2018 Fireworks Annual Report

Fireworks-Related Deaths, Emergency Department-Treated Injuries,

and Enforcement Activities During 2018

June 2019

Yongling Tu
Division of Hazard Analysis
Directorate for Epidemiology
U.S. Consumer Product Safety Commission

Jason Ng
Office of Compliance and Field Operations
U.S. Consumer Product Safety Commission

This analysis was prepared by CPSC staff. It has not been reviewed or approved by, and may not
necessarily reflect the views of, the Commission.
 Executive Summary

This report provides the results of U.S. Consumer Product Safety Commission
(CPSC) staff’s analysis of data on nonoccupational, fireworks-related deaths and injuries
during calendar year 2018. The report also summarizes CPSC staff’s enforcement
activities during fiscal year 2018.1

Staff obtained information on fireworks-related deaths from news clippings and

other sources in CPSC’s Consumer Product Safety Risk Management System
(CPSRMS). Staff estimated fireworks-related injuries treated in hospital emergency
departments from CPSC’s National Electronic Injury Surveillance System (NEISS).
CPSC staff conducted a special study of nonoccupational fireworks-related injuries
between June 22, 2018 and July 22, 2018. The special study included collecting and
analyzing more detailed incident information, such as the type of injury, the fireworks
involved, the characteristics of the victim, and the incident scenario. About 62 percent of
the estimated annual fireworks-related, emergency department-treated injuries for 2018
occurred during that period.

Highlights of the report:

Deaths and Injuries

 CPSC staff received reports of five nonoccupational fireworks-related deaths

during 2018. All of these fatalities were associated with reloadable aerial devices,
and all five victims died from direct impacts of fireworks. Reporting of fireworks-
related deaths for 2018 is not complete, and the number of deaths in 2018 should
be considered a minimum.

 Fireworks were involved in an estimated 9,100 injuries treated in U.S. hospital

emergency departments during calendar year 2018 (95 percent confidence interval
7,000–11,100). The estimated rate of emergency department-treated injuries is 2.8
per 100,000 individuals in the United States.

 There is not a statistically significant trend in estimated emergency department-

treated, fireworks-related injuries from 2003 to 2018.

 An estimated 5,600 fireworks-related injuries (or 62 percent of the total estimated

fireworks-related injuries in 2018) were treated in U.S. hospital emergency
departments during the 1-month special study period between June 22, 2018 and
July 22, 2018 (95 percent confidence interval 3,900–7,200).

1 Fiscal year 2018 refers to the period of October 1, 2017 through September 30, 2018.

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Results from the 2018 Special Study2

 Of the 5,600 estimated fireworks-related injuries sustained, 64 percent were to

males, and 36 percent were to females.

 Children younger than 15 years of age accounted for 36 percent of the estimated
injuries. Similar to last year, nearly half of the estimated emergency department-
treated, fireworks-related injuries were to individuals younger than 20 years of
age.

 Children 10 to 14 years of age had the highest estimated rate of emergency

department-treated, fireworks-related injuries (5.2 injuries per 100,000 people).
Older teens, 15 to 19 years of age, had the second highest estimated rate (3.1
injuries per 100,000 people).

 There were an estimated 500 emergency department-treated injuries associated

with sparklers and 200 with bottle rockets.

 There were an estimated 1,000 emergency department-treated injuries associated

with firecrackers. Of these, an estimated 33 percent were associated with small
firecrackers, an estimated 13 percent with illegal firecrackers, and an estimated 54
percent with firecrackers for which there was no specific information.

 The parts of the body most often injured were hands and fingers (an estimated 28
percent); legs (an estimated 24 percent); eyes (an estimated 19 percent); head,
face, and ears (an estimated 15 percent); and arms (an estimated 4 percent).

 Forty-four percent of the emergency department-treated injuries were burns.

Burns were the most common injury to hands, fingers, and arms.

 Approximately 81 percent of the victims were treated at the hospital emergency

department and then released. An estimated 17 percent of patients were treated
and transferred to another hospital, or admitted to the hospital.

 CPSC staff conducted telephone follow-up investigations on a selected sample of

fireworks-related injuries reported in NEISS during the special study period to
clarify information about the incident scenario or fireworks type. A review of data
from the 20 completed follow-up investigations showed that most injuries were
associated with misuse or malfunctions of fireworks. Most victims recovered or
were expected to recover completely. However, there were victims who reported
that their injuries may be long term.

2 The percentages are calculated from the actual injury estimates.

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Enforcement Activities

During fiscal year 2018, CPSC’s Office of Compliance and Field Operations
continued to work closely with other federal agencies to conduct surveillance on
imported fireworks and to enforce the provisions of the Federal Hazardous Substances
Act (FHSA) and regulations under the FHSA.

The Compliance and Field Operations staff, in cooperation with U.S. Customs and
Border Protection (CBP), continues to conduct surveillance on imported shipments of
consumer fireworks. With assistance from CBP, CPSC staff selectively sampled and
tested shipments of imported fireworks in fiscal year 2018, to determine compliance with
the FHSA requirements. Approximately 67 percent of the selected and tested shipments
were found to contain fireworks that were noncompliant. These violative fireworks
devices had an estimated import value of $523,000. The most frequent violations were
due to overloaded report compositions and fuse violations, comprising approximately 72
and 19 percent of all violations in fiscal year 2018, respectively. CPSC staff requested
corrective actions on these noncompliant fireworks; and in most cases, firms voluntarily
destroyed the noncompliant fireworks.

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1. Introduction

This report describes injuries and deaths associated with fireworks devices, as
well as kits and components used to manufacture illegal fireworks, during calendar year
2018. Reports for earlier years in this series can be found at:
https://www.cpsc.gov/Research--Statistics/Injury-Statistics#fuel-lighters--fireworks.

This report is organized into seven sections. Section 1 provides a description of

the data and statistical methods used in this analysis. Section 2 summarizes the 2018
fireworks-related incidents that resulted in deaths. Section 3 provides an annual estimate
of fireworks-related, emergency department-treated injuries in the United States for 2018,
and compares that estimate with the estimated injuries for previous years. Section 4
analyzes emergency department-treated, fireworks-related injuries occurring during the
month around July 4, 2018. Section 5 summarizes the telephone in-depth investigations
of a subsample of the injuries during that period. Section 6 describes enforcement
activities of CPSC’s Office of Compliance and Field Operations during 2018. The report
concludes with a summary of the findings in Section 7. Appendix A is a table on the
relationship between fireworks-related injuries and fireworks imports between 2003 and
2018. Appendix B provides details on the completed telephone investigations.

Sources of Information

Information on nonoccupational fireworks-related deaths during 2018 was

obtained from the CPSC’s CPSRMS. CPSRMS combines the data from CPSC’s Injury or
Potential Injury Incident File (IPII), Death Certificate File (DTHS), and In-Depth
Investigation File (INDP) into one incident database. Entries in IPII come from a variety
of sources, such as newspaper articles, consumer complaints, lawyer referrals, medical
examiners, and other government agencies. CPSC staff from the Office of Compliance
and Field Operations conducted in-depth investigations of the deaths to determine the
types of fireworks involved in the incidents and the circumstances that led to the fatal
injuries.

Because the data in IPII are based on voluntary reports, and because it can take
more than 2 years to receive all death certificates from the various states to complete the
DTHS, neither data source can be considered complete for 2017 or 2018 fireworks-
related deaths at the time this report was prepared. Consequently, the number of deaths
should be considered a minimum. Staff updates the number of deaths for previous years
when new reports are received. Total deaths for prior years may not coincide with the
numbers in reports for earlier years because of these updates.

The source of information on nonoccupational, emergency department-treated

fireworks-related injuries is the CPSC’s NEISS. NEISS is a probability sample of U.S.

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hospitals with emergency departments.3 Injury information is taken from the emergency
department record. This information includes the victim’s age and sex, the place where
the injury occurred, the emergency department diagnosis, the body part injured, and the
consumer product(s) associated with the injury. The information is supplemented by a
160-character narrative that often contains a brief description of how the injury occurred.

To supplement the information available in the NEISS record, CPSC staff

conducts a special study of fireworks-related injuries during the month around July 4
every year. Staff focuses its efforts on fireworks incidents during this period because, in
most years about two-thirds to three-quarters of the annual injuries occur then. During
this period, hospital emergency department staffs show patients pictures of different types
of fireworks to help them identify the type of fireworks device associated with their
injuries. The type of fireworks involved in the incident is then included in the NEISS
narrative. In 2018, the special study period lasted from June 22 to July 22.

After reading the incident case records, including the narrative description of the
fireworks device and the incident scenario, CPSC staff may assign a case for additional
telephone investigation. Cases are usually selected because they involve the most serious
injuries and/or hospital admissions. Serious injuries include: eye injuries, finger and hand
amputations, and head injuries. Cases also may be assigned to obtain more information
about the incident than what is reported in the NEISS narrative. In most years, phone
interviewers are able to collect information for one-fifth to one-half of the cases assigned.
Information on the final status of the telephone interviews conducted during the 2018
special study is in Section 5 and Appendix B of this report.

