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2021 Fireworks Annual Report

Fireworks-Related Deaths, Emergency Department-


Treated Injuries, and Enforcement Activities During
2021
June 2022
Blake Smith
Division of Hazard Analysis
Directorate for Epidemiology
U.S. Consumer Product Safety Commission

Allison Marier
Division of Hazard Analysis
Directorate for Epidemiology
U.S. Consumer Product Safety Commission

Jennifer Timian
Office of Compliance and Field Operations
U.S. Consumer Product Safety Commission

This report was prepared by the 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 non-occupational, fireworks-related deaths and injuries during
calendar year 2021. The report also summarizes CPSC staff’s enforcement activities during
fiscal year 2021. 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 also
estimated fireworks-related injuries treated in hospital emergency departments from CPSC’s
National Electronic Injury Surveillance System (NEISS). Finally, CPSC staff conducted a special
study of non-occupational, fireworks-related injuries between June 18, 2021, and July 18, 2021.
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 74 percent of the estimated annual fireworks-related, emergency department-
treated injuries for 2021 occurred during that period.

Highlights of the report

Deaths and Injuries


• CPSC staff received reports of 9 non-occupational, fireworks-related deaths during
2021. Six of the deaths were associated with firework misuse; one death was associated
with a mortar launch malfunction; and two incidents were associated with unknown
circumstances. Reporting of fireworks-related deaths for 2021 is not complete, and the
number of deaths identified for 2021 should be considered a minimum.

• Fireworks were involved with an estimated 11,500 injuries treated in U.S. hospital
emergency departments during calendar year 2021 (95 percent confidence interval
8,300–14,700). The estimated rate of emergency department-treated injuries is 3.5 per
100,000 individuals in the United States, a decrease from 4.7 estimated injuries per
100,000 individuals in 2020.

• There is a statistically significant trend in estimated emergency department-treated,


fireworks-related injuries from 2006 through 2021. This trend estimates an increase of
274 fireworks injuries per year (p-value = 0.0004).

• An estimated 8,500 fireworks-related injuries (or 74 percent of the total estimated


fireworks-related injuries in 2021) were treated in U.S. hospital emergency departments
during the 1-month special study period between June 18, 2021, and July 18, 2021 (95
percent confidence interval 5,600–11,300).

1 The 2021 federal fiscal year refers to the period of October 1, 2020, through September 30, 2021.

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Results from the 2021 Special Study
• Of the 8,500 estimated fireworks-related injuries sustained, 59 percent were to males
and 41 percent were to females.

• Adults 25 to 44 years of age experienced about 32 percent of the estimated injuries, and
children younger than 15 years of age accounted for 29 percent of the estimated injuries.
Seniors 65+ years of age experienced a small percent of the estimated injuries at only 4
percent.

• Young adults 20 to 24 years of age had the highest estimated rate of emergency
department-treated, fireworks-related injuries (5.1 injuries per 100,000 people). Children,
5 to 9 years of age, had the second highest estimated rate (4.5 injuries per 100,000
people). A general decrease is noted comparing the 2021 rates to the 2020 rates, except
for children 5 to 14 years of age, which saw an increase from 3.3 injuries to 4.2 injuries
per 100,000 people.

• There were an estimated 1,500 emergency department-treated injuries associated with


firecrackers and 1,100 with sparklers.

• The parts of the body most often injured were hands and fingers (an estimated 31
percent); head, face, and ears (an estimated 21 percent); legs (an estimated 15
percent); eyes (an estimated 14 percent); trunk/other regions (an estimated 10 percent);
and arms (an estimated 8 percent).

• An estimated 32 percent of the emergency department-treated injuries were burns.


Burns were the most common injury to hands and fingers. Contusions and lacerations,
accounting for 21 percent of the emergency department-treated injuries, were the most
common injury to the head, face, and ears.

• Approximately 83 percent of the victims were treated at the hospital emergency


department and then released. An estimated 15 percent of patients were treated and
transferred to another hospital, or they were 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 11
completed follow-up investigations showed that most injuries were associated with
misuse or malfunction of fireworks. Most victims recovered or were expected to recover
completely. However, there were victims who reported that their injuries might be long-
term.

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Enforcement Activities
During fiscal year 2021, CPSC’s Office of Compliance and Field Operations continued to
work closely with federal agencies to conduct surveillance on consumer fireworks and to
enforce the provisions of the Federal Hazardous Substances Act.
Approximately 31 percent of the selected and tested products were found to contain
noncompliant fireworks. The noncompliant fireworks devices had a combined estimated import
value of $326,000. The violations consisted of fuse violations, presence of prohibited chemicals,
and pyrotechnic materials overload.

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Table of Contents
Executive Summary ................................................................................................................. 2
Highlights of the report ........................................................................................................... 2
Deaths and Injuries ............................................................................................................. 2
Results from the 2021 Special Study .................................................................................. 3
Enforcement Activities......................................................................................................... 4

1. Introduction .......................................................................................................................... 7
Sources of Information ........................................................................................................... 7
Statistical methods ................................................................................................................. 9

2. Fireworks-Related Deaths for 2021 ....................................................................................10

3. National Injury Estimates for 2021 .....................................................................................13


Table 1: Estimated Fireworks-Related, Emergency Department-Treated Injuries: 2006-2021
..............................................................................................................................................13
Figure 1: Estimated Fireworks-Related, Emergency Department-Treated Injuries: 2006-2021
..............................................................................................................................................14
Table 2: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Race:
2006-2021 .............................................................................................................................16
Figure 2: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Race
2006-2021 .............................................................................................................................17

4. Injury Estimates for the 2021 Special Study: Detailed Analysis of Injury Patterns ........17
Fireworks Device Types and Estimated Injuries ....................................................................17
Table 3: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Device
Type: June 18–July 18, 2021 ................................................................................................18
Gender and Age of Injured Persons ......................................................................................19
Figure 3: Estimated Injuries by Gender: June 18–July 18, 2021 ............................................19
Figure 4: Percentage of Injuries by Age Group: June 18–July 18, 2021.................................20
Table 4: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Age and
Gende: June 18–July 18, 2021 ..............................................................................................21
Age and Gender of the Injured Persons by Type of Fireworks Device ...................................22
Table 5: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Device
Type and Age Group: June 18–July 18, 2021 ........................................................................23

