Injuries, and Enforcement Activities During
1999,"U. S. Consumer Product Safety Commission, Washington DC.
Greene MA and Race P (2001), "2000 Fireworks Annual Report: Fireworks-Related
Deaths, Emergency Department Treated Injuries, and Enforcement Activities During
2000," U. S. Consumer Product Safety Commission,Washington DC.
Kessler E and Schroeder T (1998), "The NEISS Sample(Design and Implementation),"
U. S. Consumer Product Safety Commission, Washington, DC.
Marker D, Lo A, Brick M and Davis W (1999), "Comparison of National Estimates from
Different Samples and Different Sampling Frames of the National Electronic Injury
Surveillance System(NEISS)," Final Report prepared for the U. S. Consumer Product
Safety Commission, Westat. Rockville, MD.
Schroeder T (2000), "Trend Analysis of NEISS Data." U. S. Consumer Product Safety
Commission,Washington, D. C.
16
•
) ) )
Appendix
Completed Telephone Investigations
Task Number Age Sex Treatment Fireworks Diagnosis Disposition Body Apparent Cause Medical Treatment and Prognosis
Date Type Part
0I0829HEP5921 2 Male 7/4/01 Unknown Burns,Thermal Admit to Upper Firework on errant flight path 2nd degree burns on chest and right thigh,skin
Hospital Trunk grafls.Clothing ignited
OI0706llEP9014 10 Male 6/29/0 I Small Bums,Thermal Admit to Face Victim held firework too long Burned eye,blurred vision,Continuing visits to
Firecracker Ilospital opthalm. Full recovery expected.
010905IIEP9002 37 Male 7/5/01 Ground Burns,Thermal Admit to Face, Firework flashed back at victim Treated for 2nd degree bums and released next day.
Spinner Hospital Hand hunting face and hand Recovered
01071211EP9014 10 Male 7/4/01 Bottle Rocket Lacerated cornea, Treat and Eye Errant flight path Treated by eve specialist. Might be partial
bruised retina Transfer blindness. Full recovery uncertain
01071711EP9016 13 Male 7/4/01 Sparkler Bums,Thermal Treat and Hand Sparkler lit hag containing other 2nd and 3rd degree bums to fingers and palm.
Transfer sparklers that blew up in victims Recovered.
hand
010712HEP9001 15 Male 7/7/01 Bottle Rocket Other Treat and Eye Errant flight path Following treatment in ER,victim recovered
Transfer
010807HEP9001 19 Male 6/30/01 Unknown Amputation, Treat and Finger Victim picket up lit firework to Amputation of index finger tip,fractured bones in
Fracture Transfer throw away from crowd,when it index finger and thumb. Expect recovery in 4
exploded in his hand months.
010709HEP9021 37 Male 7/4/01 Missile Burns,Thermal Treat and Hand Aerial firework exploded in Stitches for cuts on hand,bum treatment. Recovered
Transfer launching tube already containing
another lit firework.
010720HEP90l I 2 Male 7/4/01 Sparkler Corneal abrasion Treat and Eyc Spark in eye Victim recovered
Release
010713HE19009 3 Male 7/5/01 Sparkler Bums,Thermal Treat and Eye Spark in eye Sparkler ash removed from under eyelid.
Release Recovered.
01071311EP9010 5 Male 6/30/01 'maintain Dermatitis/Conju Treat and Eye Errant flight path Following treatment for flash burn in FR,victim
nctivitis Release recovered.
010723IIEP78I2 7 Male 7/12/01 Unknown Bums,Thermal Treat and Lower Firecracker exploded near victim's Recovered
Firecracker Release Trunk back causing hum
A-1
) ) )
010731 HEP9001 7 Male 7/5/01 Aerial Shell Burned Eyelid, Treat and Eye Debris from aerial fireworks fell into Recovered
Comcal Abrasion Release eye.
010720IIEP9014 9 Female 7/3/01 Bottle Rocket Optical Nerve Treat and Eye Misaimed bottle rocket Victim permanently blind in one eye
Damage Release
010720IIEP902 I 9 Female 7/5/01 Bottle Rocket Contusions, Treat and Face Victim got in way of rocket Recovered
Abrasions Release
010709HEP9016 9 Male 6/27/01 Unknown Contusions, treat and Eyc Hit in eye with fireworks Recovered
Firecracker Abrasions Release
OI0713HEP9008 9 Male 7/4/01 Unknown Corneal bums Treat and Eye Firework blew up near victim's eye. Following treatment by eye specialist,full recovery
Release expected
010706HEP9015 10 Male 6/29/01 Roman Candle Corneal Abrasion Treat and Eyc Victim held firework too long Sparks Full recovery expected
Release burned eyes.
010709IIEP9025 12 Male 7/4/01 Bottle Rocket Bums,Thermal Treat and Eye Bottle Rocket flew into victim's eye. Drops in eyes,recovered.
Release
010713IIEP90l I 13 Male 7/4/01 Fountain Corneal Treat and Eyc, Fountain flashed when lit. Treated at ER,debris removed from eye. Full
abrasions and Release Cornea, recovery expected but time uncertain.
burns Face
010717IIEP9002 13 Male 7/4/01 Bottle Rocket Other Treat and Eyc Errant flight path One week hospital stay following eye surgery.
Release Victim recovered.
0107I7HEP9014 14 Female 7/5/01 Aerial Shell Contusions, Treat and Eye Debris from aerial fireworks fell into Eye flushed in ER removing ash.Recovered
Abrasions Release cyc.
01072011EP9013 14 Male 7/4/01 Bottle Rocket Tom Retina Treat and Eye Errant flight path Followed up with eye specialist. Victim is legally
Release blind in one eye
0107201IEP9018 15 Male 7/5/01 Bottle Rocket Contusions, Treat and Eye Bottle rocket bent back after ignition Recovered
Abrasions Release and hit victim
010710HEP9021 16 Male 7/4/01 Unknown Corneal Abrasion Treat and Eye Black Cat firework thrown at victim, Blister under eyelid,corneal abrasion. Recovered
Release exploded,part in victim's eye.
01072011EP9017 18 Male 7/6/01 Bottle Rocket Bum Treat and Face, flit by wick of bottle rocket that shot Bum to face near eye. Full recovery.
Release Near eye off before the rocket launched
010706HEP9013 29 Female 7/1/01 Unknown Other Treat and Eye Firecracker blew up while victim was Bum in eye leaving scar. Vision blurred. Full
Firecracker Release trying to throw it. recovery expected but time period unknown.
010723IIEP9017 33 Female 7/5/01 Bottle Rocket Contusions, Treat and Face Victim leaned over lit firework RecovereI
Abrasions Release
A-2
0107091IEP9019 37 Male 7/4/01 Fountain Corneal Treat and Eye, Firework exploded in face while Recovered
Abrasion,Bums Release Neck, lighting
Face
01071711EP9017 49 Female 7/4/01 Bottle Rocket Eyc punctured Treat and Eye Misaimcd bottle rocket Bruise on eyeball,temporary blindness but full
Release vision restored.