In the telephone investigations, information is requested directly from the victim

(or the victim’s parent, if the victim is a minor) about the type of fireworks involved,
where the fireworks were obtained, how the injury occurred, and the medical treatment
and prognosis. When the fireworks device reported in the telephone investigation is
different from what is reported in the NEISS emergency department record, the device
reported in the telephone investigation is used in the data for this report.

As a result of this investigative process, three different levels of information may

be available about a fireworks-related injury case. For cases that occur before or after the
July 4 special study period, the NEISS record is almost always the only source of
information. Many NEISS records collected outside the special study period do not
specify the type of fireworks involved in the incident. Additional information is typically
available during the special study period because the NEISS record collected by the
emergency department usually contains the type of fireworks and additional details on the
incident scenario. Finally, the most information is available for the subset of the special
study cases where staff conducted telephone investigations. These different levels of
information about injuries correspond to these different analyses in the report:

3 For a description of NEISS, including the revised sampling frame, see Schroeder and Ault (2001). Procedures used
for variance and confidence interval calculations and adjustments for the sampling frame change that occurred in 1997
are found in Marker, Lo, Brick, and Davis (1999). SAS ® statistical software for trend and confidence interval
estimation is documented in Schroeder (2000). SAS® is a product of the SAS Institute, Inc., Cary, NC.

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  Estimated national number of fireworks-related, emergency department-treated
injuries
This estimate is made using NEISS cases for the entire year, from records where
fireworks were specified as one of the consumer products involved. For cases
outside the special study period, as noted above, there is usually no information
on the fireworks type, and limited information is available on the incident
scenario. Consequently, there is not enough information to determine the role
played by the fireworks in the incident. Thus the annual injury estimate may
include a small number of cases in which the fireworks device was not lit or no
attempt was made to light the device. Calculating the annual estimates without
removing these cases makes the estimates comparable to previous years.4

 Detailed analyses of injury patterns

The tables are based on the special study period only and describe fireworks type,
body part injured, diagnosis, age and sex of injured people, and other relevant
information. Fireworks-type information is taken from the telephone investigation
or the NEISS comment field when there was no telephone investigation. When
computing estimates for the special study period staff does not include cases in
which the fireworks device was not lit or no attempt was made to light the device.

 Information from telephone investigations

Individual case injury descriptions and medical prognosis information from the
telephone investigations are provided in Appendix B. These summaries also
exclude cases in which the fireworks device was not lit or no attempt was made to
light the device. These cases represent a sample of some of the most serious
fireworks-related injuries and may not represent the typical emergency
department-treated, fireworks-related injuries.

Statistical Methods

Injuries reported by hospitals in the NEISS sample were weighted by the NEISS
probability-based sampling weights to develop an estimate of total U.S. emergency
department-treated, fireworks-related injuries for the year and for the special study month
around July 4. Confidence intervals were estimated, and other statistics were calculated
using computer programs that were written to take into account the sampling design.5
Estimated injuries are rounded to the nearest 100 injuries. Estimates of fewer than 50
injuries are shown with an asterisk (*). Percentages are calculated from the actual
estimates. Percentages may not add to subtotals or to the totals in the tables or figures,
due to rounding.

This report also contains a number of detailed tables about fireworks-related

injuries during the special study period. National estimates in these tables were also made
4 The only exception to the practice of including all of the cases occurred in 2003, when nine cases representing an
estimated 150 emergency department-treated injuries were excluded from the annual injury estimates. These cases
resulted from a nightclub fire in West Warwick, RI, which also caused 100 deaths. For details see Greene and Joholske
(2004).
5 See Schroeder (2000).

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using the sampling weights. To avoid cluttering the tables, confidence intervals are not
included. Because the estimates are based on subsets of the data, they have larger relative
sampling errors (i.e., larger coefficients of variation) than the annual injury estimate or
the special study injury estimate. Therefore, interpretation and comparison of these
estimates with each other, or with estimates from prior years, should be made with
caution. For example, when comparing subsets of the data—such as between injuries
associated with two different types of fireworks, or between two different age groups—it
is difficult to determine how much of the difference between estimates is associated with
sampling variability and how much is attributed to real differences in national injury
totals.

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2. Fireworks-Related Deaths for 2018

CPSC has reports of five nonoccupational, fireworks-related deaths that occurred

during 2018. Reporting of fireworks-related deaths for 2018 is not complete, and the
number of deaths in 2018 should be considered a minimum. Brief descriptions of the
incidents, using wording taken from the incident reports, follow:

 A 16-year-old male from Florida died after a mortar tube exploded in his hand on
July 5, 2018. According to the police report, the victim’s cousin lit the charge of a
mortar and placed it in the tube and backed away. The victim then picked up the
tube and held it in his left hand. As the cousin went to tell the victim to put the
tube down, the tube exploded in the victim’s hand and knocked the victim down.
The victim suffered a penetrating open wound, approximately 2 inches in
diameter to the upper left chest, as well as, flash burns on his face, neck, and
chest. In addition, the victim’s left thumb was only attached to his hand by skin.
The victim was transported to a hospital via an ambulance, and he was
pronounced deceased in the emergency room. The cause of death was penetrating
shrapnel wound of chest with perforation of heart and lung.

 On July 7, an 18-year-old male from Iowa was setting off fireworks with his
friends at his residence. According to the sheriff’s report, an adult friend decided
to tape a tube to a football helmet using duct tape. This friend then placed the
helmet on his head and launched several fireworks from the helmet. This friend
did not experience any incidents while doing so. The victim stated he also wanted
to launch fireworks from his head and taped a tube to a second helmet. The victim
placed the helmet on his head, loaded the tube, and launched one mortar shell
from the tube while it was atop of his head. The victim loaded the second mortar
in the tube and ignited it, but the shell became stuck in the tube and didn’t launch.
The mortar exploded in the tube atop of the victim’s head a few seconds later and
caused the victim to fall to the ground. Bystanders provided first aid to the victim
until first responders arrived. The victim was taken to a local hospital and later
transported to a medical center where he died the next day due to his injuries.

 A 37-year-old male from Indiana died of massive head trauma caused by

professional grade Class 1.3G mortar shells on July 7, 2018.6 According to the
police report, the victim and another man were at the end of a residential
driveway together. They put 3-inch mortar shells with altered fuses into yellow
PVC tubes and tied wicks together attempting to light them off at the same time.
The original electronic fuse for the mortar shells was replaced with a length of
cannon fuse and attached to the shells with blue painter tape. The victim stood
directly over the tube and lit the fuse. The mortar ignited and struck the victim on
the head causing a fatal injury. The other male suffered a serious injury to his
head, as well, and was hospitalized. Law enforcement authorities confiscated all
fireworks found at the scene.

6 Class 1.3G fireworks are not within CPSC’s regulatory jurisdiction.

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  On the night of July 4, a 24-year-old male from South Carolina was fatally injured
by a reloadable artillery firework at the common area of an apartment complex.
According to the witnesses and police report, the victim put a mortar shell into a
launching tube and lit the fuse, and then he held the tube in his right hand and
pointed it towards the far end of the common area. The firework exploded in the
tube and the victim fell to the ground. Bystanders called the county dispatch, and
emergency first responders were dispatched to the location. The first responders
provided life-saving measures to the victim. The victim was transported to a local
emergency room where he was pronounced deceased later. The cause of death
was determined to be blunt force injury of the chest.

 On the New Year’s Eve of 2018, a 49-year-old male from Texas died of explosive
injuries while shooting fireworks. The incident occurred at the victim’s home. It
was reported that the victim apparently launched artillery shells from a device on
his shoulder. When the victim lit the firework device, there was a blast that caused
injuries to the victim’s shoulder and chest. The victim was transported to a local
hospital but he died en route. The cause of death was explosive injuries, including
fractures of multiple ribs, lacerations of the right lung and chest. According to the
County Attorney, this incident is still under investigation, and no other
information could be released.

Including the five deaths described above, CPSC staff has reports of 121
fireworks-related deaths between 2003 and 2018, for an average of 7.56 deaths per year.7

7 See previous reports in this series (e.g., the report for 2017: Tu and Ng (2017)). In the most recent 3 years, the number
of deaths included 12 deaths in 2015, 5 deaths in 2016, and 10 deaths in 2017. The data from 2015 to 2017 have been
updated based on new incident reports received by CPSC staff during 2018, and may differ from what was reported in
the previous reports.

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3. National Injury Estimates for 2018

Table 1 and Figure 1 present the estimated number of nonoccupational, fireworks-

related injuries treated in U.S. hospital emergency departments between 2003 and 2018.