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Body Region Injured and Injury Diagnosis .............................................................................24
Figure 5: Body Regions Injured: June 18–July 18, 2021 ........................................................24
Figure 6: Types of Injuries: June 18–July 18, 2021 ................................................................25
Table 6: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Body
Region and Diagnosis: June 18–July 18, 2021 ......................................................................26
Types of Fireworks Device and Body Region Injured.............................................................27
Table 7: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Type of
Fireworks Device and Body Region Injured: June 18–July 18, 2021......................................27
Hospital Treatment ................................................................................................................28

5. Telephone Investigations of Fireworks-Related Injuries ..................................................28


Table 8: Final Status of Telephone Investigations .................................................................29
Summary Statistics ................................................................................................................29
Hazard Patterns ....................................................................................................................30
Table 9: Hazard Patterns as Described in Telephone Investigations for Fireworks-Related
Injuries...................................................................................................................................30
Long Term Consequences of Fireworks-Related Injuries ......................................................33
Where Fireworks Were Obtained...........................................................................................34

6. Enforcement Activities .......................................................................................................34

7. Summary .............................................................................................................................34

References ..............................................................................................................................36

Appendix A ..............................................................................................................................37
Table 10: Estimated Fireworks-Related Injuries and Estimated Fireworks Imported into the
United States .........................................................................................................................38

Appendix B ..............................................................................................................................40
Telephone Investigations .......................................................................................................40

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1. Introduction
This report describes injuries and deaths during calendar year 2021 associated with
fireworks devices, as well as kits and components used to manufacture illegal fireworks.
Reports for earlier years in this series can be found at: https://cpsc.gov/Research--Statistics/Fuel-
Lighters-and-Fireworks1.
This report is organized into seven sections. Section 1 describes the data and statistical
methods used in this analysis. Section 2 summarizes the 2021 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 2021, and it compares that estimate to
previous years. Section 4 analyzes emergency department-treated, fireworks-related injuries
during the month around July 4, 2021. Section 5 summarizes the telephone in-depth
investigations of a subsample of the injury incidents that occurred during that period. Section 6
describes enforcement activities of CPSC’s Office of Compliance and Field Operations (EXC)
during fiscal year 2021. The report concludes with a summary of the findings in Section 7.
Appendix A is a table depicting the relationship between fireworks-related injuries and fireworks
imports between 2006 and 2021. Appendix B provides details on the completed telephone
investigations.

Sources of Information
Staff obtained information on non-occupational, fireworks-related deaths during 2021
from CPSC’s CPSRMS. CPSRMS combines 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 the death certificates from the various states to complete the DTHS,
neither data source can be considered complete for 2020 or 2021 fireworks-related deaths at
the time this report was prepared. Consequently, the number of deaths should be considered a
minimum. Staff updates the total number of deaths for previous years when new reports are
received. Total deaths for prior years may not coincide with the number in reports for earlier
years because of these updates.

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The source of information on non-occupational, emergency department-treated
fireworks-related injuries is CPSC’s NEISS. NEISS is a probability sample of the U.S. hospitals
with emergency departments. 2 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 narrative of 140 to 400
characters 3 in length and 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 every year during the month around July 4. 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 staff shows 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 are then included in the NEISS narrative. In 2021, the special study period lasted from
June 18 to July 18.
After reading the incident case records, including the narrative descriptions of the
fireworks device and the incident scenario, CPSC staff may assign a case for additional
telephone investigation. Staff usually selects cases that 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 can collect
information for one-fifth to one-half of the cases assigned. Information on the final status of the
telephone interviews conducted during the 2021 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

2 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. 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.
3 The maximum available number of characters changed from 142 to 400 characters on January 1, 2019.

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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 records collected by the emergency departments usually contain 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:
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.

Detailed analyses of injury patterns


The tables are based on the special study period only, and they 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, CPSC 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.

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Confidence intervals were estimated, and other statistics were calculated using computer
programs that were written to take the sampling design into consideration. 4 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 total in the tables or figures, due to rounding.
This report also contains several detailed tables about fireworks-related injuries during
the special study period. National estimates in these tables were also made using the sampling
weights. To avoid cluttering the tables, confidence intervals are not included. Because the
estimates are based on subsets of 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.

2. Fireworks-Related Deaths for 2021


CPSC has reports of 9 non-occupational, fireworks-related deaths that occurred during
2021. 5 Reporting of fireworks-related deaths for 2021 is not complete, and the number of deaths
in 2021 should be considered a minimum. Brief descriptions of the incidents, using wording
taken from the incident reports, follow:
In June, a 31-year-old male was fatally injured from a fireworks blast inside his home. The
house explosion occurred while the victim was manufacturing firework devices in his
basement. The blast caused a wall of the residence to detach leaving the second floor in a
state of collapse. The victim’s pregnant wife and four children were all home during the
incident. All but the victim managed to escape with limited injuries. After emergency
services arrived, they continued to hear explosions from the structure delaying assistance
to the victim. Once medical services could safely enter, the victim was found lying supine
on the basement floor. The victim was noted to have severe thermal injuries throughout.
The victim’s official cause of death was listed as extensive blast and thermal injuries.

4 See Schroeder (2000).


5CPSC staff excludes incidents that are indirectly fireworks-related. For instance, fireworks that start fires and lead to
deaths are excluded based on the logic that the fire is directly responsible for the death.

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In July, a 23-year-old male was fatally injured while shooting off fireworks. The victim was
lighting the device and holding it at an angle above his head. One of the devices
discharged from the bottom of the tube striking the victim in the chest and exploding. The
victim immediately ran toward the porch before collapsing. Witnesses performed CPR
until emergency personnel arrived. The victim was transported to a local hospital where
he was pronounced dead.

In July, a 55-year-old male was critically injured after lighting off fireworks utilizing a quick
match fuse. A loud boom was heard before the victim was found lying in the street. The
victim was pronounced dead at the scene. The medical examiner reports that the victim
experienced significant head injuries with near decapitation present. The official cause of
death is listed as head trauma due to a fireworks explosion. Another victim was
hospitalized with life-threatening injuries and later recovered.

