Incidence and Patterns of Firework-related Injuries: An Explosion in 2020

Introduction: Approximately 10,000 Americans are treated annually for firework-related injuries. In 2020, US police organizations reported an increased number of firework-related calls. Furthermore, because of the COVID pandemic, many major firework displays were cancelled, and celebrants shifted to smaller, distributed events. We examine if there was a concomitant increase in firework-related injuries. Methods: We performed a retrospective review of patients who presented to our urban level 1 trauma center between January 1st, 2015 and July 31st, 2020 with firework-related injuries. Patients were identified from our trauma registry and emergency department records. Charts were reviewed for patient demographics, injuries, procedures performed, and mortality. Patients were grouped by date of presentation and descriptive statistics were derived. Results: We identified 66 patients injured during the study period. The median age was 23 and 91% were male. The incidence was stable over the study period except for a dramatic rise in 2020, when half of all injuries occurred. The most common injuries were fingers (74%), hand and wrist (48%), burns (47%), and ocular (42%). 26% demonstrated the triad of injury to hand or fingers, eyes, and tympanic membrane rupture. 63% needed amputation of at least one digit. 18% required amputation of the hand. Conclusion: There has been a steep increase in the number of firework-related trauma in 2020. These injuries continue to cause serious, lifelong disability. Although the recent spike may have been driven by a combination of transient social conditions, this data should inform increased efforts at prevention and research into causative factors.