A-3
j
Incomplete Telephone Investigations
Task Number Agc Sex Treatment Date Fireworks Type Diagnosis Disposition Body Part
010904HEP9001 0.42 Male 7/11/01 Unknown Burns,Thermal Admit to Hospital Face
010724HEP9016 4 Male 6/27/01 Unknown Bums,Thermal Admit to Hospital Unknown
01071111EP5361 8 Male 7/4/01 Bottle Rocket Bums,Thermal Admit to Hospital Upper Leg
01081411EP7814 8 Male 7/26/01 Bottle Rocket Bums,Thermal Admit to I Iospital Upper Leg
0108141IEP7813 10 Male 7/5/01 Unknown Bums,Thermal Admit to I Iospital Upper Leg
010724HEP9017 12 Maic 6/29/01 Bottle Rocket Fracture Admit to Hospital Lower Arm
010904HEP9002 14 Male 7/4/01 Unknown Bums,Thermal Admit to Hospital Upper Leg
0107171IEP9003 16 Male 7/4/01 Unknown Bums,Thermal Admit to Hospital 25-50%of Body
010720HEP9010 21 Male 7/5/01 Unknown Bums,Thermal Admit to Hospital Mouth
01070911EP9022 48 Male 7/5/01 Rocket Bums,Thermal Admit to Hospital Iland
010905HEP9005 49 Malc 7/3/01 Illegal Firecracker Bums,Thermal Admit to Hospital Hand
0107I7HEP9001 13 Male 6/29/01 Bottle Rocket Other Treat and Transfer Eye
010713I1EP9012 36 Male 7/6/01 Unknown Bums,Thermal Treat and Transfer Eye
0 t070211F.P8213 3 Female 6/10/01 Sparkler Bums,Thermal Treat and Release 25-50%of Body
010806HEP9007 5 Male 7/4/01 Unknown Firecracker Burn,Scald Treat and Release Unknown
010720HEP90I6 6 Female 7/4/01 Unknown Bum,Scald Treat and Release Eyc
010724HEP9018 6 Male 7/4/01 Roman Candle Contusions,Abrasions Treat and Release Eye
01072011EP9015 7 Male 7/6/01 Unknown Contusions,Abrasions Treat and Release Eye
010720HEP9020 7 Male 7/5/01 Bottle Rocket Contusions,Abrasions Treat and Release Eyc
010727I1EP3041 8 Male 7/16/01 Small Firecracker Bums,Thermal Treat and Release Lower Leg
01071711EP9018 9 Male 7/4/01 Unknown Bums,Thermal Treat and Release Eye
01071711EP9015 10 Male 7/5/01 Bottle Rocket Bums,Thermal Treat and Release Face
010801HEP9001 II Male 7/5/01 Bottle Rocket Other Treat and Release Eye
01071111EP9017 12 Male 7/5/01 Bottle Rocket Other Treat and Release Eye
01070311EP7812 13 Malc 6/25/01 Bottle Rocket Bums,Thermal Treat and Release Lower Leg
01070411EP5761 15 Male 6/28/01 Small Firecracker Bums,'Meitrial Treat and Release Upper Leg
010711}IEP9016 15 Male 7/9/01 Unknown Bums,Thermal Treat and Release Upper Trunk
01070911EP9024 21 Male 7/4/01 Bottle Rocket Other Treat and Release _ Eye
010718FIEP9021 37 Male 7/7/01 Small Firecracker Contusions,Abrasions Treat and Release_.. Eye
01090511EP9004 37 Male 7/3/01 Bottle Rocket Contusions,Abrasions Treat and Release _ Eye
_ 010706IIEP9016 43 Male 7/4/01 Ground Spinner Contusions,Abrasions Treat and Release Eyc
0107091{EP9020 47 Male 7/5/01 Bottle Rocket }lemon-hag Treat and Release Eye
A4
•ct a
2003 Fireworks Annual Report
Fireworks-Related Deaths, Emergency Department-Treated Injuries,
and Enforcement Activities During 2003
June 2004
Michael A. Greene
Division of Hazard Analysis
Directorate for Epidemiology
U.S. Consumer Product Safety Commission
James Joholske
Office of Compliance
U.S. Consumer Product Safety Commission
These comments are those of the CPSC staff, have not been reviewed or approved by, and
may not necessarily reflect the views of the Commission.
z- EXHIBIT
Executive Summary
This report provides the results of the U. S. Consumer Product Safety
Commission(CPSC) staff analysis of data on fireworks-related deaths and injuries during
2003. The report also includes a summary of CPSC enforcement activities during that
year.
We obtained information on fireworks-related deaths primarily from news
clippings and other sources in CPSC's Injury/Potential Injury Incident (IPII) database.
We estimated fireworks-related injuries from CPSC's National Electronic Injury
Surveillance System(NEISS). More detailed analyses of injuries including the type of
injury and the firework involved, and the characteristics of the victim were based on a
special study conducted between June 20 and July 20, 2003. About two-thirds of the
annual fireworks-related injuries occurred during that period.
Highlights of the report are as follows:
• CPSC has reports of 6 deaths associated with fireworks during 2003. Four deaths
were associated with aerial fireworks. The other deaths occurred in fires that
were started by fireworks.
• Fireworks devices were involved in an estimated 9,300 injuries treated in U. S.
hospital emergency departments during calendar year 2003. CPSC staff estimated
that there were 8,800 injuries during 2002.
• One hundred people were killed and almost 200 were injured in a fire in a
nightclub in West Warwick, Rhode Island. The fire was started with fireworks,
not classified as consumer fireworks. These victims were not included in the
number of deaths and injuries above because the incident was not typical of
fireworks-related deaths or injuries.
• An estimated 6,800 fireworks-related injuries were treated in U. S. hospital
emergency departments during the one month special study period surrounding
the Fourth of July, 2003 (June 20, 2003 -July 20, 2003). CPSC staff estimated
that there were 5,700 injuries during 2002.
Results from the special study include the following:
• About three times as many males were injured as females.
• Injuries to children were a major component of total fireworks-related injuries
with children under 15 accounting for almost half the estimated injuries.
• Among different types of fireworks, firecrackers were associated with the
greatest number of estimated injuries at 1,600, followed by bottle rockets at
1,000 and sparklers at 700. Sparklers accounted for more than half the
injuries for children under 5.
• We estimated that there were a small number of injuries (100) at public
fireworks displays.
• Firecrackers and bottle rockets were the largest single fireworks types
associated with injuries to 5 to 14 year olds. About half the victims of bottle
rocket-related injuries were to 15-24 year olds.
• The parts of the body most often injured were hands (estimated 1,800
emergency department visits), eyes (1,400 visits) and the head, face and ear
(1,200 visits).
• About two-thirds of the injuries involved bums. Bums were the most
common injury to all parts of the body except the eyes, where contusions,
lacerations, foreign bodies and burns occurred with about equal frequencies.
CPSC staff conducted telephone follow-up investigations of some fireworks-
related injuries reported at NEISS hospital emergency departments during the special
study period. About half the cases were selected for follow-up because they involved
potentially serious injuries. Such injuries included eye injuries and head injuries, finger
and hand amputations. The other cases were selected from the Fire Injury Project, a
separate CPSC staff study involving follow-up of emergency department-treated cases for
fire-related injuries that were likely to have been attended by fire departments.
Findings from the completed telephone investigations include the following:
• Some of the hazard patterns included errant flight paths of aerial fireworks,
fireworks exploding earlier or later than expected, and debris or hot material
from the fireworks device.
• While most victims recovered or expected full recovery from their injuries, a
few injuries had permanent consequences. These included several eye injuries
that could result in permanent vision impairment.
• When they knew where the fireworks were obtained, most respondents
reported that the source was a stand that sold only fireworks.
