Eye Injuries and Fireworks: Prevalence and Trends
By Lynda Seminara
Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
JAMA Ophthalmology, June 2020
Studies of the trends and national prevalence of firework-related ocular injuries are scarce. Shiuey et al. set out to characterize the firework-related ocular injuries treated in emergency departments (EDs) in the United States. During the 19-year study period, fireworks caused more than 34,000 ocular injuries, most of which occurred during celebrations of Independence Day and New Year’s Day. The most common injury was ocular burn.
For this cross-sectional study, the authors gathered data from the National Electronic Injury Surveillance System (NEISS), a stratified probability sample of more than 100 hospital-affiliated U.S. EDs that represents more than 5,300 hospitals. Patients with an eye injury caused by fireworks from January 1999 through December 2017 were included. Outcomes of interest were the annual prevalence of these injuries and the firework types, stratified by such factors as demographics, diagnoses, and event date/location.
The 1,007 injuries identified in the NEISS database represented roughly 34,548 firework-related ocular injuries in U.S. EDs during the study period, or 1,840 injuries annually. Nearly 66% of patients were 18 years old or younger; 72% were male; and 51% were white. The most common injury was ocular burn (62.9%), followed by ocular foreign body (11.7%) and conjunctival irritation (9.6%). Ruptured globe occurred in 2.8%, and other severe eye trauma was present in 4.6%. More than 90% of patients were treated and released, and 8.7% were admitted or were transferred to another facility.
Injuries were most often linked to firecrackers (19.2%) and bottle rockets (17.6%), followed by sparklers (8.7%), Roman candles (6.6%), and novelty devices (6.5%) such as poppers. Bottle rockets caused a disproportionately high number of severe injuries (odds ratio, 5.82; 95% CI, 2.72-12.46; p < .001). Injuries were most common on or near Jan. 1 and July 4, with 70.2% presenting in July, 7.4% in June, 10% in January, and 4.7% in December.
The original article can be found here.