In July, a 24-year-old male was fatally injured from an errant fireworks mortar blast. The
device tilted slightly and began firing towards the people nearby. The victim was in a hot
tub and attempted to escape with several other people. The victim was taken to the
hospital by emergency services and later pronounced dead. Immediately after the
incident, the cause of death was mistakenly believed to have been from the victim slipping
and hitting his head on concrete while running from the device. This was later clarified
after autopsy and was determined that chest trauma was the official cause of death.

In July, a 34-year-old male was fatally injured while lighting commercial grade fireworks in
his front yard with his 10-year-old son. A nearby neighbor heard a loud bang and saw
smoke coming from the ground but did not see a firework launch into the air. The witness
ran to the yard and saw the victim with a fatal head injury. The witness took the victim’s
son, physically unharmed, into their home to call for emergency services. When sheriffs
arrived, they observed the victim’s body on the ground, his feet near the base of a metal
launching tube partially buried into the ground. The victim was pronounced dead at the
scene. The victim did not have proper licenses to handle regulated commercial fireworks.

In July, a 41-year-old male was fatally injured while lighting a mortar style firework device
with friends while camping. The victim was holding the mortar tube in his left hand and
ignited a shell with his right. There was believed to be a malfunction with the mortar and
shell causing the mortar to rupture, projecting the firework backwards toward the victim.
The shell struck the victim in his left side/leg area and ruptured his femoral artery. Police
were contacted by the victim’s friends and arrived at the scene noticing the victim had
very shallow breathing and massive abdominal hemorrhaging. Blood appeared to be

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coming from the victim’s pelvic area. Emergency medical services arrived and attempted
life saving measures to no avail. The victim was pronounced dead at the scene.

In July, a 55-year-old male was shooting fireworks from a paddle boat in the middle of a
bay when he was fatally injured. The victim lit a fireworks device which exploded
unexpectedly. Witnesses reported seeing the victim fall out of the boat shortly after the
explosion. When witnesses pulled the victim from the water, he was unresponsive.
Emergency responders were contacted by nearby onlookers and transported the victim to
a local hospital, where he was then pronounced dead.

In July, an 8-year-old male was fatally injured by an illegal firework. The victim was
attending an unofficial block party where several illegal mortar-style fireworks were
launched. One of the fireworks malfunctioned and hit the victim in the upper body. The
victim was taken to the hospital to be treated, but he died from his injuries.

In November, a 35-year-old male was fatally injured after lighting a large firework device in
his hands. After the firework exploded the victim immediately fell to the ground.
Emergency responders were contacted by nearby witnesses, who pronounced the victim
deceased at the scene due to explosive head trauma. The victim has been known to
frequently light fireworks.

Including the 9 deaths described above, CPSC staff has reports of 158 fireworks-related
deaths between 2006 and 2021, for an average of 9.9 deaths per year. 6

6 See previous reports in this series (e.g., the report for 2020: Marier, Smith and Lee (2021)). In the most recent 3
years, the number of deaths included 6 deaths in 2018, 20 deaths in 2019, and 26 deaths in 2020. The data from
2018 to 2020 have been updated based on new incident reports received by CPSC staff during 2021 and may differ
from previous reports.

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3. National Injury Estimates for 2021
Table 1 and Figure 1 present the estimated number of non-occupational, fireworks-
related injuries treated in U.S. hospital emergency departments between 2006 and 2021.

Table 1
Estimated Fireworks-Related, Emergency Department-Treated Injuries: 2006-2021
Year Estimated Injuries Injuries per 100,00 People

2021 11,500 3.5


2020 15,600 4.7
2019 10,000 3.0
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
Source: NEISS, U.S. Consumer Product Safety Commission. Population Estimates for 2010 to 2021 are from Annual
Estimates of the Resident Population for the United States, States, and the District of Columbia: April 1, 2010 to July
1, 2020 (NST-EST2020) with a 2021 extension: April 1, 2020 to July 1, 2021. U.S. Census Bureau. Population
Division. Population estimates for 2005 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). Population Division,
U.S. Census Bureau.

There is a statistically significant increasing trend in the fireworks-related injury


estimates from 2006 through 2021 (p-value=0.0004). 7 The slope of the fitted trend line shows an

7For details on the method to test a trend that incorporates the sampling design, see Schroeder (2000) and Marker et
al. (1999).

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increase of about 274 injuries per year. In calendar year 2021, there were an estimated 11,500
fireworks-related, emergency department-treated injuries (95 percent confidence interval 8,300
– 14,700). There were an estimated 15,600 such injuries in 2020. The difference between the
injury estimates for 2020 and 2021 is statistically significant (p-value = 0.0015). The 26 percent
decrease in emergency department-treated injuries may stem from the increased reopening of
public fireworks displays that were closed due to the COVID-19 pandemic in 2020.
Figure 1: Estimated Fireworks-Related, Emergency Department-Treated Injuries: 2006-
2021

18,000 5

16,000 4.5

14,000 4

3.5
Estimated Injuries

12,000

Injury Rates
3
10,000
2.5
8,000
2
6,000
1.5
4,000 1
2,000 0.5

0 0

Year

Fireworks Injuries Rate per 100K Population Trend (Fireworks Injuries)

Source: NEISS, U.S. Consumer Product Safety Commission. Population Estimates for 2010 to 2021 are from Annual
Estimates of the Resident Population for the United States, States, and the District of Columbia: April 1, 2010 to July
1, 2020 (NST-EST2020) with a 2021 extension: April 1, 2020 to July 1, 2021. U.S. Census Bureau. Population
Division. Population estimates for 2005 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). Population Division,
U.S. Census Bureau.