During 2003, CPSC's Office of Compliance continued to work closely with other
agencies to conduct surveillance on imported fireworks and to enforce the provisions of
the Federal Hazardous Substances Act. Examples of these activities are as follows:
r
• CPSC and Customs staffs selectively sampled and tested 286 shipments of
fireworks. Approximately 27 percent of the shipments were found to contain
violative fireworks. These shipments accounted for more than one million
units with violations serious enough to warrant seizure or other actions by
Customs.
• CPSC staff also initiated and participated in several multi-state criminal
investigations with the Bureau of Alcohol, Tobacco, Firearms and Explosives
(AFT), the Department of Transportation (DOT) and the Department of
Justice.
• Three criminal cases of note were closed during 2003. A Washington state
man was sentenced to 48 months for manufacturing and distributing illegal
fireworks. An Indiana man was sentenced to 80 months for dealing in display
fireworks without a license and for related ATF and DOT charges. An Illinois
man was sentenced to 30 months in jail for dealing in illegal fireworks.
Additional indictments and prosecutions are expected in 2004.
Introduction
This report describes injuries and deaths associated with fireworks during 2003.
The report also describes CPSC staff enforcement activities for 2003. The report is part
of an annual series. Reports for earlier years can be found on the intemet at www.cpsc.
gov/library/data.html.
The report is organized into 8 sections. Following the discussion of data and
methods in this section, the next section describes fireworks-related deaths. Section 3
describes an incident in West Warwick, Rhode Island that resulted in 100 deaths and
almost 200 injuries. Section 4 provides a national annual estimate of fireworks-related
emergency department-treated injuries for 2003 and compares that estimate with
estimates for previous years. Section 5 is based on a special study of emergency
department-treated injuries during the month around July 4. That section presents tables
of the number of injuries broken down by different categories. Section 6 summarizes the
in-depth telephone investigations of fireworks injuries. Section 7 describes enforcement
activities by CPSC's Office of Compliance. The main body of the report then concludes
with a summary of the findings. An appendix contains more detail on the telephone
investigations that were summarized in Section 6.
Sources of Information
Information on non-work-related fireworks deaths occurring during 2003 was
obtained from the CPSC Injury/Potential Injury Incident file (IPII) and CPSC's Death
Certificate File. Entries in IPII come from sources such as newspaper articles, consumer
complaints, referrals by lawyers, medical examiners and other government agencies.
There may be multiple reports on a single death. We screened reports to eliminate
duplicates. Then the CPSC field staff conducted in-depth investigations on these
fireworks-related deaths. The purpose of that investigation is to determine the type of
fireworks involved and the circumstances that led to the fatal injury.
Because IPII is based on voluntary reports and because it takes up to two years to
receive all death certificates from the various states to complete the Death Certificate
File, neither data source can be considered complete at this time for 2003 fireworks-
related deaths. As a result, the number of deaths might have been greater than the
number reported here.
The source of information on fireworks-related injuries was the National
Electronic Injury Surveillance System GNEISS). NEISS is a probability sample of U. S.
hospitals with emergency departments. Injury information is taken from the emergency
department record. Information includes the victim's age and sex, where the injury
For a description of NEISS,including the revised sampling frame, see Kessler and Schroeder(1998).
Procedures used for variance and confidence interval calculations,and adjustments for the sampling frame
change in 1997 are found in Marker,Lo, Brick,and Davis(1999). SAS statistical software for trend and
confidence intervals is documented in Schroeder(2000).
1
occurred, the emergency department diagnosis,body part injured and the consumer
product associated with the injury. The information is supplemented by a 160 character
narrative that often contains a brief description of how the injury occurred.
For emergency-department treated-fireworks-related injuries reported in NEISS,
there are three different levels of information that were collected during the year, as
follows:
• NEISS records collected during the July 4th special study period. During
this period, which for 2003 was June 20 to July 20, we requested that
hospital emergency department staff show pictures of different types of
fireworks to patients and ask them to identify the type of firework device
associated with the injury. For this period, the narrative usually contained
a description of how the incident happened and the type of firework
involved.
• In-depth investigations during the July 4th special study period. On the
basis of information in the NEISS coded fields and the narrative, some
cases were assigned for telephone investigation. The victim was
telephoned and asked to describe in detail the type of fireworks involved,
how the injury occurred, the medical treatment and the prognosis. The
victim was also asked about the source of the fireworks.
• Incidents occurring during the remainder of the year. No special
information was collected for the remaining 11 months. In particular, this
meant that the narrative usually did not include the fireworks type or
information on how the injury occurred.
While the numbers vary slightly from year to year, about two-thirds of the annual
fireworks-related injuries usually occur during the July 4th special study period. During
2003, approximately one-third of these special study period cases were selected for
telephone investigations. There were two criteria for selecting cases. About half the
cases were selected because they involved the most serious injuries and/or hospital
admissions. Serious injuries included eye injuries, fmger and hand amputations, and
head injuries. The other cases were selected from the Fire Injury Project, a separate CPSC
staff study involving follow-up of emergency department-treated cases with fire-related
injuries that were likely to haw been attended by fire departments.2 As a result of these
criteria, most cases selected for the telephone surveys tended to have more serious
injuries than typical NEISS hospital cases.
2 The information collected by the Fire Injury Project included almost all the information required for the
fireworks special study. The Fire Injury questionnaire was used first during the telephone interview,
followed by an abbreviated form of the fireworks questionnaire. This allowed collection of data on many
additional fireworks-related injuries at a relatively low cost.
2
About half the telephone investigations were completed. The most frequent
reasons why investigations were not completed were difficulty contacting the victim or
refusal to participate.
These different levels of information about injuries correspond to different
analyses in the report as follows:
• Estimated natioml annual fireworks-related injuries. This estimate is
made using all NEISS reported fireworks-related injuries for the calendar
year. No cases are removed. That is because the information in the
comment field is not usually complete enough for the approximately one-
third of fireworks-related injuries that occur outside the special study
period. As a result, the annual injury estimate includes a small number of
cases where(1) the firework has not been lit or attempted to be lit or the
victim was not attempting to light it or(2) some other product was more
substantially involved in the injury than the firework.3 Calculating the
annual estimates without removing these cases makes the estimates
comparable to previous years.
• Detailed analyses of injury patterns. Tables in the report describe body
part injured, diagnosis, fireworks types, age and sex of injured people and
other information. These tables are based only on the special study period.
Fireworks types are taken from the telephone investigation or the NEISS
comment field, when there was no telephone investigation. When
computing national estimates for the special study period, we remove
cases where the fireworks device was not lit or the victim was not
attempting to light the device or some other product was more
substantially involved. Like the annual estimates for all injuries, estimates
in these tables also use sampling weights.
• Information from the telephone investigations. Individual case injury
descriptions and medical prognosis information from the telephone
investigations are listed in the appendix to this report. These listings also
exclude cases where the fireworks device was not lit or the victim was not
attempting to light the device. Weighted national estimates are not made
for medical prognoses or injury descriptions, because the cases do not
represent a probability sample.
3We identified three cases in the 2003 data. In one case,a 53 year-old male was trea`ed for a lumbar sprain
from lifting fireworks. In a second,a 24 year-old woman was treated after a box of fireworks fell on her
ankle. In the third case a person stepped on a nail while stomping out fireworks. Using the sampling
weights,these three cases account for an estimated 100 injuries.
3
Statistical Methods
Injuries reported by NEISS sample hospitals were multiplied by the associated
sampling weights to develop an estimate of total fireworks-related injuries for the year
and for the special study month around July 4th. Confidence intervals were estimated
and hypothesis tests were performed using computer programs that were written to take
into account the sampling design. Results are rounded to the nearest 100 injuries.
