Bottle Rockets Disproportionally Cause Most Severe Fireworks Eye Injuries: Study

Thousands of injuries each year are linked to fireworks, with bottle rockets disproportionally causing serious ocular injury reports, according to the findings of a new study.

Eye injuries from bottle rockets can range from mild to severe, and usually affect young white males under the age of 18 around Independence Day or New Years, researchers with Thomas Jefferson University found in a study published this month in the medical journal JAMA Ophthalmology.

Researchers conducted a cross-sectional study of the National Electronic Injury Surveillance System, using a sample of more than 100 hospital-affiliated U.S. emergency rooms representing more than 5,300 national hospitals.

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The study included patients who experienced a fireworks-related eye injury treated in emergency rooms in the U.S. from 1999 to 2017. A total of 34,500 firework related ocular injuries were seen in U.S. ERs during the 19-year study.

More than 2,000 fireworks-related ocular injuries occurred every year between 1999 and 2017. Most injuries occurred around holidays in July and January.

The majority, 63%, involved burns to the eye. About 12% of the injuries involved foreign bodies being lodged into the eye, and conjunctival irritation occurring in 10% of injuries. Severe eye trauma and ruptured eye globe occurred less frequently, accounting for 5% and 3% of injuries, respectively. Some patients needed eye surgery, and some never regained their vision.

The fireworks that the caused the most injuries were firecrackers, involving about 19% of injuries. Bottle rockets resulted in about 17% of injuries, but were the most frequent type of serious eye injury, including ocular ruptured globe. Other types of fireworks associated with injuries included sparklers (9% of injuries), roman candles (6% of injuries), and novelty items like poppers (6.5% of injuries).

Bottle rockets eye injures resulted in the most cases requiring intensive treatment, admittance to the hospital, or surgery, with ocular burns the most frequent type of eye injury.

The majority of injuries occurred at a patient’s home, and more than 70% of injuries occurred on or around the Fourth of July. About 10% occurred around New Year’s Eve.

Most patients who were injured by fireworks were younger than 18 years old, male and white. Many patients were children. While most patients could be treated at the ER and released, 9% of injuries required patients to be admitted to the hospital.

“These findings support that firework-related ocular injuries range from mild irritation to ruptured globe, and most occur frequently in those who are young, male, and white,” the researchers concluded. “Focused preventive methods and regulations may be imperative in decreasing fireworks-related ocular morbidity, namely from bottle rockets and especially near national holidays.”


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