Appendix A contains a table showing estimated fireworks-related, emergency


department-treated injuries and fireworks imports between 2006 and 2021.
Table 2 shows that each year, the number of victims treated are mostly white, followed
by victims of an unknown race, black victims, and victims of an “other” race. The “other” race
category contains Asian, Pacific Islander/Native Hawaiian, and American Indian/Alaskan Native
individuals. CPSC began collecting ethnicity information in 2018, which includes information

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about whether a victim is Hispanic; as a result, ethnicity information cannot be included at this
time for the full 2006-2021 period. 8
Figure 2 shows the trend by race across years; there is a statistically significant upward
trend for white victims (p = 0.0031), but not black or “other” race victims. Between the years
2020 and 2021, there was a significant decrease in the number of white victims (p=0.0077) and
neither black nor “other” race victims experienced a significant change.
When comparing the proportion of victims with a known race to the US population, 9
there were proportionately fewer white victims (70.9% of victims, 75.9% of the U.S. population
identifies as white), proportionately more black victims (21.5% of victims, 13.6% of the U.S.
population identifies as black), proportionately fewer victims associated with an “other” race
(7.6% of victims, 7.7% of the U.S. population identifies as another race).These percentages are
calculated using only the victims where race was collected. Victims with unknown race values
accounted for over 31% of all fireworks incidents in 2021.

8 The ethnicity indicator is missing for 29 percent of the fireworks victims in 2021, and thus ethnicity is excluded from

this report.
9 Total U.S. Population race estimates obtained from Census 2020 monthly report estimates (NC-EST2020-
ALLDATA: Monthly Population Estimates by Age, Sex, Race, and Hispanic Origin for the United States: April 1, 2010,
to July 1, 2020 (with short-term projections to December 2021) Release Date: June 2021); Census 2021 estimates
were not available at the time of this report.

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Table 2
Estimated Fireworks-Related, Emergency Department-Treated Injuries by Race:
2006-2021
Year White Black/African- Other Unknown Total
American
N % N % N % N % N
2006 5,200 56.0 900 9.3 600 6.7 2,600 28.1 9,200
2007 5,500 56.8 800 8.6 500 5.6 3,000 29.0 9,800
2008 4,500 63.8 400 6.4 400 5.9 1,700 23.9 7,000
2009 6,000 68.6 600 7.4 400 4.9 1,700 19.1 8,800
2010 5,000 58.4 600 7.1 600 6.6 2,400 27.9 8,500
2011 5,800 60.8 800 8.7 1,200 12.6 1,700 17.9 9,600
2012 5,200 59.6 800 8.8 700 10.0 1,900 21.6 8,700
2013 6,800 60.0 600 5.4 1,000 9.2 2,900 25.4 11,400
2014 5,600 52.9 800 7.8 600 5.5 3,600 33.8 10,500
2015 6,400 53.7 1,000 8.3 1,000 8.5 3,500 29.5 11,900
2016 5,800 51.9 1,500 13.3 1,400 12.4 2,500 22.4 11,100
2017 7,100 54.9 800 6.3 1,600 12.5 3,400 26.4 12,900
2018 4,900 53.7 1,200 12.7 700 8.0 2,400 25.7 9,000
2019 5,500 54.7 1,500 14.9 400 3.8 2,700 26.6 10,000
2020 8,100 51.5 3,000 18.7 1,000 6.7 3,600 23.1 15,600
2021 5,600 49.1 1,700 14.7 600 5.2 3,600 31.0 11,500
Source: NEISS, U.S. Consumer Product Safety Commission.

Race percentages do not match the previous paragraph’s values, as incidents with unknown race values are included
in the calculations for Table 2.

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Figure 2: Estimated Fireworks-Related, Emergency Department-Treated Injuries by Race:
2006-2021

9,000
8,000
7,000
Estimated Injuries

6,000
5,000
4,000
3,000
2,000
1,000
0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

White Black/African-American Other

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

4. Injury Estimates for the 2021 Special Study:


Detailed Analysis of Injury Patterns
The injury analysis in this section presents the results of the 2021 special study of
fireworks-related injuries treated in hospital emergency departments between June 18, 2021,
and July 18, 2021. During this period, there were an estimated 8,500 fireworks-related injuries
(sample size=255, 95 percent confidence interval 5,600 – 11,300) accounting for 74 percent of
the total estimated fireworks-related injuries for the year, which is statistically lower than the
estimated 10,300 fireworks-related injuries in the 2020 special study period (p-value = 0.0193).
The remainder of this section provides the estimated fireworks-related, emergency
department-treated 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 3 shows the estimated number and percent of emergency department-treated
injuries by type of fireworks device during the special study period of June 18, 2021, to July 18,
2021.

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Table 3
Estimated Fireworks-Related, Emergency Department-Treated Injuries by Device
Type: June 18–July 18, 2021
Fireworks Device Type Estimated Injuries Percent

Total 8,500 100%

All Firecrackers 1,500 18%


Small 200 2%
Illegal 200 2%
Unspecified 1,000 12%

All Rockets 500 6%


Other Rockets 300 4%
Bottle Rockets 200 2%

Other Devices 1,900 22%


Multiple Tube * *
Reloadable 400 5%
Roman Candles 200 2%
Novelties 200 2%
Sparklers 1,100 13%
Fountains * *

Homemade/Altered 100 1%
Unknown 4,500 53%
Source: NEISS, U.S. Consumer Product Safety Commission. Based on 255 NEISS emergency department-reported
injuries between June 18, 2021, and July 18, 2021, and supplemented by 11 completed In-Depth Investigations.
Firework types are obtained from the in-depth investigation, when available; otherwise, firework 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 CPSC’s FHSA
regulations (16 C.F.R. § 1500.17 (Banned hazardous substances)). Fireworks that may be illegal under state and
local regulations are not listed as illegal unless they violate the CPSC’s FHSA regulations. 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.

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There were no injuries identified due to public firework displays during 2021. Unknown
fireworks devices were associated with the most injuries during the 2021 special study period.
Multiple tube devices and fountains were involved in less than 1 percent of the total estimated
injuries during the 2021 special study period.

Gender and Age of Injured Persons


Males experienced an estimated 3.1 fireworks-related, emergency department-treated
injuries per 100,000 individuals during the special study period. Females had 2.1 injuries per
100,000 people. Figure 3 shows the distribution of estimated fireworks-related injuries by
gender.

Figure 3: Estimated Injuries by Gender: June 18 – July 18, 2021

Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between June 18, 2021,
and July 18, 2021.