Table 1
Estimated Fireworks-Related Injuries: 2003–2018

Year Estimated Injuries Injuries per 100,000 People

2018 9,100 2.8

2017 12,900 4.0
2016 11,100 3.4
2015 11,900 3.7
2014 10,500 3.3
2013 11,400 3.6
2012 8,700 2.8
2011 9,600 3.1
2010 8,600 2.8
2009 8,800 2.9
2008 7,000 2.3
2007 9,800 3.3
2006 9,200 3.1
2005 10,800 3.7
2004 9,500 3.3
2003 9,300 3.2
Source: NEISS, U.S. Consumer Product Safety Commission. The estimate for 2003 excludes an estimated 150
emergency department-treated injuries following the nightclub fire in West Warwick, RI. Population estimates for 2010
to 2018 are from Table 1. Annual Estimates of the Resident Population for the United States, Regions, States, and
Puerto Rico: April 1, 2010 to July 1, 2018 (NST-EST2018-01), U.S. Census Bureau, Population Division. Release
Date: December 2018. Population estimates for 2003 to 2009 are from Table 1. Annual Estimates of the Resident
Population for the United States, Regions, States, and Puerto Rico: April 1, 2000 to July 1, 2009 (NST-EST2009-01).
Population Division, U.S. Census Bureau.

There is not a statistically significant trend detected in the fireworks-related injury

estimates from 2003 to 2018.8 In calendar year 2018, there were an estimated 9,100
fireworks-related, emergency department-treated injuries (95 percent confidence interval
7,000–11,100). There were an estimated 12,900 injuries in 2017. The difference between
the injury estimates for 2018 and 2017 is statistically significant.

8
For details on the method to test a trend that incorporates the sampling design, see Schroeder (2000) and Marker et al.
(1999).

10
 Figure 1
Estimated Fireworks-Related, Emergency Department-Treated Injuries
2003–2018

Source: NEISS, U.S. Consumer Product Safety Commission.

Appendix A contains a table showing estimated fireworks-related injuries and

fireworks imports between 2003 and 2018.

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4. Injury Estimates for the 2018 Special Study: Detailed Analysis of Injury Patterns

The injury analysis in this section presents the results of the 2018 special study of
fireworks-related injuries treated in hospital emergency departments between June 22,
2018 and July 22, 2018. During this period, there were an estimated 5,600 fireworks-
related injuries (95 percent confidence interval 3,900–7,200), accounting for 62 percent
of the total estimated fireworks-related injuries for the year, which is statistically
different from the estimated 8,700 fireworks-related injuries in the 2017 special study
period.

The remainder of this section provides the estimated fireworks-related injuries

from this period, broken down by fireworks device type, victims’ demographics, injury
diagnosis, and body parts injured.

Fireworks Device Types and Estimated Injuries

Table 2 shows the estimated number and percent of emergency department-

treated injuries by type of fireworks device during the special study period of June 22,
2018 to July 22, 2018.

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 Table 2
Estimated Fireworks-Related Injuries
By Type of Fireworks Device
June 22–July 22, 2018

Fireworks Device Type Estimated Injuries Percent

Total 5,600 100

All Firecrackers 1,000 19

Small 300 6
Illegal 100 2
Unspecified 600 10
All Rockets 300 6
Bottle Rockets 200 3
Other Rockets 200 3
All Other Devices 2,300 41
Sparklers 500 9
Fountains * *
Novelties 200 4
Multiple Tube 500 8
Reloadable Shells 700 12
Roman Candles 400 7
Homemade/Altered * *
Public Display 100 2
Unspecified 1,800 33
Source: NEISS, U.S. Consumer Product Safety Commission. Based on 146 NEISS emergency department-reported
injuries between June 22, 2018 and July 22, 2018, and supplemented by 20 completed In-Depth Investigations (IDIs).
Fireworks types are obtained from the IDI, when available; otherwise, fireworks types are identified from information
in victims’ reports to emergency department staff that were contained in the NEISS narrative. Illegal firecrackers
include M-80s, M-1000s, Quarter Sticks, and other firecrackers that are banned under the Federal Hazardous
Substances Act (FHSA) (16 C.F.R. § 1500.17). Fireworks that may be illegal under state and local regulations are not
listed as illegal, unless they violate the FHSA. Estimates are rounded to the nearest 100 injuries. Estimates of fewer
than 50 injuries are denoted with an asterisk (*). Estimates may not sum to subtotal or total due to rounding.
Percentages are calculated from the actual estimates, and they may not add to subtotals or the total due to rounding.

Although public display fireworks are not associated with a large number of
injuries, the larger load in these devices makes them involved disproportionately in
serious injuries. Fountains and homemade/altered devices were involved in less than 1
percent of the total estimated injuries each during the 2018 special study period.

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Gender and Age of Injured Persons

Males experienced an estimated 2.2 fireworks-related, emergency department-

treated injuries per 100,000 individuals during the special study period. Females had 1.2
injuries per 100,000 people. Figure 2 shows the distribution of estimated fireworks-
related injuries by gender.

Figure 2
Estimated Injuries by Gender

Female
36%

Male
64%

Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between
June 22, 2018 and July 22, 2018.

Children under 5 years of age experienced an estimated 400 injuries (7 percent of

all fireworks-related injuries during the special study period), as shown in Figure 3 and
Table 3. Children in the 5- to 14-year-old age group experienced an estimated 1,600
injuries. Breaking down that age group further, children 5 to 9 years of age had an
estimated 500 injuries and children 10 to 14 years of age accounted for 1,100 injuries.9

9The percentages are calculated from actual injury estimates, and age subcategory percentages may not sum to the
category percentage due to rounding.

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 Figure 3
Percentage of Injuries by Age Group

45-64
5% 65+
25-44 3%
34%
0-4
7%

20-24 5-9
10% 10%

15-19 10-14
12% 19%

Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between
June 22, 2018 and July 22, 2018.

The detailed breakdown by age and gender is shown in Table 3. The

concentration of injuries among males and people under 25 has been typical of fireworks-
related injuries for many years.

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 Table 3
Estimated Fireworks-Related Injuries
By Age and Gender
June 22–July 22, 2018

Per 100,000
Age Group Total Male Female
People

Total 5,600 1.7 3,600 2,000

0–4 400 2.0 200 200

5–14 1,600 4.0 1,000 600

5–9 500 2.7 300 200
10–14 1,100 5.2 700 400

15–24 1,200 2.8 700 500

15–19 600 3.1 300 300
20–24 600 2.6 400 200

25–44 1,900 2.2 1,400 500

45–64 300 0.3 100 200

65+ 100 0.3 100 *

Sources: NEISS, U.S. Consumer Product Safety Commission. NC-EST2017-AGESEX-RES: Annual Estimates of the
Resident Population by Single Year of Age and Sex for the United States: April 1, 2010 to July 1, 2017. U.S. Census
Bureau, Population Division. Release Date: June 2018. The oldest victim was 71 years of age. Estimates are rounded to
the nearest 100 injuries. Estimates of fewer than 50 injuries are denoted with an asterisk (*). Age subcategory estimates
may not sum to the category total due to rounding.

When considering injury rates (number of injuries per 100,000 people), children
and young adults had higher estimated rates of injury than the other age groups during the
2018 special study period. Children 10 to 14 years of age had the highest estimated injury
rate at 5.2 per 100,000 population. This was followed by 3.1 injuries per 100,000 people
from older teens 15 to 19 years of age, and 2.7 injuries per 100,000 people from children
5 to 9 years of age.

Age and Gender of the Injured Persons by Type of Fireworks Device

Table 4 shows the ages of those injured by the type of fireworks device associated
with the injury. For children under 5 years of age, sparklers accounted for 54 percent of
the total estimated injuries for that specific age group.10

10 The percentages are calculated from the actual injury estimates.

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 No clear relationship between age and fireworks type is suggested by the data in
Table 4. It is worth noting that the number of estimated injuries does not completely
represent the usage pattern because victims are often injured by fireworks used by other
people. This is especially true for rockets and aerial shells (e.g., fountains, multiple tube,
and reloadable devices), which can injure people located some distance away from where
the fireworks are launched.

Table 4
Estimated Fireworks-Related Injuries
By Device Type and Age Group
June 22–July 22, 2018

Age Group
Fireworks Type Total 0–4 5–14 15–24 25–44 45–64 65+

Total 5,600 400 1,600 1,200 1,900 300 100

All Firecrackers 1,000 100 500 200 200 * *

Small 300 * 200 100 * * *
Illegal 100 * * 100 100 * *
Unspecified 600 100 300 100 100 * *

All Rockets 300 * 100 200 * 100 *

Bottle Rockets 200 * * 200 * * *
Other Rockets 200 * 100 * * 100 *

Other Devices 2,300 300 500 500 900 * 100

Sparklers 500 200 * 100 200 * 100
Fountains * * * * * * *
Novelties 200 100 100 * * * *
Multiple Tube 500 * 100 200 200 * *
Reloadable 700 * * 200 400 * 100
Roman Candles 400 * 200 * 100 * *

Homemade/Altered * * * * * * *
Public Display 100 * * 100 * * *
Unspecified 1,800 * 500 300 800 200 *
Source: NEISS, U.S. Consumer Product Safety Commission. Estimates are rounded to the nearest 100 injuries.
Estimates of fewer than 50 injuries are denoted with an asterisk (*). Estimated injuries may not sum to subtotals or
totals due to rounding.

