Deaths and hospitalisation from fireworks injuries

Statement of the Problem Little is known about the severity of fireworks injuries and no international reviews have been conducted. This study aimed to document and describe the severity of fireworks injuries and the implications for prevention in several countries. Method This retrospective epidemiological study of fireworks-related deaths and hospitalisations obtained injury surveillance data and vital statistics from Australia, the Netherlands, New Zealand and the United States. Of three further countries approached, none was able to supply the full dataset. Results From 1991 to 1995, there were 22 deaths involving fireworks in the United States, 5 in the Netherlands and none in Australia or New Zealand. Except in 1994, the Netherlands had higher admission rates from fireworks injuries than Australia, New Zealand and the United States. Overall, Australia experienced the lowest admission rates. Australian injuries may also have been less severe. Males and children <15 years of age accounted for most admissions. Fatal injuries were mostly to males aged 15-44 years. Conclusions Deaths from fireworks injuries are rare in Australia and New Zealand. Differences in rates and in some characteristics of admitted cases were observed between countries. This study should serve as a benchmark and a pilot to future studies. International comparisons will require enhanced epidemiological data, possibly by collaborative prospective data collection, with appropriate quality control, rather than routinely collected data. Such studies should include developing countries, where the manufacture and use of fireworks is widespread. Since differences may relate to regulatory control and exposure, these should be documented.