The report also contains a number of detailed tables about fireworks-related
injuries during the special study period. Estimates are also made using the sampling
weights. To avoid cluttering the tables, we do not include confidence intervals and
hypotheses tests with these tables. Because the estimates are based on subsets of the
data, they have large relative sampling errors (i.e. larger coefficients of variation than the
annual injury estimate or the special study month injury estimate.). As a result,
interpretation and comparison of these estimates should be made with caution. For
example, when comparing subsets of the data, say between injuries associated with two
different types of fireworks, or between two different age groups, it is difficult to
determine how much of the difference between estimates is associated with sampling
variability and how much comes from real differences in national injury totals.
Estimates in the tables are also rounded to tIr nearest 100 injuries. Estimates of
less than 50 injuries are shown with an asterisk (*). Totals may not add due to rounding.
Fireworks-related Deaths for 2003
CPSC has reports of 6 non-work fireworks-related deaths that occurred in 2003.
We reported on 4 fireworks deaths for 2002 and 4 for 2001.4 Brief descriptions of the
2003 incidents are found below. In addition, in February 2003, 100 people were killed in
West Warwick, Rhode Island in a nightclub fire that was started with non-consumer
fireworks. This incident is not typical of fireworks-related fatal injuries and is described
later in the text.
Descriptions of 2003 fireworks-related deaths are as follows:
• A 2-year-old Florida male died of smoke inhalation in a mobile home fire. The
fire was started in the laundry room by another child (3 years old) who brought a
lit sparkler into contact with combustibles. The 2-year-old child was overcome
by smoke.
• An 18-year-old Michigan male was fatally injured when lighting a mortar type
firework. The victim and his friend were huddled around a launching tube to
block the wind. The victim peeled back part of the paper surrounding the wick of
a mortar shell that was in the launching tube. A witness told officials that the
°See Greene MA and Joholske J(2003), and Greene MA and Race PM (2002).
4
firework did not fly out of the tube as expected but it flew into the air and ignited
with a large flash close to the victim. The victim died seven days after the
incident from traumatic brain injuries. Three other people were injured in the
incident.
• A 24-year-old Pennsylvania man was setting off fireworks in a field. The victim
had an aerial display canister in a tube that was six inches in diameter and three
feet high. The firework did not go off after being lit. When the victim went over
to the tube to examine the firework, it detonated. He died instantly from massive
head injuries.
• A 38-year-old Connecticut man was struck in the chest by a commercial-type
firework projectile that he launched from a pipe he had placed in the ground. The
police reported that the victim was leaning over the tube lighting the fuse when it
went off
• A 38-year-old Iowa man was setting off fireworks for his friends. He placed a tan
baseball shaped device into a plastic launch tube. After lighting the fuse there
was an immediate explosion that caused the victim to fall onto the ground. Then
there was a second much louder explosion. The victim sustained fatal head
injuries and was pronounced dead at the scene.
• During the early morning hours of December 2003 in Massachusetts, a 57-year-
old man lit several fireworks devices. These were 2 inch long cylinders that spin
on the ground and emit multicolored sparks and small flames. One of these
devices ignited a dry Christmas tree after bouncing underneath. The resulting fire
caused the death of a 45-year-old woman and injured three other adults.
According to the Centers for Disease Control and Prevention, there were 84
fireworks-related deaths (an average of 6 deaths annually)between 1988 and 2001.5
Nightclub Fire at The Station, West Warwick, Rhode Island
One hundred people died and almost 200 hundred people were injured in a
nightclub fire in West Warwick, Rhode Island on February 20, 2003. The fire was
caused by a pyrotechnic display that was lit during the concert. Because this incident was
so different from every other fireworks incident, it is being reported separately from other
fireworks-related deaths and injuries in this document.
This is what was reported about the incident.
5 Data from CDC for ICD 9 code 923.0(1988-1998)and ICD IC code W39 for 1999-2001. See
httn://wonder.cdc.goy/mortsol.html. These totals are different from our estimates because they include
include work-related deaths.
5
At about 11 pm during the band's opening number someone working at the club
ignited a pyrotechnic canister that releases a fountain of sparks. The ceiling and walls
above the stage caught fire immediately. Unsure if the fire was part of the act, many
patrons did not immediately head for the exits. Soon the entire club was engulfed in
flames. Thick black smoke soon filled the club, making it more difficult for patrons to
leave the club. When firefighters arrived, the size of the conflagration made rescue efforts
difficult. Then firefighters were ordered to evacuate the building. Shortly after that, the
roof caved in.6
A task force convened by the Commonwealth of Massachusetts Department of
Public Safety summarized the situation. They said,
Each of these elements contributed to the tragedy: the proximity of
pyrotechnics and foam insulation in a wood-frame building, the crowd's
initial lack of awareness of an emergency situation, untrained staff, too
many people with insufficient exits and most important, the lack of a
potentially life-saving sprinkler system. Individually, they presented a
danger. Together, they formed a `perfect storm' of events that precipitated
the catastrophe.
The firework devices involved in the incident, "gerbs", emit a shower of sparks
about 15 feet high for about ten to fifteen seconds. These are not classified as consumer
fireworks. The devices are classified as 1.4G/Articles Pyrotechnic and have a UN number
of UN0431 or UN0432 which is different from typical consumer fireworks that are
designated as 1.4G/UN0336. While 1.4G/Articles Pyrotechnic do not require a Bureau of
Alcohol, Tobacco, Firearms and Explosives (AFTE) license or permit for use, and while
they are constructed similarly to consumer fireworks, they are not intended for consumer
use according to the ATFE.
National Injury Estimates for 2003
Table 1 and Figure 1 present the estimated number of fireworks-related injuries
for 1991 —2003 that were treated in U. S. hospital emergency departments.
6 Shelly Reese(2004),"If Onlys Become Never Agains," NFPA Journal. Available from
www.nfoa.ork/NIFPAJournal/Coversionlvsif04/onlvsif04.aso.
Secretary's Task Force on Fire&Building Safety(2003),"Safeguarding the Public from Fire: A Strategy
for the Commonwealth." Executive Office of Pubiic Safety,Boston, MA.
6
Table 1
Estimated Fireworks-Related Injuries 1991-2003
Year Estimated Injuries Injuries per 100,000 people
2003 9,300 3.2
2002 8,800 3.0
2001 9,500 3.3
2000 11,000 3.9
1999 8,500 3.1
1998 8,500 3.1
1997 8,300 3.0
1996 7,300 2.7
1995 10,900 4.1
1994 12,500 4.8
1993 12,100 4.6
1992 12,500 4.9
1991 10,900 4.3
Source: NEISS,U. S.Consumer Product Safety Commission/EPHA. Based on 291 fireworks-related
injuries recorded in NEISS hospital emergency departments during 2003. This estimate does not include
an estimated 150 injuries associated with the incident in West Warwick.RI,based on cases treated in
participating emergency departments. Estimates for 1991-1996 were revised to adjust for the new sampling
frame and do not match values published in reports for 1997 or earlier.U. S.population estimates from
1991-1999 from httu://eire.census.gov/popest/data/national/tables/intercensal/US-EST90INT-04.phi;
population projections for 2000-2003 from htto://eire.census.gov/popest/data/states/tables/NST-EST2003-
01.xls.
In calendar year 2003, there were an estimated 9,300 fireworks-related injuries
(95% confidence interval 6,800— 11,800). Total emergency department-treated injuries
and per capita injuries were larger than 2002, but the difference is not statistically
significant.