Children under 5 years of age experienced an estimated 800 injuries (9 percent of all
fireworks-related injuries during the special study period), as shown in Figure 4 and Table 4.
Children in the 5- to 14-year-old age group experienced an estimated 1,700 injuries. Breaking
down that age group further, children 5 to 9 years of age had an estimated 900 injuries and
children 10 to 14 years of age accounted for 900 injuries. 10

10 The 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 4: Percentage of Injuries by Age Group: June 18 – July 18, 2021

Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between July 18, 2021, and
July 18, 2021.

The detailed breakdown by age and gender is shown in Table 4. The concentration of
injuries among males and people under 25 years of age has been typical of fireworks-related
injuries for many years. However, 2021 saw a decrease in the emergency department visits
related to fireworks injuries among males in the 15 – 24 years age group (from 1,700 incidents
in the 2020 special study period to approximately 900 incidents in 2021).

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Table 4
Estimated Fireworks-Related, Emergency Department-Treated Injuries by Age and
Gender: June 18–July 18, 2021
Age Group Total Per 100,000 Male Female
People
Total 8,500 2.6 5,000 3,500

0-4 800 4.1 400 400

5-14 1,700 4.2 1,200 500


5-9 900 4.5 600 300
10-14 900 4.3 700 200

15-24 1,700 4.0 900 800


15-19 600 2.9 400 200
20-24 1,100 5.1 600 500

25-44 2,700 3.1 1,700 1,000

45-64 1,400 1.7 700 700

65+ 300 0.5 100 200


Sources: NEISS, U.S. Consumer Product Safety Commission. NC-EST2020-AGESEX-SEL: Annual Resident
Population Estimates by Selected Age Groups and Sex for the United States: April 1, 2010, to July 1, 2019; April 1,
2020; and July 1, 2020. Release date: August 2021. Census 2021 estimates were not available at the time of this
report. Based on the special study between June 18, 2021, and July 18, 2021. The oldest victim was 81 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 2021
special study period. Young adults aged 20 to 24 years had the highest estimated injury rate at
5.1 per 100,000 population. This was followed by 4.5 injuries per 100,000 people for children 5
to 9 years of age and 4.3 injuries per 100,000 people for children ages 10 to 14 years. A general
decrease is noted when comparing the 2021 rates to the 2020 rates, except for children 5 to 14
years of age which saw an increase from 3.3 injuries to 4.2 injuries per 100,000 people.

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Age and Gender of the Injured Persons by Type of Fireworks Device
Table 5 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 63 percent of the total
estimated injuries for that specific age group. 11 Unknown fireworks devices accounted for 53
percent of all injuries during the special study period.
No clear relationship between age and known fireworks type is suggested by the data in
Table 5. 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., multiple tube and reloadable devices), which
can injure people located some distance away from where the fireworks are launched.

11 The percentages are calculated from the actual injury estimates.

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Table 5
Estimated Fireworks-Related, Emergency Department-Treated Injuries by Device
Type and Age Group: June 18–July 18, 2021
Age Group
Fireworks Type Total 0-4 5-14 15-24 25-44 45-64 65+

Total 8,500 800 1,700 1,700 2,600 1,400 300

All Firecrackers 1,500 100 400 200 500 200 100


Small 200 * * * 100 100 *
Illegal 200 * * * 100 100 *
Unspecified 1000 100 300 200 300 100 100

All Rockets 500 * 100 100 300 * *


Other Rockets 300 * 100 100 100 * *
Bottle Rockets 200 * * * 100 * *

Other Devices 1,900 500 400 400 400 100 *


Multiple Tube * * * * * * *
Reloadable 400 * * 200 100 100 *
Roman Candles 200 * 100 * 100 * *
Novelties 200 * 200 * * * *
Sparklers 1,100 500 100 200 200 * *
Fountains * * * * * * *

Homemade/Altered 100 * * * 100 * *


Unknown 4,500 100 800 1,000 1,300 1,000 200
Sources: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between June 18, 2021,
and July 18, 2021. 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.

As shown previously in Figure 3, males accounted for 59 percent of the estimated


fireworks-related injuries, and females comprised 41 percent. Males and females were injured at
approximately the same rate by fireworks device. Both males and females were most often
injured by an unknown fireworks device (48 percent for males, 60 percent for females).

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Body Region Injured and Injury Diagnosis
Figure 5 presents the distribution of estimated emergency department-treated injuries by
the specific parts of the body injured. Hands and fingers were associated with an estimated
2,600 injuries. These were followed by an estimated 1,800 head/face/ear region injuries; 1,300
leg injuries; 1,200 eye injuries; 800 trunk/other injuries; and 700 arm injuries.

Figure 5: Body Regions Injured: June 18 – July 18, 2021

Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between June 18, 2021,
and July 18, 2021. 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 includes chest, abdomen, pubic region, “all parts of body,” internal, and “25-
50 percent of body.”

Figure 6 shows the diagnoses of the estimated injuries associated with fireworks
devices. “Other” diagnoses accounted for 2,800 estimated injuries and were the most frequent
diagnosis. Burns were associated with 2,700 estimated injuries, contusions and lacerations
were associated with 1,800 estimated injuries, and fractures and sprains accounted for the
remaining 1,100 estimated injuries. 12

12 Estimated injuries may not sum to the total due to rounding. Percentages are calculated from the actual injury

estimates.

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Figure 6: Types of Injuries: June 18 – July 18, 2021

Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between June 18, 2021,
and July 18, 2021. 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 6, burns accounted for over half (54 percent) of the injuries to
hands/fingers. As a single-diagnosis category, burns caused the most injuries to trunk/other
regions. Contusions and lacerations were the most frequent injuries to the head/face/ear
regions, while fractures were the most common diagnoses to both the arm and leg regions.
Other diagnoses were most associated with injuries in the eye region.

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Table 6
Estimated Fireworks-Related, Emergency Department-Treated Injuries by Body
Region and Diagnosis: June 18–July 18, 2021
Diagnosis
Contusions/ Fractures/ Other
Body Region Total Burns
Lacerations Sprains Diagnoses

Total 8,500 2,700 1,800 1,100 2,800

Arm 700 200 200 300 *


Eye 1,200 100 400 * 700
Head/Face/Ear 1,800 300 800 100 700
Hand/Finger 2,600 1,400 400 100 700
Leg 1,300 400 100 500 300
Trunk/Other 800 300 * 100 400
Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between June 18, 2021,
and July 18, 2021. Fractures and sprains also include dislocations. “Other diagnoses” include all other injury
categories. 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.

