Injuries/Violence
A National Multi-Center Analysis of the Epidemiology of Pediatric Facial Injuries from Fireworks Aidin Gharavi* Aidin Gharavi Chase Lueder Andrew Tom Sergio M. Navarro
Firework injuries remain a significant public health concern, with an estimated 9,700 injuries reported in 2023. This study examines trends in pediatric facial injuries from fireworks over the past decade using the National Electronic Injury Surveillance System (NEISS). Pediatric cases from 2014–2023 were identified using the fireworks consumer code (1313) and filtered for facial injuries (body part code 76). Data was analyzed using chi-square tests to assess significance and logistic regression to evaluate trends. An estimated 4,625 pediatric facial injuries were treated in emergency departments from 2014–2023 (95% CI: 3,884–5,367). Among cases from NEISS-reporting hospitals (n = 177), 68.4% were male and 31.6% were female. Thermal burns (60.5%), lacerations (15.3%), and contusions/abrasions (11.9%) were the most common injuries. Males were more likely to be injured than females (p-value: < 0.001). Overall, 17.5% of injuries required hospitalization or transfer. Older children were significantly more likely to sustain injuries requiring hospitalization (OR: 1.13, 95% CI: 1.04–1.23, p = 0.005). Younger children had higher odds of sparkler-related injuries, although the risk rapidly decreased with age (OR: 0.76, 95% CI: 0.68–0.86, p < 0.001). Our results show fireworks continue to cause significant pediatric facial injuries, with thermal burns being the most common diagnosis. Nearly one in five injuries require hospitalization. To best address the current landscape of facial injuries from fireworks, efforts should focus on minimizing the risk of injury in younger children while ensuring safety protocols are in place to address more significant injuries in older children.