Figure 1 below shows that the highest numbers of estimated injuries were
between the years 1991 and 1995, followed by a decline in 1996,and then a relatively
stable pattern between 1998 and 2003 that varied between 8,500 injuries (1998) and
9,500 injuries (2001). This pattern was interrupted in 2000, where there were increased
numbers of injuries associated with fireworks activities for the millennium celebration
that January.
r-.
7
Figure 1
Fireworks Injuries 1991-2003
0
O
O —
co
0
O -
N
O
O
O -
w
N
C O
O —
Sc
r
E
N
W O
O
O —
O
O
O
O —
co
O
O
N
I I I I
1992 1994 1996 1998 2000 2002
Year
Injury Estimates for the 2003 Special Study
The injury analysis in this section presents the results of the 2003 special study of
fireworks-related injuries that were treated between June 20 and July 20, 2003. During
this period, there were an estimated 6,800 fireworks-related injuries (95% confidence
interval 4,800— 8,900), accounting for about 70 percent of the total injuries for the year.
The remainder of this section presents estimates for fireworks-related injuries broken
down by different categories.
8
•
Fireworks Device Types and Injury Dispositions
Table 2 shows the number and percent of emergency department-treated injuries
by fireworks device type.
Table 2
Estimated Fireworks-Related Injuries
By Type of Fireworks Device
June 20-July 20, 2003
Fireworks Device Type Estimated Injuries Percent
Total 6,800 100
All Firecrackers 1,600 24
Small 300 5
Illegal 200 2
Unspecified 1,200 17
All Rockets 1,200 18
Bottle Rockets 1,000 15
Other Rockets 200 3
All Other Devices 2,000 30
Sparklers 700 11
Fountains 100 1
Novelties 400 5
Multiple Tube 100 2
Reloadables 300 5
Roman Candles 400 6
Public Display 100 2
Unspecified 1,800 27
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. Based on 204 reported emergency
department visits between June 20,2003 and July 20,2003. Subtotals include categories listed directly
below. Estimates rounded to nearest 100 injuries. Estimates of less than 50 injuries shown with an
asterisk(*).Totals may not add due to rounding.
As shown in Table 2, firecrackers accounted for an estimated 1,600 injuries,
which was about one-fourth of the total fireworks-related injuries. After firecrackers,
rockets accounted for about 1,200 injuries, 18 percent of the total. Most of the rocket
9
injuries involved bottle rockets. Sparklers accounted for about 700 injuries or a little
more than 10 percent.
Table 2 shows that the firecracker size could not be identified for about 1,200
injuries (17 percent) and the fireworks device could not be identified for 1,800 injuries
(27 percent). Sometimes the victim does not know the type of device because the victim
didn't purchase or light the firework. Estimates from previous years have shown a
substantial number of injuries where fireworks types were unknown.
There were a small number of injuries associated with public displays. This is
also in keeping with previous years.
Age and Sex of Injured Persons
Children under 5 experienced slightly more than 10 percent (700 injuries) of all
fireworks-related injuries as shown in Table 3. The injury rate was 3.7 injuries per
100,000 `or these children. Children in the 5 to 14 age group accounted for 35 percent
(estimated 2,400) of the fireworks-related injuries. Their rate was 5.9 injuries per
100,000. This was composed of 6.5 injuries per 100,000 for children 5 to 9 and 5.3
injuries per 100,000 for children 10-14. Together, children under 15 accounted for about
45 percent of the fireworks injuries.
The age group 15 to 24 had about 25 percent of the injuries (1,800) as did the 25
to 44 age group (1,700 injuries). Young adults 15 to 24 years old experienced 4.4
injuries per 100,000 people for the special study month. The injury rate declined for
older people; for example people between 25 and 44 had 2.1 injuries per 100,000 and
those 45 to 64 had 0.5 injuries per 100,000.
Males had 4,900 injuries, representing about 72 percent of the total. This pattern
and the concentration of injuries among people 25 and younger has been typical of
fireworks injuries for previous years.
10
Table 3
Estimated Fireworks-Related Injuries
By Age and Sex
June 20-July 20, 2003
Age Group Total Male Female Per 100,000
People
Total 6,800 4,900 1,900 2.4
0 To 4 700 400 300 3.7
5 To 14 2,400 1,900 400 5.9
5 To 9 1,300 1,000 300 6.5
10 To 14 1,100 1,000 100 5.3
15 To 24 1,800 1,300 500 4.4
15 To 19 1,000 700 300 5.1
20 To 24 700 500 200 3.6
25 To 44 1,700 1,200 500 2.1
45 To 64 300 100 200 0.5
65+ * * * *
Sources NEISS,U. S. Consumer Product Safety Commission/EPHA,U. S.population from
http://www.census.gov/population/projections/nation/summary/np-t3-b.txt See notes for Table 2.
Age and Sex of the Injured Person by Type of Fireworks Device
Table 4 shows the ages of those injured by the type of fireworks device associated
with the injury. About half the estimated 700 injuries to children under 5 were from
sparklers. Firecrackers and bottle rockets were the largest single fireworks type
associated with injuries for people between 5 and 14 and between 15 and 24 years of age.
11
Table 4
Estimated Fireworks-Related Injuries
By Device Type and Age Group
June 20-July 20, 2003
Age Group
Fireworks Type Total 0-4 5-14 15-24 25-44 45+
Total 6,800 700 2,400 1,800 1,700 300
Firecrackers 1,600 100 500 300 600 100
Small 300 * 100 100 100 *
Illegal 200 * * 100 100 *
Size Unknown 1,200 100 400 200 300 100
Rockets 1,200 * 400 500 200 *
Bottle Rockets 1,000 * 300 500 200 *
Other Rockets 200 * 100 * 100 *
*
All Other Devices 2,000 400 600 500 400 200
Sparklers 700 400 100 * 100 100
Fountains 100 * * * 100 *
Novelties 400 100 100 100 100 *
Multiple Tube 100 * * 100 * *
Reloadables 300 * * 200 * 100
Roman Candles 400 * 200 100 100 *
*
Public Display 100 100 * * * *
Unspecified 1,800 100 800 400 500 *
Source: NEISS,U.S.Consumer Product Safety Commission/EPHA. See notes for Table 2.
Injury Diagnosis and Body Part Injured
Table 5 presents the types of injuries sustained to specific parts of the body.
Hands and forgers with an estimated 1,800 injuries, accounted for 26 percent of the total
injuries. There were almost as many eye injuries (1,400) and leg injuries (1,200) as head,
face and ear injuries (1,200).
12
Burns with 4,300 estimated injuries and 63 percent of the total, were the most
frequent diagnosis. Contusions and lacerations, at 1,200 injuries and 18 percent of the
total were the second most frequent. Head and facial injuries were evenly distributed
among bums, contusions and lacerations, and other diagnoses. Eye injuries were equally
divided among bums, contusions and lacerations, and other diagnoses including foreign
bodies in the eye.
Table 5
Estimated Fireworks-Related Injuries
By Body Part and Diagnosis
June 20-July 20, 2003
Injury Diagnosis
Body Part Total Burns Contusions Fractures Other
Lacerations Sprains Diagnoses
Total 6,800 4,300 1,200 100 1,200
* * * *
Arm/Shoulder 500 300 100
Eye 1,400 400 500 * 500
Hand/Finger 1,800 1,600 100 * 100
Head/Face/Ear 1,200 500 400 * 300
Leg 1,200 1,000 100 100 100
Trunk 800 500 200 * 100
Source: NEISS, U. S. Consumer Product Safety Commission/EPHA. See notes for Table 2.