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Types of Fireworks Devices and Body Regions Injured

Table 7 presents estimated injuries by the type of fireworks device and body region
injured.

Table 7
Estimated Fireworks-Related, Emergency Department-Treated Injuries by Type of
Fireworks Device and Body Region Injured: June 18–July 18, 2021

Region of the Body Injured


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

Total 8,500 700 1,200 1,800 2,600 1,300 800

All Firecrackers 1,500 300 200 400 600 100 *


Small 200 100 100 * 100 * *
Illegal 200 * * 100 200 * *
Unspecified 1,000 200 100 300 400 100 *

All Rockets 500 100 300 100 * * *


Other Rockets 300 100 100 100 * * *
Bottle Rockets 200 * 200 * * * *

Other Devices 1,900 * 200 300 1,000 300 100


Multiple Tube * * * * * * *
Reloadable 400 * * 300 100 * *
Roman Candles 200 * 100 * * 100 100
Novelties 200 * * * 200 * *
Sparklers 1,100 * 100 * 800 200 *
Fountains * * * * * * *

Homemade/
100 100 * * 100 * *
Altered
Unknown 4,500 300 600 1,000 900 900 700
Source: NEISS, U.S. Consumer Product Safety Commission. Based on the special study between June 18, 2021,
and July 18, 2021. 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.

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Most injuries resulted from fireworks devices of an unknown type; this uncertainty results
from victims’ (or parent/guardians’) inability to identify the firework device that injured them,
when asked.

Hospital Treatment
An estimated 83 percent of the victims of fireworks-related injuries in the special study
period were treated at the emergency department and then released; about 9 percent of the
victims were admitted to the hospital. Approximately 6 percent of the victims were treated and
then transferred to another hospital. The remaining 3 percent of victims had other dispositions
(i.e., left the hospital without being seen or were held for observation). 13 The percentage of
victims that were treated-and-released, treated, and admitted, or held for observation for
fireworks-related injuries was lower than for all consumer products in 2021. The percentages of
those treated and transferred and those that left before being seen were higher for the
fireworks-related injuries in the special study period than those for all consumer products. This
trend is relatively similar compared to prior years.
For all injuries associated with consumer products in 2021, 85 percent of patients were
treated and released; 11 percent were admitted to the hospital; 2 percent of patients were
transferred to other hospitals; and 3 percent had other dispositions, including left hospital
without being seen, held for observation, or dead on arrival. 14

5. Telephone Investigations of Fireworks-Related


Injuries
CPSC staff conducted in-depth telephone investigations of a sample of fireworks
incidents that occurred during the 1-month special study period surrounding the 4th of July
holiday (June 18, 2021, to July 18, 2021). 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.

13 The percentages are calculated from actual injury estimates and may not sum to 100 due to rounding.
14 Comparisons are calculated using actual injury estimates and differences may not appear due to rounding.

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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 111 emergency department-treated, fireworks-related injuries during the
special study period, staff selected 60 cases for telephone investigations, of which 11 were
completed and determined to be in scope, and 49 were incomplete. Table 8 shows the final
status of these investigations, including the reasons why some investigations were incomplete.

Table 8
Final Status of Telephone Investigations
Final Case Status Number of Percent
Cases

Total Assigned 60 100

Completed Investigation 11 18
In Scope 11 18

Incomplete Investigation 49 82
Failed to Reach Patient 21 35
Victim Name Not Provided by Hospital 15 25
Victim Refused to Cooperate 13 22

Short descriptions of the 11 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 Statistics
Of the 11 completed in-scope cases, 6 involved males, and 5 involved females. There
were two victim aged 0 to 4 years old; three victims aged 5 to 14 years old; four victims aged 15
to 33 years old; and two victims aged 34 to 59. Four victims were admitted to the hospital and
seven victims were treated and released.

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The fireworks devices consisted of eight reloadable aerial shells, 15 two roman candles,
and one unspecified device.
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 investigations on more serious injuries and incomplete NEISS records. Eighteen
percent of the victims selected for the telephone interviews completed the survey.

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 had two
or more hazard patterns, staff selected the hazard pattern most likely to have caused the injury.
Hazard patterns are presented in Table 9 below, and a detailed description of the incidents
follows Table 9. Case numbers refer to the case numbers shown in Appendix B.

Table 9
Hazard Patterns as Described in Telephone Investigations for Fireworks-Related
Injuries
Hazard Pattern Number of Cases Percent of Total

Total Cases 11 100%

Malfunction 6 55%
Errant Flightpath 3 27%
Early Detonation 2 18%
Tip Over 1 9%

Misuse 5 45%
Improper Preparation 5 45%

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

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Malfunction (6 Victims, 55 percent of total)

Errant Flight Path


Case 2: A 15-year-old female victim was sitting with their parent approximately 40 to 50 feet
away from the device watching fireworks be shot off. One of the devices shot from the side
landing on the victim’s lap. The device then exploded which lit the victims shorts on fire. The
parent quickly ripped the pants off. After applying a cold compress, the parent decided to take
the victim to the hospital. The victim was admitted to the hospital with third degree burns from
the victim’s inner thigh to the intergluteal cleft. The victim recovered fully after three weeks the
only long-term consequence being a large amount of scarring.

Case 6: A 6-year-old female victim was with her family watching another family member set off
fireworks. After one device was detonated, the victim turned to their mother with a bleeding
mouth. The grandmother took the victim to the garage to assess the damage. Due to the
amount of blood, it was difficult to see the injury, so it was decided to take the victim to the
hospital. At the hospital the victim was sedated and given seven stitches to sew the bottom of
her lip back as well as close a hole in her cheek. The victim recovered after one month with
scarring to the face and difficulties chewing.

Case 5: A 3-year-old female victim was being held by their mother when a family friend was
lighting fireworks in the yard. After the first firework ignited with no incident, the second device
then began shooting in random directions. The mother tried to leave the scene, but the
firework flew over the mother’s shoulder and struck the victim in the face. The victim was
taken to the hospital and was given an ointment and bandages to cover the wound. The
victim fully recovered after one week with no long-term consequences.