As shown previously in Figure 2, males accounted for 64 percent of the estimated

fireworks-related injuries, and females comprised 36 percent. Males accounted for all the

17
estimated injuries from illegal firecrackers, fountains and homemade/altered devices. In
addition, males were associated with a majority of the estimated injuries from small and
unspecified firecrackers; sparklers; multiple tube devices; reloadable devices; and Roman
candles. Females accounted for all the estimated injuries from public display of
fireworks, as well as a majority of the estimated injuries from other rockets and novelty
devices.

Body Region Injured and Injury Diagnosis

Figure 4 presents the distribution of estimated emergency department-treated

injuries by the specific parts of the body to which the injury occurred. Hands and fingers,
were associated with an estimated 1,600 injuries. These were followed by an estimated
1,300 leg injuries; 1,100 eye injuries; 800 injuries to the head/face/ear region; 500
injuries to trunk/other category; and 200 arm injuries.

Figure 4
Body Regions Injured
Trunk/Other
10%
Leg
24% Arm
4%

Hand/Finger Eye
28% 19%

Head/Face/Ear
15%
Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between
June 22, 2018 and July 22, 2018. Arm includes NEISS codes for upper arm, elbow, lower arm,
shoulder, and wrist. Head/Face/Ear regions include eyelid, eye area, nose, neck, and mouth but not
the eyeball. Leg includes upper leg, knee, lower leg, ankle, foot, and toe. Trunk/other regions include
chest, abdomen, pubic region, “all parts of body,” internal, and “25–50 percent of body.”

18
 Figure 5 shows the diagnoses of the estimated injuries associated with fireworks
devices. Burns, with 2,500 estimated injuries were the most frequent injury diagnosis.
Contusions and lacerations were associated with 1,600 estimated injuries, and fractures
and sprains were associated with 500 estimated injuries. The remaining 1,100 estimated
injuries were attributed to other diagnoses.11

Figure 5
Type of Injuries

Burns
44%

Other
19%
Contusions and
Lacerations
28%
Fractures and
Sprains
8%
Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between
June 22, 2018 and July 22, 2018. Fractures and sprains also include dislocations. Other diagnoses
include all other injury categories. Percentages may not sum to 100 due to rounding.

As shown in Table 5, burns accounted for all the estimated injuries to arms,
around half of the injuries to hands and fingers, legs, and head/face/ear regions, as well as
over 60 percent of injuries to the trunk and other regions. Contusions and lacerations
were the most frequent injuries to eyes, which included foreign bodies in the eye.

11Estimated injuries may not sum to total due to rounding. Percentages are calculated from the actual injury estimates
and may not sum to 100 due to rounding.

19
 Table 5
Estimated Fireworks-Related Injuries
By Body Region and Diagnosis
June 22–July 22, 2018

Diagnosis
Body Region Total Burns Contusions Fractures Other
Lacerations Sprains Diagnoses

Total 5,600 2,500 1,600 500 1,100

Arm 200 200 * * *
Eye 1,100 * 700 * 300
Head/Face/Ear 800 400 300 * 100
Hand/Finger 1,600 800 100 300 300
Leg 1,300 700 400 100 200
Trunk/Other 500
1,100 300 * * 200
Source: NEISS, U.S. Consumer Product Safety Commission. Fractures and sprains also include dislocations. Estimates
are rounded to the nearest 100 injuries. Estimates of fewer than 50 injuries are denoted with an asterisk (*). Estimated
injuries may not sum to subtotals or totals due to rounding.

Type of Fireworks Device and Body Region Injured

Table 6 presents estimated injuries by the type of fireworks device and body
region injured.

20
 Table 6
Estimated Fireworks-Related Injuries
By Type of Fireworks Device and Body Region Injured
June 22–July 22, 2018

Region of the Body Injured

Fireworks Type Total Arm Eye Head/Face/Ear Hand/Finger Leg Trunk/Other

Total 5,600 200 1,100 800 1,600 1,300 500

All Firecrackers 1,000 * 300 * 500 200 *

Small 300 * 300 * 100 * *
Illegal 100 * * * 100 * *
Unspecified 600 * 100 * 300 100 *
All Rockets 300 * 100 * 100 200 *
Bottle Rockets 200 * 100 * 100 * *
Other Rockets 200 * * * * 200 *
Other Devices 2,300 100 300 400 700 500 300
Sparklers 500 100 * 100 200 100 *
Fountains * * * * * * *
Novelties 200 100 * * * * 200
Multiple Tube 500 * * 100 * 300 *
Reloadable 700 * 100 * 400 100 200
Roman Candles 400 * 200 100 100 * *
Homemade/Altered * * * * * *
Public Display 100 * * 100 * * *
Unspecified 1,800 100 400 400 300 600 200
Source: NEISS, U.S. Consumer Product Safety Commission. Estimates are rounded to the nearest 100 injuries. Estimates of fewer than 50 injuries
are denoted with an asterisk (*). Estimated injuries may not sum to subtotals or totals due to rounding.

21
 Nearly all of the estimated injuries from illegal firecrackers involved hands and
fingers. In addition, 51 percent of the estimated reloadable device injuries, 48 percent of
the estimated bottle rocket injuries, and 40 percent of the estimated sparkler injuries
involved the hands and fingers as well. A majority of the estimated injuries associated
with small firecrackers affected the eyes.

Hospital Treatment

An estimated 81 percent of the victims of fireworks-related injuries in the special

study period were treated at the emergency department and then released; about 12
percent were admitted to the hospital; approximately 6 percent of the victims were treated
and transferred to another hospital; and 2 percent of the victims had other dispositions
(i.e. left hospital without being seen or held for observation).12 The treat-and-release
percentage was lower compared to that for all consumer products in 2018, and the
percentages of the treated and transferred and the admitted were higher for the fireworks-
related injuries in the special study period than those for all consumer products.13

12The percentages are calculated from actual injury estimates and may not sum to 100 due to rounding.
13For all injuries associated with consumer products in 2018, 88 percent of patients were treated and released; 9
percent were admitted to the hospital; 1 percent of patients were transferred to other hospitals; and 2 percent had other
dispositions, including left hospital without being seen, held for observation, or dead on arrival.

22
5. Telephone Investigations of Fireworks-Related Injuries

CPSC staff conducted telephone in-depth investigations of a sample of fireworks

incidents that occurred during the 1-month special study period surrounding the 4th of
July holiday (June 22, 2018 to July 22, 2018). Completed telephone investigations
provided more detail about incidents and injuries than the emergency department
information summarized in the narrative in the NEISS record. During the telephone
interview, respondents were asked how the injury occurred (hazard pattern); what
medical care they received following the emergency-department treatment; and what
long-term effects, if any, resulted from their injury. Respondents were also asked detailed
questions about the fireworks involved in the incident, including their type, markings,
and where they were obtained.

Cases were selected for telephone investigations based on the information

provided in the NEISS narrative and coded information in the NEISS records. The
selection criteria included: (1) unusual hazard patterns, (2) severity of the injury, and (3)
lack of clear information in the narrative about the type of fireworks associated with the
injury. For these reasons, and because many victims did not respond, the telephone
investigation cases cannot be considered typical of fireworks-related injuries.

From the 146 emergency department-treated, fireworks-related injuries during the

special study period, staff selected 95 cases for telephone investigations, of which 20
were completed and determined to be in scope, and 75 were incomplete. Table 7 shows
the final status of these investigations, including the reasons why some investigations
were incomplete.

Table 7
Final Status of Telephone Investigations

Final Case Status Number of Cases Percent

Total Assigned 95 100

Completed Investigation 20 21
In Scope 20 21
Incomplete Investigations 75 79
Failed to Reach Patient 49 52
Victim Name Not Provided by Hospital 7 7
Victim Refused to Cooperate 19 20

23
 Short descriptions of the 20 completed in-scope cases are found in Appendix B.
The cases are organized in order of emergency department disposition, with Admitted (to
the hospital) first, followed by Treated and Released, and Left without Being Seen by A
Doctor. Within dispositions, cases are in order of increasing age of the victim.

Summary Statistics14

Of the 20 completed in scope cases, 14 (70 percent) involved males, and 6 (30
percent) involved females. There were six victims (30 percent) ages 5 to 14 years old; six
victims (30 percent) ages 15 to 24 years old; six victims (30 percent) ages 25 to 44 years
old; one victim (5 percent) aged 45 to 64 years old; and one victim aged 65 years or
older. As for emergency department dispositions, eight victims (40 percent) were
admitted to the hospital; 11 victims (55 percent) were treated and released; and one
victim (5 percent) left without being seen by a doctor.