Fractures and sprains also include dislocations. Other diagnoses included all other injury categories. Arm
and shoulder includes NEISS codes for upper arm,elbow,lower arm,shoulder and wrist. Head/Face'Est
includes eyelid,eye area,nose,neck,and mouth. Leg includes upper leg,knee,lower leg, ankle, foot and
toe. Trunk includes lower trunk,upper trunk,pubic region,all parts of body,internal and 25-50%of body.
Type of Fireworks Device and Body Part Injured
Table 6 below presents estimated injuries by the type of fireworks device and
body part involved.
13
Table 6
Estimated Fireworks-Related Injuries
By Type of Fireworks Device and Body Part Injured
June 20-July 20, 2003
Body Part
Hands Head
Fireworks Type Total Arm Eye Fingers Face/Ear Leg Trunk
Total 6,800 500 1,400 1,800 1,200 1,200 800
Firecrackers 1,600 100 300 700 300 200 *
Small 300 100 100 100 * * *
Illegal 200 * * 100 * 100 *
Size Unknown 1,200 * 200 500 300 100 *
Rockets 1,200 100 200 100 400 200 200
Bottle Rockets 1,000 100 200 100 300 200 100
Other Rockets 200 * * * 100 100 100
Other Devices 2,000 100 300 600 200 500 300
Sparklers 700 * * 300 * 500 *
Fountains 100 * * * * * *
Novelties 400 * 100 100 * * 100
Multiple Tubes * * * * 100 * 100
Reloadables 300 100 100 * * * 100
Roman Candles 400 * 100 100 100 * 100
Public Display 100 * 100 * * * *
Unspecified 1,800 200 500 400 300 300 200
Source: NEISS,U. S. Consumer Product Safety Commission/EPHA. See notes for Table 2 and notes for
Table 5 for definition of body parts.
About half the firecracker injuries occurred primarily to the hands, usually when
the victim was lighting the device. Bottle rockets were associated with injuries to various
parts of the body. Most of these injuries occurred when the rocket hit a victim. Sparkler
injuries occurred mostly to hands, fingers and legs. Almost all of these injuries were
14
bums. The other fireworks devices had injury patterns that were almost equally divided
among the different parts of the body.
Hospital Disposition
Although most of these fireworks-related injuries were characterized as "treat and
release," an estimated 5 percent required hospital admission or transfer to another
hospital for treatment.
Telephone Investigations of Fireworks Injuries
CPSC staff assigned telephone investigations of some fireworks injuries that
occurred during the month surrounding the July 4 holiday. About half the cases were
selected on the basis of injury severity such as serious eye injuries, concussions, limb
amputations or because the person was admitted to the hospital. Also, cases were
included that were selected for CPSC's Fire Injury Project. The criteria for those cases
specified fire-related injuries with fire department attendance likely. Because these cases
were selected on the basis of severity, they are only representative of scenarios associated
with the most serious injuries.
In the questionnaire, respondents were asked about the hazard patterns associated
with the injury, their medical care following the emergency department treatment, and
about long term effects, if any, of the injury. Respondents were also asked about the
source of the fireworks that caused the injury.
Summaries of the 40 completed investigations are found in the Appendix to this
report. The investigations are organized in order of emergency department disposition:
"Admit to Hospital" followed by "Treat and Release." Within disposition, cases are
sorted by the age of the victim.
Hazard Patterns
In ten investigated cases injuries were associated with firework debris and other
hot material from the fireworks. Debris in victims' eyes was involved in case 8, 11, 15,
24, 25, 32 and 37. Ashes from a sparkler fell on a victim's leg in case 9 and pieces of a
sparkler broke off and burned a victim in case 22. In case 26, embers from fireworks
were involved in starting a fire that was extinguished by the victim. The victim stepped
on glass that had been broken in that fire.
In nine investigated cases, victims were struck by aerial fireworks. Cases 1,4, 5,
27, 29 and 31 involved bottle rockets. Several victims were struck in the eye resulting in
admission to the hospital for three cases. In case 16, a free standing rocket was
accidentally misaimed while being lit. In case 23, an 11-year-old female was watching a
15
fireworks display from her uncle's house when a stray firework hit her in the chest
catching her sleeve on fire. The victim in case 28 was struck in the back by a flying
Roman Candle.
In nine other cases, victims were injured when fireworks exploded earlier or later
than expected. In cases 6, 21 and 35, the fireworks device exploded earlier than the
victim expected. Cases 14, 20, and 30 resulted in injuries because the firework had not
exploded and the victim may have believed that it would not explode. In case 14, the
victim picked up a Roman Candle, which then emitted flames; in case 20, a buried
firework exploded when the victim approached; while in case 30 a firework stuck in a
tube exploded when the victim approached. Case 13 involved an explosion of a ground
popper when the victim was leaning over the device. Case 33 involved a firework that
blew up while it was in the launching tube. Case 38 resulted in an injury when the victim
righted one launching tube and another tube fired.
Five cases involved fireworks thrown or aimed at the victim. A smoke bomb was
thrown into a car in case 3. A victim's shirt caught on fire as a result of a thrown
firework in case 7 and a novelty device thrown at another victim resulted in bums inside
the victim's shirt in case 18. Case 17 involved a young child aiming a Roman Candle at
the victim, and Case 10 involved a 4-year-old male struck by a ground popper novelty
device.
In two cases, injuries occurred while the victim was lighting the fireworks. These
include case 2 involving a smoke bomb and case 36, where the lit fuse from a bottle
rocket dropped into powder which then exploded.
Finally there were five cases, each with unique patterns. Case 12 involved a
butterfly novelty firework that landed on a victim's shirt causing second degree bums to
his lower arm. Case 19 involved a sparkler that exploded in a victim's hand. Another
sparkler injury occurred in case 34, where a victim lit a number of sparklers to give out to
some people. He couid not give them out fast enough resulting in buns to his hand. In
case 39, a ground spinner blew up,burning the victim's knee and hand. Case 40 involved
a woman at a dance on the side of a lake. Firecrackers were being lit and thrown over the
lake by a sling. The sling malfunctioned and threw a firecracker into the crowd injuring
this victim in the lower leg.
Long Term Consequences of Fireworks-related Injuries
Victims were asked if there were any long term consequences of their injuries.
Most expected a complete recovery. Some of the exceptions were the victims with eye
injuries. Five victims struck in the eye by bottle rockets (cases 1, 4, 5, 29 and 31)
experienced loss of vision that may become permanent. Also, two victims with eye
injuries from other aerial fireworks in cases 21 and 38 may have some long term vision
impairment.
16
The only other incident that mentioned long term effects was case 39, where a
ground spinner blew up burning the victim's knee and hand. The victim had physical
therapy and expected to have partial to full recovery within the year.
Where Fireworks Were Obtained
In the telephone interview, victims were asked where the fireworks that caused
the injuries were obtained. Of the 40 respondents with completed telephone interviews,
16 did not know where the fireworks were acquired or did not answer the interviewer's
question. In some cases, this was because the victim was not the person who acquired the
fireworks.
For the 24 respondents aware of the source of the fireworks, most (18) reported
that the fireworks came from a stand that sells only fireworks. Two respondents said that
fireworks were obtained from a store. Three obtained the fireworks from a friend and
one purchased them from a van.