Early Detonation
Case 10: A 30-year-old female victim was watching her neighbors light store-bought fireworks
when a mortar-style firework device exploded from the bottom of the tube. The victim was hit
underneath her left arm and debris entered her left eye. The victim felt fine after the incident
noting only singed hair on her arm and eye pain. A few days later the victim developed an
infection in her eye. The victim visited the emergency department where she was treated with
IV antibiotics as well as antibiotics to take after her release. The victim is unsure of any long-
term consequences due to the incident but notes having a “knot” on her eye from the
infection.

Case 11: A 45-year-old male victim was supervising teenagers who were lighting reloadable
mortar fireworks. One mortar was ignited and never launched, eventually exploding on the
ground. The victim was struck by debris in his right eye and was taken to the emergency
department by a witness. The victim was given eye drops, pain medication, as well as steroid

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for his eye. The victim made a full recovery after three weeks and does not suspect any long-
term consequences.

Tip Over
Case 7: A 7-year old male victim was outside his home in a field setting off fireworks with his
father and cousin. After lighting a firework, the device fell over and launched towards the
victim. The victim attempted to run but tripped and the firework struck him in the head. The
firework then exploded hitting the victims face, head, and both arms. The victim was taken to
the hospital and given antibiotic ointment and was wrapped with bandages. The victim
recovered after one week with no long-term physical consequences.

Misuse (5 Victims, 45 percent of total)

Improper Preparation
Case 1: A 4-year-old male victim was outside in a field near their home with his father watching
others light fireworks. One of the participants lit a multiple tube device and burned
themselves, causing them to drop the device. The device shot into the crowd after it was
dropped. The firework hit the victim in the left eye and exploded. Due to the nature of the
victim’s injuries, they were taken via ambulance to a nearby field to be airlifted. At the hospital
the victim was given stitches for the laceration under his eye, as well as bandages for the
burns. The victim recovered with no suspected long-term consequences although
hemorrhaging of the eye is still present.

Case 3: A 33-year-old female victim was sitting on a lawn chair at a park when she noticed a
group standing nearby. She heard a member of the group shout “Oh man I kicked it over”.
The victim then turned around and a firework landed on her lap and exploded. The victims
dress and underwear caught on fire, severely burning her inner thighs and part of her genital
area. The victim underwent skin grafting surgery, was given staples, and then attended
physical therapy. The victim now must wear compression shorts daily to prevent the scars on
her leg from chafing. The victim also mentioned that they experience numbness in the area as
well. Doctors believe it could take up to two years for the injury to be fully healed.

Case 4: A 59-year-old male victim was purchasing fireworks. While the victim was looking
around, someone launched a reloadable device. The firework struck the victim in his left arm
and chest area and then exploded. The victim mentioned having “the wind knocked out” of
him, causing him to collapse. The victim caught on fire due to the explosion. A nearby police
officer along with the victim’s wife helped to extinguish the fire. At the hospital the wound was
bandaged and dressed. There does not appear to be any long-term consequences from the
incident aside from scarring.

Case 8: A 12-year-old male victim was with his friends lighting fireworks in the yard outside of
his house. Someone lit a rocket nearby that struck the victim in the left eye. The victim went

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32
inside to tell his mother of the incident. The mother then called 911 for emergency medical
transport. At the hospital the victim was given an antibiotic ointment as well as a laser eye
treatment. The victim was also referred to an eye specialist because surgery would be
required to fix the victim’s eye. The victim is currently scheduled for surgery to remove a
cataract on the injured eye. A second surgery will be needed to repair the lens, as well.
Doctors believe that after both surgeries, the victim should have his sight fully restored.

Case 9: A 17-year old male watched as his brother lit a rocket type firework and proceeded to
point it at the victim. The rocket hit the victim in his right eye. The victim ran his eye under
cold water, which did not help, so then travelled to the emergency department. The victim was
given an ointment for the burn. The victim fully recovered after three days with only a small
scar.

Long Term Consequences of Fireworks-Related Injuries


Respondents were asked if there were any long-term consequences of their injuries.
Seven of the 11 victims (64 percent of the total) experienced or expected complete recovery,
with no long-term consequences. However, four victims described their expected long-term
adverse consequences:
Case 3: A multiple tube device exploded in the victim’s lap. The victim has extreme scarring
after the incident along with the results of skin grafting surgery. The victim is also
experiencing numbness in the groin area. The victim also experiences severe chafing when
walking due to the scarring rubbing together. Doctors believe it will take up to two years for
the injuries to be fully healed.

Case 6: A unknown device exploded and hit the victim in the mouth. The victim still experiences
difficulties chewing which they plan to visit a dentist in hopes of correcting the issue.

Case 8: The victim was struck by a rocket in the eye. The victim has a scheduled surgery to
remove a cataract as well as a second surgery to repair the lens of the eye. Doctors hope that
with both surgeries the victim will have their sight restored.

Case 10: A reloadable device struck the victim under her left arm with debris entering her eye.
The victim is unsure of any long-term consequences but states that she still has a knot in her
eye from the infection.

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Where Fireworks Were Obtained
Of the 11 telephone survey respondents, five knew where the fireworks were obtained.
All five respondents stated that the fireworks were purchased from a store.
Six of the 11 respondents did not know the source of the fireworks. This is typically the
case when the respondent did not purchase the firework that caused injury.

6. Enforcement Activities
During fiscal year 2021, CPSC’s Office of Compliance and Field Operations continued to
work closely with federal agencies to conduct surveillance on consumer fireworks and to
enforce the provisions of the Federal Hazardous Substances Act.
Approximately 31 percent of the selected and tested products were found to contain
noncompliant fireworks. The noncompliant fireworks devices had a combined estimated import
value of $326,000. The violations consisted of fuse violations, presence of prohibited chemicals,
and pyrotechnic materials overload.

