TOPLINE

A retrospective analysis of US emergency department (ED) data found that upper-extremity injuries related to fireworks in pediatric patients predominantly affected boys and adolescents, with thermal burns to the hands and fingers accounting for most injuries and nearly 14% of patients requiring hospitalization.

METHODOLOGY

• Researchers used data from the National Electronic Injury Surveillance System (NEISS), which compiles information on injuries from approximately 100 EDs across the United States.
• The analysis included all cases of firework-related upper-extremity injuries reported between 2015 and 2024 among patients younger than 18 years.
• The primary outcomes included injury occurrence, demographic trends, anatomic injury patterns, diagnostic categories, ED disposition, and annual injury trends.

TAKEAWAY

• A total of 434 pediatric cases (national estimate = 16,872) of firework-related upper-extremity injuries were reported between 2015 and 2024. Injuries were more common among boys than among girls (77.9% vs 22.1%; P < .001) and among patients aged 12-14 years (23.3%) or 15-17 years (25.1%).
• Injuries to the hands and fingers accounted for 48.8% and 32.7% of all injuries, respectively, and the anatomic distribution of injuries differed significantly across body regions (P < .001).
• Thermal burns accounted for 74.0% of injuries, followed by amputations (representing 9.0% of injuries); the overall distribution of diagnostic categories differed significantly (P < .001).
• Of the patients, 13.8% required hospitalization, whereas 78.8% were treated in and discharged from the ED.

IN PRACTICE

"These findings highlight the need for multifaceted public health strategies, including the implementation of stricter regulatory policies, targeted educational campaigns, and enhanced community-level safety interventions, to mitigate the burden of firework-related injuries in the pediatric population," the authors of the study wrote.

SOURCE

The study was led by Coen R. Zediker, Des Moines University College of Osteopathic Medicine in Des Moines, Iowa. It was published online on July 15, 2026, in Injury.

LIMITATIONS

The study was limited by potential sampling errors inherent to the NEISS database, possible injury misclassification due to variability in coding and documentation, exclusion of injuries not treated in EDs, and a lack of detailed clinical information on injury severity, treatment, and long-term outcomes. 

DISCLOSURES

The study did not receive any funding. The authors reported having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.