The most frequently involved fireworks devices in these incidents were aerial
15
shells, which were associated with 12 incidents (60 percent). Roman candles and
novelty devices each accounted for two incidents (10 percent). Bottle rockets; public
display of fireworks; homemade devices; and unspecified devices each were involved in
one incident (5 percent).

Note that the distribution of the types of fireworks and the emergency department
dispositions differ from the special study data in Section 4. These differences reflect the
focus in the telephone investigation on more serious injuries and incompletely specified
NEISS records. Note also that only 21 percent of the victims selected for the telephone
investigations responded.

Hazard Patterns

The hazard patterns described below are based on the incident descriptions
obtained during the telephone investigations and summarized in Appendix B. When an
incident has two or more hazard patterns, the hazard pattern most likely to have caused
the injury was selected. Hazard patterns are presented in Table 8, below, and a detailed
description of the incidents follows Table 8. Case numbers refer to the case numbers
shown in Appendix B.

14 Percentages may not add to 100 due to rounding.

15 The category “aerial shells” includes multiple tube, reloadable mortars and rockets, but excludes bottle rockets.

24
 Table 8
Hazard Patterns, as Described in Telephone Investigations of Fireworks-Related Injuries

Hazard Pattern Number of Cases Percent

All 20 100
Misuse 6 30
Lighting Fireworks in Hand 2 10
Pointing Lit Fireworks at Someone 1 5
Lighting Fireworks Incorrectly 1 5
Setting Fireworks Improperly 1 5
Lighting Fireworks under Influence of Alcohol 1 5
Malfunction 12 60
Errant Flight Path 7 35
Tip-Over 2 10
Early Ignition 2 10
Blowout 11 53
Other 2 10
Unknown 2 10

Misuse (6 victims injured, 30 percent)

Six victims were injured when fireworks were used in ways that departed from
proper usage.

Lighting Fireworks in Hand

 In Case 2, an 11-year-old male and his friend found a homemade smoke bomb on
a driveway in their neighborhood. The victim held the firework in his left hand
while his friend lit it. As soon as the firework was ignited, it exploded in the
victim’s hand. The victim sustained amputation of his left index finger as well as
exposed muscles and shattered bone in his left thumb. He also suffered burns in
his face, eyes, neck, and chest.
 In Case 11, it was reported that a 13-year-old male ignited a golf ball-size smoke
bomb, and the firework exploded into a ball of fire in the victim’s hand. The
victim suffered severe burns over his hand and a lot of skin came off. The victim
also suffered burns on his face and nose.

Pointing Lit Fireworks at Someone

 In Case 1, an 8-year-old boy lost one eye when he was injured by a Roman
candle. It was reported that the victim was on the sidewalk of his apartment
complex, an adult male literally aimed a Roman candle at his eye, and the
firework went directly into the victim’s eye. The victim was transported to the
emergency department and admitted to three hospitals for treatment and surgery.

25
 The victim had to have his injured eye removed. In addition, his remaining eye
began to close.

Lighting Fireworks Incorrectly

 In Case 10, an 11-year-old girl was injured by an unspecified firework. The
victim’s mother handed the victim an unspecified firework after the mother
straightened the wick. The victim used a long barbecue lighter to ignite the
firework. The victim lit the firework at the base instead of at the end of the wick,
and there was a big flame from the lighter. The victim straddled over the firework
instead of standing beside it when she lit the firework. As soon as she lit the
firework, it blew up between her legs. The victim was wearing polyester leggings
and some plastic from the firework melted on her skin. The victim sustained a
second-degree burn about the size of a quarter on her left thigh and spark marks
on her right thigh.

Setting Fireworks Improperly

 In Case 20, a 29-year-old female and her family were waiting to see a fireworks
show. They brought their own fireworks to set off with children while waiting for
the show. One relative put a multiple tube device type firework on top of a car
and ignited it. The first shot went up, and then the firework device fell over
shooting remaining four shots in all directions. One shot lodged between the
victim’s right foot and her footwear and exploded. The victim suffered a third-
degree burn about the size of a softball on her right foot.

Lighting Fireworks under Influence of Alcohol

 In Case 7, a 40-year-old male was setting off mortar type of fireworks in the yard.
The victim reported that he had consumed too much alcohol before the incident
and felt that he was impaired. The victim lit a mortar and thought that the
firework had not gone off, but it did actually. The victim put his hand out to
deflect the firework away from his face when the mortar shot out the tube. The
firework exploded and broke three fingers of the victim’s hand.

Malfunction (12 victims injured, 60 percent)

Twelve victims were injured when fireworks reportedly malfunctioned. These

injuries resulted from errant flight paths, tip-overs, early ignitions, and a blowout. Note
that some of the errant flight path injuries may have involved tip-overs, but victims may
have been unable to observe the tip-over if they were far from the fireworks.

Errant Flight Path

 In Case 6, a 29-year-old male and his friends were setting off fireworks. The
victim lit a mortar type firework but it did not go off, so he kicked it out of the
way. About 30 minutes later, the victim tried to relight this firework. The victim
crouched down and used a long torch lighter to light the firework at an arm-
length. The mortar came out the tube at a weird angle and hit the victim in his eye

26
 instead of going straight up. The firework blew out the victim’s eyebrow ring and
injured his eyeball.
 In Case 9, a 6-year-old boy was at a neighborhood gathering for the 4th of July.
There was a neighborhood display of fireworks, and a lot of children gathered on
the street. The victim’s father set off a firework that was with a propeller and
designed to spin up into the air and explode. The first firework went off as it was
supposed to do. The father lit the second firework (same type), the firework
flopped on its side instead of shooting up. The firework spun on the street and
then shot into the crowd of the children, and it exploded on the victim. The victim
suffered a first-degree burn on his chest, and first and second-degree burns on his
inside upper arms and biceps.
 In Case 13, a 15-year-old male and his family were setting off fireworks in the
backyard. When the last firework—a multiple tube device—was lit, the first shot
discharged from the side instead of shooting up. The victim was struck in both
legs by the explosion from this misfired shell. The victim sustained holes on his
right leg and burns on both legs.
 In Case 14, a 16-year-old female and her family were at a parking lot watching a
public display of fireworks set up by the city. Multiple fireworks malfunctioned
and shot into the crowd instead of going up. Several people were hurt. The victim
was hit in the left leg and forehead. The victim suffered a burn on her left leg and
a bump with a burn on the forehead near the temple.
 In Case 15, a 22-year-old female and her boyfriend’s family were setting off
fireworks for the 4th of July in the backyard. A multiple tube device type of
firework was lit on a platform that was a thick piece of wood. The first few shots
fired correctly, but the next three shots went in completely different directions.
Two went towards the woods, and one shot straight at the victim. As the victim
had her hand up to block her face, the shell hit the victim in the head and not the
face. The victim suffered three burns on the side of her arm, a burn on her right
ear, and some of her hair was burned off. The victim also sustained a concussion.
 In Case 16, a 24-year-old male and his cousins were lighting off fireworks in the
street. One cousin lit a bottle rocket about five to six feet away from the victim.
The bottle rocket shot just up 2 to 3 feet in the air and then came towards the
victim. The firework blew up as soon as the victim grabbed it. The victim suffered
third-degree burns on his thumb and three fingers.
 In Case 17, a 31-year-old female was at a friend’s house, and one person lit a
Roman candle. The victim saw the firework going straight towards her son, so she
pushed her son out of the way. The Roman candle hit the victim in her face before
she could get away. The victim sustained permanent nerve damage in her face,
partial eye loss in the right eye, as well as a hole about an inch in her face. In
addition, the victim’s seizure disorder had returned as a result. Furthermore, the
victim will be losing six teeth because of an abscess developed in her mouth due
to the treatment received at the emergency department.

Tip-Over Incidents
 In Case 12, a 13-year-old male, his cousin and the family were setting off
fireworks at an open field. It was reported that a multiple tube device type

27
 firework fell over and one shell struck the victim at the ankle. The shell did not
explode, but it fractured his ankle.
 In Case 19, a 66-year-old male and his friend sat in a yard, and his friend’s
children and grandchildren were igniting fireworks across the street 40 yards
away from them. The children lit a mortar and the mortar tipped over. The
firework flew under a van, hit the sidewalk, bounced up, and then hit the victim
on the side and exploded. The firework burned through the victim’s shirt. The
victim suffered first, second, and third-degree burns on the side of his upper body
as well as burns on his stomach.

Early Ignition
 In Case 4, a 20-year-old male victim was given a mortar type firework. When the
victim lit the mortar, it failed to launch and blew up the victim’s right hand.
 In Case 18, a 41-year-old male was injured by a multiple tube device type
firework. The victim and his family were setting off fireworks in the driveway.
The victim lit the fuse of a 60-shot multiple tube device. As soon as the victim
ignited the fuse, the firework went off into the victim’s face as he stood up and
walked away. The victim stated that although he got a little closer to the firework
to see the fuse because it was getting darker, he did not stand over the firework
device. The victim was hit four times in the face. The victim suffered separation
of septum from inside of his nose and a few bruises on the left side of his face.