Enforcement Activities
CPSC's Office of Compliance enforces regulations for fireworks devices that are
sold to consumers under provisions of the Federal Hazardous Substances Act. CPSC's
enforcement activities are focused on reducing the number of fireworks-related deaths
and injuries. A variety of enforcement techniques and initiatives were utilized in 2003 to
keep unsafe fireworks from consumers.
CPSC staff continues to work closely with the Bureau of Customs and Border
Protection to conduct surveillance on imported shipments of fireworks. Fireworks were
selected based on their past violation history, the type of device, and whether the item
had been sampled previously. In fiscal year 2003, CPSC and Customs staffs selectively
sampled and tested 286 shipments of fireworks to determine if they were in compliance
with CPSC regulations. Of those, approximately 27% were found to contain violative
fireworks. These shipments accounted for more than one million units with violations
serious enough to warrant seizure or other actions by Customs.
Another enforcement activity that continues to remain a priority for CPSC staff is
the investigation into firms and individuals that offer kits and components to make illegal
and dangerous firecracker type explosives, such as M-80s, Cherry Bombs and
Quartersticks.
CPSC staff also initiated and participated in several multi-state criminal
investigations. Staff worked with other Federal agencies, including the Bureau of
Alcohol, Tobacco, Firearms and Explosives (ATF), the Department of Transportation
(DOT), and the Department of Justice's Office of Consumer Litigation, as well as state
and local law enforcement agencies. Staff provided legal, field, and technical support in
17
several cases involving the distribution of illegal explosive devices and the illegal
diversion of professional fireworks to consumers.
Three cases of note, in which CPSC staff participated in the investigation and/or
prosecution, came to a conclusion in 2003. In January, a Washington state man was
sentenced to 48 months in prison for manufacturing and distributing illegal fireworks,
among other charges. In November, an Indiana man was sentenced to 80 months for
dealing in display fireworks without a license, and related ATF and DOT charges. Also
in November, an Illinois man was sentenced to 30 months in prison and two years of
supervised release for dealing in illegal fireworks, including illegal flash powder devices.
Additional indictments and prosecutions are expected in 2004.
Summary
In 2003, both reported deaths and estimated injuries were at about the same level
as in 2002 and 2001. There were 6 fireworks deaths reported in 2003 as compared with 4
in 2002 and 4 in 2001. Annual injury estimates were 9,300 in 2003 as compared with
8,800 for 2002 and 9,500 for 2001. These injury estimates, developed from a sample,
have some amount of sampling error. The difference in the estimates among these three
years was not statistically significant.
The fire at The Station in West Warwick, Rhode Island, was the first fireworks-
related incident in recent years to result in a large number of deaths and injuries. One
hundred people died and about 200 were injured. We have excluded the deaths and
injuries in our annual totals because that incident was so different from typical incidents.
During the one-month special study period of June 20 to July 20, 2003, there were
an estimated 6,800 injuries, somewhat more than the estimate of 5,700 in 2002.
Children under 15 years old accounted for about halt the number of injuries. Among all
five year age groups, children aged 5-9 experienced the greatest number of injuries at
1,300 during the special study period. Males were three times more likely to be injured
than females.
Almost two-thirds of the injuries were burns. The most frequent part of the body
injured was the hand with about 25 percent of injuries followed by eye injuries at about
20 percent. Although most of these fireworks-related injuries were characterized as
"treat and release,"an estimated 5 percent required hospital admission or transfer to
another hospital for treatment.
Firecrackers were associated with the largest number of injuries. Bottle rockets
were second and sparklers were third. Most of the sparkler injuries were among children
under 5 years of age. Almost all the sparkler injuries were bums and most were to the
hands and legs. More than half of the victims of sparkler injuries were between 5 and 14.
Firecrackers resulted in injuries primarily to the hands.
18
A review of data from the telephone follow up survey of people injured by
fireworks showed that typical causes of injuries included (1) fireworks exploding earlier
or later than expected by the user, (2) badly aimed rockets or rockets with errart flight
paths, (3) fireworks debris, and(4) fireworks thrown or aimed at victims. According to
the telephone survey, most victims already had recovered or will recover from their
fireworks injuries. But several victims experienced serious eye injuries, putting them at
greater risk for future eye problems.
CPSC's enforcement activities remained at a high level. CPSC's Office of
Compliance worked with U.S. Customs to sample imported fireworks and to seize illegal
shipments. Also during 2003, CPSC staff provided legal, field and technical support in
cases involving large-scale distribution of illegal explosive devices and illegal diversion
of professional display fireworks to consumers. These investigations have led to seizures
of fireworks and to criminal convictions. Additional indictments and prosecutions are
expected in 2004.
References
Greene MA and Race P (2002), "2001 Fireworks Annual Report: Fireworks-Related
Deaths, Emergency Department Treated Injuries, and Enforcement Activities During
2001," U. S. Consumer Product Safety Commission, Washington DC.
Greene MA and Joholske J (2003), "2002 Fireworks Annual Report: Fireworks-Related
Deaths, Emergency Department Treated Injuries, and Enforcement Activities During
2002,"U. S. Consumer Product Safety Commission, Washington DC.
Kessler E and Schroeder T (1998), "The NEISS Sample (Design and Implementation),"
U. S. Consumer Product Safety Commission, Washington, DC.
Marker D, Lo A, Brick M and Davis W (1999), "Comparison of National Estimates from
Different Samples and Different Sampling Frames of the National Electronic Injury
Surveillance System(NEISS)," Final Report prepared for the U. S. Consumer Product
Safety Commission, Westat. Rockville, MD.
Schroeder T (2000), "Trend Analysis of NEISS Data." U. S. Consumer Product Safety
Commission, Washington, D. C.
19
) ) )
Appendix
Summaries of Completed Telephone Investigations
Case Age Sex Diagnosis Disposition Body Part Fireworks Incident Synopsis Medical Treatment and Prognosis
Injured Type
Bottle Cornea damaged. Has had surgery and
1 8 Male Other Admitted Eye Rocket Victim struck in the eye. may require more. Some loss of vision
may be permanent.
Thermal Novelty Jeans caught on fire while victim Victim was hospitalized,no information on
2 9 Male Bums Admitted Lower Leg (Smoke was setting off smoke bombs. prognosis
Bomb)
Novelty Firework thrown into car,
3 12 Female Thermal Admitted Lower Trunk (Smoke exploded and the victim's shirt Scarring expected. Length of time to full
Burns Bomb) caught on fire resulting in burns recovery not known.
to back and arms.
Bottle Bottle rocket lit,thrown in the air, May require additional eye surgery.
4 14 Male Other Admitted Eye Rocket came down and struck victim in Future prognosis may involve loss of sight
eye as it exploded. in one eye.
Bottle Victim lit firework and threw it in Victim had eye surgery. Full recovery of
5 14 Male Other Admitted Eye Rocket the air. When it came down,it sight is uncertain.
struck the victim in the eye.
Firework went off immediately
Thermal 25-50%of Multiple after being lit,resulting in 1st and
6 19 Male Bums Admitted Body Tube Device 2nd degree burns to victim's Fully recovered.
chin,neck,arms and stomach.
Thermal Unknown Fireworks thrown at victim Hospitalized for 4 weeks. No information
7 33 Male Bums Admitted Lower Arm Fireworks burning arm and hands. Shirt provided on recovery.
Type caught on fire.
Unknown
Thermal Refused Medical Fireworks debris or a bug in
8 5 Male Bums Treatment Eye Fireworks victim's eye. Seen by MD next day and was OK.
