Firework and sparkler burns in paediatric patients

Main Article Content

Daniel Ricciardello
Nam Kyu Yang
Kira Chamberlain
Andrew Holland

Keywords

child, burns, burns prevention and control, explosive agents, wounds and injuries

Abstract

Background: While the consumer sale of fireworks is illegal in New South Wales, the sale of sparklers is legal—however, both still pose a significant risk of harm in the paediatric population. Anecdotally, burns services are aware that the misuse of sparklers can result in burns but there appears to be a paucity of studies examining this incidence in the paediatric population in Australia.
Method: A retrospective review of all burns related to the use of fireworks or sparklers referred to the Children’s Hospital at Westmead (CHW) Burns Unit (BU) from January 2004 to December 2019. 
Results: 96 patients were referred to the CHW BU with a burn as a result of a firework or sparkler. Sparklers accounted for 69 (72%) of burns, compared with 27 (28%) from fireworks. The mean age of those injured by sparklers was five years compared with eight years in the firework group. Average total body surface area (TBSA) affected for both mechanisms was similar—for sparkler burns (2.0%) firework burns (2.4%), with a range of 0.1–15 per cent. Hands were the most common area burnt in both groups comprising 41 (59%) of sparkler burns and 13 (48%) of firework burns. Twenty patients required a total of 32 visits to the operating theatre for acute management of their burns.
Conclusion: This study demonstrates the potential for significant injuries as a result of fireworks and sparklers. These findings can be used to raise awareness regarding their dangers, direct targeted educational campaigns and guide safety advice regarding their use.

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References

1. Berger LR, Kalishman S, Rivara FP. Injuries from fireworks. Pediatrics. 1985;75(5):877–82. Available from: https://pediatrics.aappublications.org/content/75/5/877/tab-article-info.
2. Australian Capital Territory Government. Dangerous substances (explosives) regulation, 2004 [web report]. Canberra: Australian Government. [Cited 2 April 2020]. Available from: https://www.legislation.act.gov.au/View/sl/2004-10/current/PDF/2004-10.PDF.
3. Australian Capital Territory Government. Fireworks reform regulatory impact statement executive summary, 2009 [web report]. Canberra: Australian Government. [Cited 2 April 2020]. Available from: http://www.legislation.act.gov.au/ri/db_35434/20090826-40550/rtf/db_35434.rtf.
4. Northern Territory Government. Dangerous goods regulations 1985 [web report]. Darwin: Northern Territory Government. [Cited 2 April 2020] Available from: https://legislation.nt.gov.au/Legislation/DANGEROUS-GOODS-REGULATIONS-1985.
5. Worksafe Tasmania. Do I need a fireworks permit? [web page]. Hobart: Tasmanian Government. [Cited 2 April 2020]. Available from: https://worksafe.tas.gov.au/topics/licensing-permits-and-registration/fireworks-permits/do-i-need-a-fireworks-permit.
6. Ghengis Fireworks. Sparklers: how are they made? [Cited 6 May 2020]. Available from: https://www.fireworks.co.uk/fireworks-information/sparklers-how-are-they-made.
7. United States Consumer Product Safety Commission. CPSC reminds consumers to celebrate with safety this fourth of July season [web page]. Maryland: United States Government. [Cited 2 April 2020]. Available from: https://cpsc.gov/Newsroom/News-Releases/2019/CPSC-Reminds-Consumers-to-Celebrate-with-Safety-This-Fourth-of-July-Season.
8. Billock RM, Chounthirath T, Smith GA. Pediatric firework-related injuries presenting to United States emergency departments, 1990–2014. Clin Pediatr (Phila). 2017;56(6):535–44. https://doi.org/10.1177/0009922816664063 PMid:27550873
9. Smith GA, Knapp JF, Barnett TM, Shields BJ. The rockets’ red glare, the bombs bursting in air: fireworks-related injuries to children. Pediatrics. 1996;98(1):1–9. Available from: https://pediatrics.aappublications.org/content/98/1/1.long.
10. Abdulwadud O, Ozanne-Smith J. Injuries associated with fireworks in Victoria: an epidemiological overview. Injury Prevention. 1998;4:272–74. https://doi.org/10.1136/ip.4.4.272 PMid:9887417 PMCid:PMC1730423
11. Van den Boogaard CJ, Wallis BA, Kimble RM. Sparkler burns and the potential for serious injury in children. J Burn Care Res. 2008;29(4):679–80. https://doi.org/10.1097/BCR.0b013e31817db9bc PMid:18535464
12. Yang NK, Tellam N, Jung M, Wijewardena A, Vandervord J. A retrospective analysis of fireworks and sparkler burns. Abstract Journal Plastic & Reconstructive Surgery. Royal Australasian College of Surgeons 88th Annual Scientific Congress, Bangkok, Thailand, 6-10 May 2019. ANZ J Surg, 2019;89(S1):133–52. https://onlinelibrary.wiley.com/doi/epdf/10.1111/ans.15197
13. Fogarty BJ, Gordon DJ. Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland. Burns. 1999;25(1):53–56. https://doi.org/10.1016/S0305-4179(98)00119-3
14. Nizamoglu M, Frew Q, Tan A, Band H, Barnes D, El-Muttardi N, Dziewulski P. The ten-year experience of firework injuries treated at a UK regional burns and plastic surgery unit. Ann Burns Fire Disasters. 2018;31(1):13–16. Available from: http://www.medbc.com/annals/review/vol_31/num_1/text/vol31n1p13.pdf.
15. Witsaman RJ, Dawn Comstock R, Smith GA. Pediatric fireworks-related injuries in the United States: 1990–2003. Pediatrics. 2006;118(1):296–303. https://doi.org/10.1542/peds.2006-0790 PMid: 16818578
16. Puri V, Mahendru S, Rana R, Deshpande M. Firework injuries: a ten-year study. J Plast Reconstr Aesthet Surg. 2009;62(9):1103–111. https://doi.org/10.1016/j.bjps.2007.12.080 PMid:18603491
17. Edwin AFL, Tania CS, Pape TCS, Pape SA. The impact of recent legislation on paediatric fireworks injuries in the Newcastle upon Tyne region. Burns. 2008;34(7):953–64. https://doi.org/10.1016/j.burns.2008.01.018 PMid:18508200
18. Read DJ, Bradbury R, Yeboah E. Firework-related injury in the Top End: a 16-year review. ANZ J Surg. 2017;87(12):1030–034. https://doi.org/10.1111/ans.14182 PMid:29044852
19. Jorm L. Firework injures in New South Wales, 1992–93 to 2001–02. NSW Public Health Bull. 2003;14(6):110–13 https://doi.org/10.1071/NB03032 PMid:12908000
20. US Consumer Product Safety Commission. Fireworks annual report, 2018. [web report]. [Cited 2 April 2020]. Available from: https://www.cpsc.gov/s3fs-public/Fireworks_Report_2018.pdf.
21. Sheller JP, Muchardt O, Jonsson B, Mikkelsen MB. Burn injuries caused by fireworks: effect of prophylaxis. Burns. 1995;21(1):50–53. https://doi.org/10.1016/0305-4179(95)90782-U PMid: 7718120
22. D’Argenio P, Cafaro L, Santonastasi F, Taggi F, Binkin N. Capodanno senza danno: the effects of an intervention program on fireworks injuries in Naples. Am J of Public Health. 1996;86(1):84–86 https://doi.org/10.2105/AJPH.86.1.84 PMid:8561250 PMCid:PMC1380368