Blowout
 In Case 5, a 28-year-old male was seriously injured by fireworks. The victim and
his friend were igniting mortars in a driveway. It was reported that the fireworks
were yellow plastic cylinders about 5 inches long and were bought by his friend 3
or 4 years ago. The victim’s friend set off four to five mortars with no problems.
The victim stated that when he lit a mortar, both charges ignited at the same time
and the firework exploded at the bottom of the launching tube. The explosion split
the tube open and a piece of firework or plastic tubing shot and punctured the
victim’s left hand, and his left thumb was injured severely.

Other (Two victims injured, 10 percent)

There were two victims whose injuries were related to fireworks, based on the
NEISS incident narrative and telephone IDI. However, the telephone IDI did not yield
enough information to pinpoint definitively the hazard associated with the incident.

Unknown
 In Case 3, a 17-year-old male’s left hand was seriously injured by fireworks. The
victim and his family were in an open field on a tribal land. They were setting off
fireworks while watching other people doing the same. When they were ready to
leave, they heard something coming towards them. As they turned around, a
firework exploded on the victim. The victim sustained serious injuries on his left
hand. The fingertips of his left index and middle fingers were amputated, the

28
 thumb was shattered, and the ring finger was fractured at the base. Additionally,
the victim suffered several abrasions in his cornea, face and abdomen.
 In Case 8, a 52-year-old female was hit by a rocket while walking a dog in a park.
The victim was disorientated and suffered thermal burns on her right leg and
knee. The victim stated that she did not see who set off the rocket or where the
firework came from.

Long-Term Consequences of Fireworks-Related Injuries

Victims were asked whether there were any long-term consequences of their
injuries. Most victims (12 of 20, or 60 percent) have experienced or expected complete
recoveries with no long-term effects. Eight victims reported that they have experienced or
might suffer long-term effects of the injuries, as follows:

 In Case 1, the victim was hit in the eye directly by a Roman candle, and his
injured eye had to be removed as a result.
 In Case 2, the victim held a homemade firework while his friend ignited it. The
firework exploded in the victim’s hand. The victim sustained amputation of his
left index finger as well as exposed muscles and shattered bone in his left thumb.
The victim may not regain full function of his left hand.
 In Case 3, a firework exploded on the victim. The fingertips of the victim’s left
index and middle fingers were amputated, the thumb was shattered, and the ring
finger was fractured at the base. The victim may not regain the full function of his
left hand.
 In Case 4, a mortar failed to launch and blew up the victim’s right hand. The
victim stated that the wrist movement in his right hand was lost permanently as a
result of the injury.
 In Case 5, a mortar exploded at the bottom of the launching tube, and a piece of
firework or plastic tubing shot and punctured the victim’s left hand. The victim
reported that he suffered severe nerve loss and will not have the full mobility of
his left hand as a result.
 In Case 6, a mortar came out the launching tube at a weird angle and hit the
victim in his eye instead of going up. The firework blew out the victim’s eyebrow
ring and injured his eyeball. The victim lost one eye and suffered night vision
impairment. The victim reported that he could no longer drive at night.
 In Case 7, the victim used his hand to deflect a mortar away from his face when
the mortar shot out from the launching tube. The mortar exploded and broke three
fingers of the victim’s hand. The victim reported that he suffered some loss of
mobility in his hand as a result.
 In Case 17, the victim was hit in the face by a Roman candle. The victim said that
she sustained permanent nerve damage in her face and partial eye loss in the right
eye.

29
Where Fireworks Were Obtained

Of the 20 telephone survey respondents, 15 (75 percent) knew where the

fireworks were obtained. Among them, five respondents reported that the fireworks were
purchased from a stand/tent; another five respondents stated that fireworks were acquired
from a friend or a relative; three said that the fireworks were bought from a store; one
reported that the fireworks was found on a driveway; and one respondent said that the
fireworks were obtained at a tribal land.

Three victims (15 percent) stated that they did not know the source of the
fireworks. This is typically the situation when the victim did not purchase or light the
fireworks device that caused the injury. One (5 percent) victim was injured at a public
display of fireworks. In the remaining case, the response for the question was not
recorded due to technical problems.

6. Enforcement Activities

During fiscal year 2018, CPSC’s Office of Compliance and Field Operations
continued to work closely with other federal agencies to conduct surveillance on
imported fireworks and to enforce the provisions of FHSA and FHSA regulations.

The Compliance and Field Operations staff, in cooperation with CBP, continues
to conduct surveillance on imported shipments of consumer fireworks. With assistance
from CBP, CPSC staff selectively sampled and tested shipments of imported fireworks in
fiscal year 2018, for compliance with the FHSA requirements. Approximately 67 percent
of the selected and tested shipments were found to contain fireworks that were
noncompliant. These violative fireworks devices had an estimated import value of
$523,000. The most frequent violations were due to overloaded report compositions and
fuse violations, comprising approximately 72 and 19 percent of all violations in fiscal
year 2018, respectively. CPSC staff requested corrective action on these noncompliant
fireworks; and in most cases, firms voluntarily destroyed the noncompliant fireworks.
Because CPSC’s fireworks program stops noncompliant fireworks at import, fewer
violative and dangerous imported fireworks are reaching retail stores and roadside stands.

CPSC staff’s enforcement effort remains focused on reducing the number of

fireworks-related deaths and injuries, by stopping the sale and distribution of consumer
fireworks that violate mandatory regulations.

30
7. Summary

In calendar year 2018, there were five reported nonoccupational fireworks-related

deaths. However, reporting for 2018 may not be complete at this time. Emergency
department-treated injuries are estimated at 9,100 for calendar year 2018.

During the 1-month special study period from June 22, 2018 to July 22, 2018,
there were an estimated 5,600 emergency department-treated fireworks-related injuries.
Children under 15 years of age experienced about 36 percent of the estimated injuries,
and males of all ages experienced 64 percent of the estimated injuries.

Additionally, similar to results from previous special study periods, 44 percent of

the estimated injuries during the special study period in 2018 involved burns. Burns were
the most frequent injury to fingers, hands and arms. The parts of the body most often
injured were hands and fingers (an estimated 28 percent of the injuries); followed by legs
(24 percent); eyes (19 percent); the head, face, and ears (15 percent); trunk (10 percent);
and arms (4 percent). Most of the estimated injuries (81 percent) involved treat-and-
release dispositions. An estimated 17 percent were treated and transferred to another
hospital or admitted to the hospital where the emergency department was located.

Among the different types of fireworks, firecrackers accounted for 19 percent of

the estimated injuries during the special study period; reloadable shells were involved in
12 percent; and sparklers were associated with 9 percent. Multiple tube devices were
involved in 8 percent of the estimated injuries and Roman candles were related to 7
percent. Novelty devices were associated with 4 percent of the estimated injuries. Bottle
rockets and other rockets each accounted for 3 percent of the estimated injuries. Public
display of fireworks were involved in 2 percent of the estimated injuries. Fountains and
homemade/altered devices each were associated with less than 1 percent of the estimated
injuries.

A review of data from telephone follow-up investigations showed that the typical
causes of injuries were as follows: misuse of fireworks; errant flight paths; tip-overs;
early ignitions; and blowout. At the time of the telephone investigation, which was
conducted typically 1 to 2 months after the injury, most victims had recovered from their
injuries. Eight of the 20 victims interviewed reported that the effect of their injuries might
be long term.

Finally, in fiscal year 2018, CPSC staff continued to actively monitor import
shipments of fireworks and products in the marketplace. CPSC staff worked with CBP to
sample imported fireworks. Compliance staff conducted inspections at fireworks retailers
to collect samples for analysis and testing for compliance with mandatory requirements.

31
 References

Greene MA and Joholske J (2004), “2003 Fireworks Annual Report: Fireworks-Related

Deaths, Emergency Department-Treated Injuries, and Enforcement Activities During
2003,” U.S. Consumer Product Safety Commission, Washington DC.
https://www.cpsc.gov/s3fs-public/pdfs/2003fwreport.PDF

Marker D, Lo A, Brick M and Davis W (1999), “Comparison of National Estimates from

Different Samples and Different Sampling Frames of the National Electronic Injury
Surveillance System (NEISS),” Final Report prepared for the U.S. Consumer Product
Safety Commission by Westat, Inc. Rockville, MD.

Schroeder T (2000), “Trend Analysis of NEISS Data.” U.S. Consumer Product Safety
Commission, Washington, DC.