Type
20
)
9 2 Female Thermal Treat and Release Upper Leg Sparkler Ashes fell on her leg. Fully recovered.
Bums
' Dermatitis, Novelty
10 4 Male Conjunctiviti Treat and Release Eye Device Thrown at victim and struck him Fully recovered.
(Ground in the eye.
s
Poppers)
Unknown
Thermal Debris in victim's eyes from
11 5 Female Bums Treat and Release Eye Fireworks aerial fireworks causing burns. Fully recovered.
Type
Thermal ButterflyAfter being lit,firework landed on
12 6 Male Bums Treat and Release Lower Arm firework victim's shirt causing second Fully recovered in 3 weeks.
degree burns.
Novelty
13 7 Male Other Treat and Release Eye Device One device exploded when Fully recovered.
(Ground victim was leaning over it.
Poppers)
Victim lit firework then dropped it
Contusions, Roman when it didn't go off. When he
14 8 Male Abrasions Treat and Release Eye Candle picked it up,flames shot out from Fully recovered.
the back striking the victim in the
left eye.
Unknown Victim diagnosed with corneal
15 8 Female Thermal Treat and Release Eye Fireworks burn after attending a fireworks Fully recovered.
Bums display where spectators were
Type also lighting fireworks.
Free Misaimed rocket hit victim in the Victim received stitches. Full recovery
16 9 Male Laceration Treat and Release Lower Trunk standing stomach and then exploded. likely.
rocket
Thermal Roman 6 year old brother lit a Roman
17 9 Male Bums Treat and Release Ear Candle Candle and pointed it at victim. Fully recovered.
Second degree burn to right ear.
Thermal Novelty Firework thrown at victim burning
18 9 Male Bums Treat and Release Lower Trunk Device his forearms and left side inside No information available.
shirt.
19 9 Female Thermal Treat and Release Hand Sparkler Exploded in victim's hand. Full recovery expected.
Bums
21
) ) )
Victim buried firework,then lit it.
Unknown When it didn't explode
20 9 Male Contusions, Treat and Release Eye Fireworks immediately, he approached the Fully recovered.
Abrasions Type device which then exploded
sending powder into the victim's
eye.
Multiple Victim treated by opthalmogist after
Burns, Not Tube Device Shell exploded immediately
21 11 Male Treat and Release Eye hospital visit. Slight vision impairment.
Specified
(Artillery when lit, injuring victim's eye.
Shell) No information on future prognosis.
Thermal Piece of lit sparkler broke off and
22 11 Female Bums Treat and Release Upper Trunk Sparkler fell down her shirt resulting in 3rd Full recovery expected.
degree burns to her chest.
Unknown Victim hit in chest by firework at
23 11 Female Thermal Treat and Release Lower Arm Fireworks neighborhood show. Burns to Despite some scarring,victim has
Bums recovered.
Type arm when sleeve caught on fire.
Thermal Novelty
24 12 Female Bums Treat and Release Eye (Smoke Fragment flew into victim's eye. Fully recovered.
Bomb)
25 13 Male Contusions, Treat and Release Eye Roman Spark from firework hit victim's Fully recovered in several days.
Abrasions Candle eye
Victim was extinguishing a
Foreign Unknown garage fire that started from Victim experienced smoke inhalation and
26 13 Male Body Treat and Release Foot Fireworks embers from fireworks. He a foot injury from the glass. Recovered.
Type stepped on glass from windows
that had been broken in the fire.
27 14 Female Other Treat and Release Eye Bottle Bottle rocket struck victim in the Full recovery expected.
Rocket eye causing internal bleeding.
28 16 Male Thermal Treat and Release Upper Trunk Roman Victim hit in the back by a Fully recovered.
Bums Candle Roman Candle.
29 17 Male Hemorrhage Treat and Release Eye Bottle Victim walked in the path of a Lost vision in the eye for three days. May
Rocket bottle rocket. Struck in the eye. have permanent damage to eye.
Multiple Firework became stuck in tube,
Radiation Tube Device then exploded when the victim
30 17 Male Bums Treat and Release Eye (Artillery approached. Burns to victim's No information available.
Shell) eyes.
22
) )
31 18 Female Other Treat and Release Eye Bottle Struck in eye by bottle rocket. After eye surgery long term effects
Rocket unknown.
A firework exploded near the
32 19 Female Other Treat and Release Eye Public crowd causing sparks and debris Full recovery expected.
Display to fly everywhere.Victim
received corneal abrasion.
Multiple
33 21 Male Thermal Treat and Release Face Tube Device Device blew up in the tube. 2nd Fully recovered.
Bums (Artillery and 3rd degree burns.
Shell)
Victim lit a number of sparklers
34 21 Male Thermal Treat and Release Hand Sparkler and could not give them out Except for scarring,full recovery
Bums quickly enough. Burns to victim's expected.
hand.
Thermal Bottle Burned in left eye by bottle
35 23 Male Burns Treat and Release Eye Rocket rocket that went off earlier than Fully recovered.
expected.
Part of the lit fuse from a bottle
36 28 Male Thermal Treat and Release Face Bottle rocket ignited black powder, No information available.
Bums Rocket which flashed causing burns to
face.
Contusions, Public Large embers from the display
37 34 Female Abrasions Treat and Release Eye Display were falling. Victim experienced Fully recovered.
corneal abrasion.
Multiple Stitches at hospital for lacerated eyelid.
Tube Victim righted one launching tube Advised to see retinal specialist for trauma
38 41 Male Laceration Treat and Release Face (Grenade when another tube launched and to the eye. Complete recovery of vision
Launcher) the device hit him in the eye. uncertain.
39 41 Male Thermal Treat and Release Hand Ground Device blew up burning victim's Will have physical therapy,expect partial
Bums Spinner knee and hand. to full recovery within a year.
40 41 Female Foreign Treat and Release Lower Leg fvlrac Me leg. d firecracker hit victim in Fully recovered.
Body Firecracker the leg.
23
fi ken tl ,n 4
v tii • : :
Executive Summary
This report provides the results of a CPSC staff analysis of
Jj 1998 data on fireworks-related injuries. Annual estimates are
derived from the National Electronic Injury Surveillance System
(1998) . Estimates for the July 4`h period are based on a one-
month special survey (June 23 to July 23, 1998) of fireworks-
related injuries treated in hospital emergency rooms reporting to
NEISS. Highlights are as follows:
• Fireworks devices were involved in an estimated 8, 500 injuries
treated in U. S. hospital emergency rooms during calendar year
1998 . This estimate is significantly lower than estimates for
the years 1992 through 1994 (12, 500) .
• There were thirteen deaths from fireworks in 1998. Seven of
these deaths occurred from an explosion in a fireworks
factory.
• An estimated 5, 000 injuries, directly involving fireworks,
were treated in U.S. hospital emergency rooms during the one-
month period surrounding the Fourth of July, 1998. The
highest injury estimates were for firecrackers (1, 900) ,
rockets (800) , and sparklers (500) .
• Over 40 percent of the injuries were to children under age 15 .
The estimated number of injuries to males (3,700) was
approximately three times the number of injuries to females
(1, 300) .
• The parts of the body most often :Injured were the hands
(1, 800) , eyes (1, 100) ,and head/face (1, 000) . Over half the
injuries involved burns. Burns were the most frequent injury
received by all parts of the body except the eye, where
contusions and lacerations were the most frequent injuries.
%OAt
2, /
Hello