Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland
Introduction
Fireworks are used worldwide for their visible and audible effects and are an integral part of national and cultural celebrations. They are also explosive devices capable of inflicting great harm. The extent of trauma due to fireworks has been highlighted by a number of authors, and annually accounts for over 12,000 emergency room attendances in the United States[1]. In the United Kingdom fireworks are mainly used around Halloween (October 30th) and Guy Fawkes night (November 5th), when the incidence of firework injuries peaks dramatically[2]. Although data on firework injury numbers in the United Kingdom is collected by government agencies, there has been no work published in the medical literature regarding the nature of firework associated injury in the United Kingdom.
Over the Halloween holiday period of 1996, a number of deaths occurred as a direct result of fireworks. These deaths resulted in a surge of media and public interest in firework safety with calls for more stringent controls on firework use in the United Kingdom. Despite a number of studies examining the law and firework injuries, it remains uncertain whether legislative change has an impact on the incidence of firework trauma3, 4.
In Northern Ireland because of the continued civil disturbance all fireworks, apart from sparklers, were banned. In September 1996 new more liberal legislation was passed making the law governing fireworks in Northern Ireland the same as in Great Britain[5]. Thus while there were no fireworks legally available in Northern Ireland before 1996 (apart from sparklers) after 1996 all fireworks were legally available to the public except those fireworks used only by professional display organisers i.e. class 4 fireworks such as larger rockets and mortars. Bangers however, remained illegal both before and after 1996 as is the case in the rest of the United Kingdom.
The Northern Ireland Plastic and Maxillofacial surgery unit provides a regional service for a population of 1.5 million people. As such it receives all patients with burns and hand injuries and will thus be responsible for those patients with a severe firework related injury. In this study we sought to describe the epidemiology of severe firework related trauma within this part of the UK. More importantly in light of the change in legislation with regard to firework sale in Northern Ireland, we were in a unique position to observe the effect of this change on the pattern of disease following liberalisation of the law. In this paper we present our results and review the literature on firework associated injuries.
Section snippets
Prospective study
For the two consecutive years following legislative change (1996 & 1997), we examined those patients with firework related injuries who required admission to hospital during the 6 week period extending from October 14th (when the first injuries were admitted to our care) to November 30th. In providing the regional plastic surgery and burns service we were responsible for the care of all those patients in Northern Ireland who required admission with either burns or a serious hand injury.
Results
Over the 5 year period under study there was a total of 30 patients with a firework related injury admitted to the hospitals involved. The mean annual number of admissions during the retrospective period of study was 5.6 while the mean number for the prospective period was 6.5. The incidence of firework admissions was therefore 0.38 per 100,000 in the retrospective study and 0.43 per 100,000 in the prospective study. In both periods of study the mean age of the patients admitted was 14 years
Discussion
Although a number of authors have described firework injuries in the past they have tended to focus on specific aspects such as burns or hand injuries6, 7. In the more detailed study by Smith et al., only paediatric patients were included and the study was based in the United States. There has been no detailed clinical study of severe firework injuries in the United Kingdom (UK). With an increasing incidence in firework trauma in the UK we therefore wanted to study firework injury admissions
Acknowledgements
The authors would like to thank Mrs Janice Bisp of The Royal Society for the Prevention of Accidents (RoSPA) and Inspector S. McQueen of the Explosives Division, The Royal Ulster Constabulary, who have helped by providing information used in the preparation of this manuscript.
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