Schroeder T and Ault K (2001), “The NEISS Sample (Design and Implementation), 1997
to Present” U.S. Consumer Product Safety Commission, Washington, DC.
http://www.cpsc.gov//PageFiles/106617/2001d011-6b6.pdf

32
 Appendix A
Fireworks-Related Injuries and Fireworks Imported

Table A-1 shows that fireworks imports have generally risen over the period
2003–2007, peaking in 2005 at 275.1 million pounds. From 2008 to 2014, fireworks
imports have been relatively steady with modest changes for some years. In 2015, the
fireworks imports soared to 279.5 millions of pounds, which was the highest since 2003.
It decreased to 262.3 and 247.0 million pounds in 2016 and 2017, respectively. In 2018,
the fireworks imports increased to 278.1 million pounds, the second highest since 2003.

As for the number of estimated emergency department-treated fireworks-related

injuries, year 2018 with 9,100 estimated injuries was the lowest since 2013. The highest
three estimated fireworks-related injuries were 12,900 in 2017, 11,900 in 2015, and
11,400 in 2013.

As shown in Table A-1 below, the estimated number of injuries per 100,000
pounds of fireworks imported was 3.3 in 2018, which was the lowest since 2003. The
highest three estimated number of injuries per 100,000 pounds of fireworks were 6.3
injuries in 2013, 5.2 injuries in 2017, and 4.8 injuries in 2014. For the other years, that
number ranged between 3.4 injuries and 4.4 injuries per 100,000 pounds of fireworks
imported.

33
 Table A-1
Estimated Fireworks-Related Injuries and
Estimated Fireworks Imported into the U.S. 2003–2018

Estimated Fireworks Injuries Per 100,000

Imports Pounds of
Year Estimated Injuries (millions of pounds)¥ Fireworks Imported

2018 9,100 278.1 3.3

2017 12,900 247.0 5.2
2016 11,100 262.3 4.2
2015 11,900 279.5 4.3
2014 10,500 219.6 4.8
2013 11,400 180.2 6.3
2012 8,700 201.0 4.3
2011 9,600 228.1 4.2
2010 8,600 199.6 4.3
2009 8,800 200.2 4.4
2008 7,000 208.3 3.4
2007 9,800 260.1 3.8
2006 9,200 272.1 3.4
2005 10,800 275.1 3.9
2004 9,500 230.0 4.1
2003 9,300 214.6 4.3
Source: Injuries from NEISS, U.S. Consumer Product Safety Commission. See Table 1 for further details. Estimated
fireworks imports data from the U.S. International Trade Commission (ITC), using Harmonized Tariff Schedule (HTS
code 3604.10). Imports include consumer fireworks (1.4G HTS code 3604.10.90.10 and 3604.10.90.50) and display
fireworks (1.3G HTS code 3604.10.10.00). Display fireworks were about 6.6 percent of the total imports in 2018. In
addition to imported fireworks used in the United States, there is also a small amount of fireworks manufactured in the
United States for domestic consumption; the data for these fireworks is not available from the International Trade
Commission and is not shown in this table. Fireworks imports data were downloaded from ITC website in April 2019.
¥ Fireworks imports data subject to change by ITC. These changes have typically been minor.

Although the table suggests a relationship between weight and the number of
injuries, it should be interpreted with caution. First, the logical unit of exposure is the
number of fireworks devices used, instead of the collective weight of the devices because
a person is exposed to injury when a device is consumed (i.e., lit). Injuries per 100,000
fireworks devices imported might be more meaningful, but the number of devices
imported is not available. Moreover, using weight overrepresents heavy devices and
underrepresents light devices. There is no reason to assume that a heavy device is
inherently more dangerous than a light device because the weight of the device includes
things other than just the amount of explosive material.

In addition, international trade statistics do not provide weight by fireworks

device types. Thus, it is not possible to associate injuries with the weight of different
types of fireworks imported. As shown in Table 2 earlier in this report, different
fireworks devices have different numbers of injuries. Thus, the decrease in injuries per
100,000 pounds between 2003 and 2008 may be due to different mixtures of types of

34
fireworks imported over time, or an overall decrease in injuries among all types of
fireworks. Similarly, the increase in injuries per 100,000 pounds in 2013 may have
resulted from different fireworks mixtures, a decrease in importation of fireworks, or just
statistical variation. The data do not provide enough information to determine the relative
contribution of these factors.

35
 Appendix B
Completed Telephone Investigations

Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

It was reported that the victim was on the

sidewalk of his apartment complex. An
adult male literally aimed a Roman candle
at the victim’s eye, and the firework went The victim had additional medical visits for
directly into the victim’s eye. The victim surgery and treatment of an eye infection
Thermal Roman
1 8 Male Eye Admit was transported to the emergency after discharge from the hospital. The
Burns Candle
department (ED) and admitted to three victim was still recovering from his injuries
hospitals for treatment and surgery. The at the time of the telephone interview.
victim had to have his injured eye removed.
In addition, his remaining eye began to
close.
The victim was airlifted to the ED and was
The victim and his friend found a
admitted for one night. After discharge, the
homemade smoke bomb on a driveway in
victim had follow-up visits to get more X-
their neighborhood. The victim held the
rays, to change the bandage/dressing, and
firework in his left hand while his friend lit
to check his eyes and the healing of his
it. As soon as the firework was ignited, it
hand. The victim was still recovering at the
2 11 Male Amputation Finger Admit Homemade blew up in the victim’s hand. The victim
time of the telephone interview. The
sustained amputation of his left index
victim’s mother who answered the
finger as well as exposed muscles and
telephone interview indicated that the
shattered bone in his left thumb. The victim
victim may need more surgeries later, and
also suffered burns on his face, eyes, neck
she did not know how long it will take for
and chest.
the victim to recover fully.

36
 Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

The victim and his family were in an open

field on a tribal land. They were setting off
fireworks while watching other people
doing the same. When they were ready to
leave, they heard something coming
towards them. As they turned around, a
The victim was admitted to the hospital for
Reloadable firework exploded on the victim. The
3 17 Male Amputation Finger Admit 2 to 3 days. It took approximately 1 month
Aerial Shell victim sustained serious injuries on his left
for the victim to recover fully.
hand. The fingertips of his left index and
middle fingers were amputated, the thumb
was shattered, and the ring finger was
fractured at the base. In addition, the victim
suffered several abrasions on his cornea,
face and abdomen.
The victim was hospitalized for 14 to 15
days. After discharge from the hospital, the
victim had additional follow-up visits, and
The victim was given a mortar type
he was expected to have a surgery to fuse
Reloadable firework. When the victim lit the firework,
4 20 Male Avulsion Hand Admit the bones in his right wrist. When the
Aerial Shell it failed to launch and blew up the victim’s
victim was interviewed for this report, he
right hand.
was still recovering from the injuries. The
victim stated that it will take 2 more
months for him to recover fully.
The victim and his friend were igniting
mortars in a driveway. It was reported that
the fireworks were yellow plastic cylinder
The victim was hospitalized for 4 days and
about 5-inch long and were bought by his
his left thumb was reattached. After
friend 3 or 4 years ago. The victim’s friend
discharge, the victim had follow-up visits
set off four to five mortars with no
to remove the cast and to determine the
Reloadable problems. The victim stated that when he
5 28 Male Amputation Finger Admit next stage of surgery. At the time of the
Aerial Shell lit a mortar, both charges ignited at the
telephone interview, the victim was still
same time and the firework exploded at the
undergoing treatment. The victim estimated
bottom of the launching tube. The
that it may take 6 to 12 months for him to
explosion split the tube open and a piece of
fully recover.
firework or plastic tubing shot and
punctured the victim’s left hand and
severely injured his left thumb.

37
 Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

The victim and his friends were setting off

The victim was admitted to the hospital for
fireworks. The victim lit a mortar type
3 days. After discharge from the hospital,
firework but it did not go off, so he kicked
the victim had weekly follow-up visits to
it out of the way. About 30 minutes later,
have surgery and to check the progress of
the victim tried to relight this firework. The
his eye. Doctors tried to save the victim’s
Reloadable victim crouched down and used a long
6 29 Male Other Eye Admit eyeball by stitching it, but they had to
Aerial Shell torch lighter to light the firework at an arm-
remove it eventually. The victim was still
length. The mortar came out the tube at a
undergoing treatment when he was
weird angle and hit the victim in his eye
interviewed for this report, and he
instead of going straight up. The firework
estimated it may take 4 to 5 months for him
blew out the victim’s eyebrow ring and
to recover fully.
injured his eyeball.
The victim was setting off mortar type
fireworks in the yard. The victim reported
that he had consumed too much alcohol
before the incident and felt that he was The victim was admitted to the hospital for
impaired. The victim lit a mortar and 3 to 4 days. After discharge, the victim had
Reloadable
7 40 Male Fracture Finger Admit thought that the firework had not gone off, follow-up visits to have surgery and hand
Aerial Shell
but it did actually. The victim put his hand therapy. The victim had recovered fully in
out to deflect the firework away from his 3 months.
face when the mortar shot out of the tube.
The firework exploded and broke three
fingers of the victim’s hand.
The victim was walking a dog in a park
when she was hit by a rocket type firework.
The victim was disoriented and suffered The victim was admitted to the hospital for
Thermal Lower
8 52 Female Admit Rocket thermal burns on her right leg and knee. a few hours, and she had since fully
Burns Leg
The victim stated that she did not see who recovered in a month and a half.
set off the rocket and where the firework
came from.

38
 Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

The victim was at a neighborhood

gathering for the 4th of July, and there was
a neighborhood display of fireworks. A lot
of children gathered on the street. The
victim’s father set off a firework that was
with a propeller and designed to spin up
into the air and explode. The first firework After the treatment at the ED, the victim
went off as it was supposed to do. The had a follow-up visit to remove dead skin
Thermal Upper Treat and Novelty
9 6 Male father lit the second firework (same type), and to make sure the wounds are healing.
Burns Arm Release Device
the firework flopped on its side instead of The victim had fully recovered in about a
shooting up into the air. The firework spun week.
on the street and then shot into the crowd
of the children, and it exploded on the
victim. The victim suffered a first-degree
burn on his chest, and first- and second-
degree burns on his inside upper arms and
biceps.
The victim’ mother handed the victim an
unspecified firework after she straightened
the wick for it. The victim used a long
barbecue lighter to light the firework. The
victim lit the firework at the base instead of
at the end of the wick, and there was a big
frame from the lighter. The victim
After being treated and released from the
Thermal Upper Treat and straddled over the firework instead of
10 11 Female Unspecified ED, the victim did not seek further
Burns Leg Release standing beside it when she lit the firework.
treatment.
As soon as she ignited the firework, it blew
up between her legs. The victim was
wearing polyester leggings and some
plastic from the firework melted on her
skin. The victim suffered a second-degree
burn about the size of a quarter on her left
thigh and spark marks on her right thigh.

39
 Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

The victim was taken to the ED for

treatment. Doctors there had to clean and
It was reported that the victim ignited a
scrap off the burned skin form the victim’s
golf ball-size smoke bomb, and the
hand. The victim had follow-up visits to
firework exploded into a ball of fire in the
Thermal Treat and Smoke change bandage/dressing for the wounds
11 13 Male Hand victim’s hand. The victim suffered severe
Burns Release Bomb and to have therapy for his hand.
burns over his hand, and a lot of skin came
According to the victim’s father who
off. The victim also had burns on his face
answered the telephone interview, the
and nose.
victim will recover fully when his skin
grows back completely in 2 weeks.
The victim was taken to the ED and was
put in a splint. The victim had follow-up
The victim, his cousin and the family were visits with a pediatric orthopedic doctor to
setting off fireworks at an open field. It was get a cast. The victim was in the cast for
Multiple
Treat and reported that a multiple tube device type about 9 weeks before it was removed.
12 13 Male Fracture Ankle Tube
Release firework fell over and one shot struck the According to the victim’s mother who
Device
victim at the ankle. The shell did not responded to the telephone survey, the
explode, but it fractured his ankle. victim had fully recovered but had a
walking boot at the time of the telephone
interview.
The victim and his family were setting off The victim was treated at the ED and
fireworks in their backyard. When the last released. The victim had follow-up visits to
firework—a multiple tube device—was lit, remove debris and change
the first shot discharged from the side bandage/dressing for his wounds.
Multiple
Lower Treat and instead of shooting up. The remaining 14 According to the victim’s mother who
13 15 Male Avulsion Tube
Leg Release shots fired correctly. The victim was struck answered the telephone survey, the victim
Device
in both legs by the explosion from this was still healing from his injuries at the
misfired shell. The victim sustained holes time of the telephone interview. The
on his right leg as well as burns on both mother stated that the victim was expected
legs. to recover fully in about 8 weeks.

40
 Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

After being treated at the ED, the victim

The victim and her family were at a
had follow-up visits with her regular doctor
parking lot watching a public display of
to make sure that everything was healing
fireworks set up by the city. Multiple
correctly. According to the victim’s mother
fireworks malfunctioned and shot into the
Thermal Treat and Public who answered the telephone survey, the
14 16 Female Face crowd instead of going up. Several people
Burns Release Display victim was still recovering at the time of
were hurt. The victim was hit in left leg and
the telephone interview. The victim’s
the forehead. The victim sustained a burn
mother stated that she did not know how
on her leg and a bump with a burn on the
long it will take for the victim to recover
forehead near the temple area.
fully.
The victim was with her boyfriend’s family
to celebrate her boyfriend’s birthday and
the 4th of July, and they were setting off
fireworks in the backyard. A multiple tube
device type firework was lit on a platform
that was a thick piece of wood. The first
The victim was treated at the ED and
few shots fired correctly, but the next three
Multiple released. When she was interviewed for
Treat and shots went in completely different
15 22 Female Concussions Head Tube this report, the victim stated that the burns
Release directions. Two shots went towards the
Device had healed in 2 weeks but she was still
woods and the third one shot straight at the
recovering from the concussion.
victim. The victim had her hand up to
block her face, and the firework hit her in
the head. The victim suffered three burns
on the side of her arm, a burn on her right
ear, and some of her hair was burned off.
The victim sustained a concussion as well.
The victim was at his aunt and cousins’
house, and they were setting off fireworks
in the street. One cousin lit a bottle rocket
about five to six feet away from the victim.
Thermal Treat and Bottle The bottle rocket did not shoot up all the The victim recovered fully in about a
16 24 Male Hand
Burns Release Rocket way (just up 2 to 3 feet in the air) and then month and a half.
came towards the victim. The firework
blew up as soon as the victim grabbed it.
The victim suffered third-degree burns on
his thumb and three fingers.

41
 Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

The victim was at a friend’s house, and one

person set off a Roman candle. The victim
saw that the firework was going straight
The victim had follow-up visits to change
towards her son, so she pushed her son out
bandage/dressing for her wounds. She was
of the way. The firework hit the victim in
still healing at the time of the telephone
her face before she could get away. The
interview. The victim stated that she will
Nerve Treat and Roman victim sustained permanent nerve damage
17 31 Female Face need plastic surgery to look normal, and
Damage Release Candle in her face, partial eye loss in the right eye,
she can no longer drive and has to be
as well as a hole about an inch in her face.
seizure free for 2 years to return to work.
In addition, the victim’s seizure disorder
She did not know when she will be
had returned as a result. Furthermore, the
recovered fully.
victim will be losing six teeth because of an
abscess developed in her mouth due to the
treatment received at the ED.
The victim and his family were setting off
fireworks on the driveway. The victim lit
the fuse of a 60-shot multiple tube device.
As soon as the victim lit the fuse, the The victim received a couple stitches on
firework went off into his face as he stood the outside of his nose at the ED. The
Multiple up and walked away. The victim stated that victim had a follow-up visit to remove the
Contusions Treat and
18 41 Male Face Tube he got a little closer to the firework to see stitches later. When the victim was
Abrasions Release
Device the fuse because it was getting darker, but interviewed for this report, he stated that he
he did not stand over the firework device. had a scar on the inside of his nose and did
The victim was hit four times in the face. not know if he had fully recovered.
He suffered separation of septum from
inside of his nose and a few bruises on the
left of his face.
The victim and his friend sat in a yard, and
his friend’s children and grandchildren
After the treatment at the ED, the victim
were setting off fireworks across the street
sought additional treatments at a few other
40 yards away from them. The children lit
hospitals. The victim had a nurse come to
a mortar and the mortar tipped over
change bandage/dressing for him three
Thermal Upper Treat and Reloadable somehow. The firework flew under a van,
19 66 Male times of a week for about a month. At the
Burns Trunk Release Aerial Shell hit the sidewalk, bounced up, and then hit
time of the telephone interview, the victim
the victim on the side and exploded. The
was still recovering from his injuries. The
firework burned through the victim’s shirt.
victim stated that he will be able to go
The victim sustained the first, second, and
without bandages soon hopefully.
third-degree burns on the side of his upper
body as well as burns on his stomach.

42
 Body Fireworks
Case Age Sex Diagnosis Disposition Incident Description Medical Treatment and Prognosis
Part Type

The victim and her family were waiting to

see a fireworks show. They brought some
their own fireworks to set off with children
The victim waited for 4 days to go to the
while waiting for the show. One of the
ED and was told to come back after her
victim’s relatives put a multiple tube device
vacation. The victim had a follow-up
Left Multiple type firework on top of a car and ignited it.
Thermal appointment scheduled to determine if she
20 29 Female Foot without Tube The first shot went up, and then the
Burns needs a skin graft. The victim was still
Being Seen Device firework device fell over shooting
recovering at the time of the telephone
remaining four shots in all directions. One
interview and stated that it will 6 weeks for
shot lodged between the victim’s right foot
her to recover fully.
and her footwear and went off. The victim
sustained a third-degree burn about the size
of a softball on her right foot.

43