7. Summary
In calendar year 2021, there were 9 reported non-occupational fireworks-related deaths.
However, reporting for 2021 may not be complete at this time. There were an estimated 11,500
fireworks-related emergency department-treated injuries for calendar year 2021.
During the 1-month special study period from June 18, 2021, to July 18, 2021, there
were an estimated 8,500 emergency department-treated fireworks-related injuries. Adults aged
25 to 44 years of age experienced about 32 percent of the estimated injuries, and males of all
ages experienced 59 percent of the estimated injuries, down from 71 percent in 2020.
Additionally, 33 percent of the estimated injuries during the special study period involved
an injury diagnosis of “Other” which included debris landing in the eye, the device striking the
eye, potential hearing loss, etc. The estimated injuries were somewhat evenly distributed with
regards to the body part that was affected. Thirty-two percent of the estimated injuries during
the special study period involved burns. Burns were the most common injury to hands/fingers as
well as the trunk/other region. The parts of the body most often injured were hands and fingers
(an estimated 31 percent of the injuries); followed by head, face, and ears (21 percent); eyes
(14 percent); legs (15 percent); trunk/unspecified (9 percent); and arms (8 percent). Most of the
estimated injuries (83 percent) were treated-and-released. An estimated 14 percent were

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34
treated and transferred to another hospital or admitted to the hospital where the emergency
department was located.
Among the different types of fireworks, sparklers were involved in 13 percent of the
estimated injuries during the special study period; this is an increase from 9 percent in 2020.
Firecrackers were involved in 18 percent, rocket-type devices accounted for 6 percent of
injuries, reloadable tube devices were associated with 5 percent of injuries, and novelties and
roman candles were both associated with 2 percent of injuries. Fountains and multiple tube
devices were each associated with less than 50 estimated injuries which at a maximum equates
to about one-half of 1 percent of injuries. Most fireworks-related injuries, 53 percent, were
associated with unknown firework device types.
A review of data from telephone follow-up investigations showed that the typical causes
of injuries were due to both the malfunction and misuse of fireworks. 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. Three of the 11 respondents interviewed reported that
the injury will be long term, while one reported that they were unsure if they would face long
term consequences.
Finally, in fiscal year 2021, CPSC staff continued to actively monitor import shipments of
fireworks and products in the marketplace. CPSC staff worked with the U.S. Customs and
Border Protection agency to sample imported fireworks. Compliance staff conducted inspections
at fireworks retailers to collect samples for analysis and testing for compliance with mandatory
requirements.

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References
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

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Appendix A
Fireworks-Related Injuries and Imported Fireworks
Table 10 reports the total estimated number of injuries per 100,000 pounds of imported
fireworks. Table 10 shows an average of 247.7 million pounds of fireworks were imported each
year between 2006 and 2021, with a standard deviation of 53.2 million pounds. Between 2006
and 2010, the number of imports declined from a peak of 272.1 million pounds in 2006 to a low
of 199.6 million pounds in 2010. From 2011 to 2014, the number of imports were relatively
steady with modest changes for some years. In 2015, fireworks imports reached their highest
level since 2005, with an estimated 279.5 million pounds. Since 2015, the imports have
remained relatively high compared to the 2008 to 2014 period. The year 2021 had the largest
number of imports within the 15-year window with a total of 415.9 million pounds. This 2021
value surpassed the previous high of 277.5 million pounds in 2018 by 138.4 million pounds.
As for the number of estimated emergency department-treated fireworks-related injuries,
2018, with 9,100 injuries, had the lowest since 2013. The highest three annual estimated
fireworks-related injuries were 15,600 in 2020, 12,900 in 2017, and 11,900 in 2015.The 2021
total of 11,500 fireworks-related injuries was the fourth highest number of injuries in the 2006-
2021 timeframe.
As shown in Table 10 below, the estimated number of injuries per 100,000 pounds of
fireworks imported was 2.8 in 2021.The 2021 value is the smallest estimated number of injuries
per 100,000 pounds of fireworks in the 15-year period. The highest three estimated number of
injuries per 100,000 pounds of fireworks were 6.3 injuries in 2013, 6.1 in 2020, and 5.2 injuries
in 2017. The large decrease in injuries per 100,000 pounds of fireworks for 2021 stemmed from
the large increase in overall imports. 2021 experienced the largest number of fireworks imports
in the 15-year timeframe with 136.4 million pounds more than the second largest (2015) which
had 279.5 million pounds of imports.

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Table 10
Estimated Fireworks-Related Injuries and Estimated Fireworks Imported into the
United States: 2006-2021
Year Estimated Injuries Estimated Fireworks Injuries Per 100,000
Imports (millions of Pounds of Fireworks
pounds) ¥ Imported

2021 11,500 415.9 2.8


2020 15,600 255.0 6.1
2019 10,000 256.5 3.9
2018 9,100 277.5 3.3
2017 12,900 247.0 5.2
2016 11,100 262.4 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

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 codes 3604.10.90.10 and 3604.10.90.50) and display
fireworks (1.3G HTS code 3604.10.10.00). Display fireworks were about 1.4 percent of the total imports in 2021. In
addition to imported fireworks used in the United States, there is also a small number of fireworks manufactured in
the United States for domestic consumption; the data for these fireworks is not available from ITC and is not shown in
this table.
¥Fireworksimports data were downloaded from the ITC website in February 2022. Fireworks imports data subject to
change by ITC. These changes have typically been minor.

Table 10 should be interpreted with caution. First, while there may be a relationship
between the number of fireworks devices and estimated injuries resulting from fireworks, the
number of imported fireworks is not available. Table 10 uses the total import weight as an
approximation for the number of fireworks devices.

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Second, the total import weight over-represents heavy devices and under-represents
light devices. A heavy device may not be more dangerous than a light device because a
firework’s weight includes things other than just the amount of explosive material.
In addition, international trade statistics do not provide weight by fireworks device types.
It is not possible to associate injuries with the weight of different types of imported fireworks. As
shown in Table 2 earlier in this report, different fireworks devices are associated with different
numbers of injuries. Thus, the decrease in injuries per 100,000 pounds between 2014 and 2016
may be due to different mixtures of types of 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.

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Appendix B
Telephone Investigations
Case Age Sex Diagnosis Body Disposition Fireworks Narrative Medical Long Term Hazard Source
Part Type Treatment and Consequences
Prognosis
1 4 M Laceration Face Treated and Multiple tube On an evening in July The victim was No long-term Misuse, Unknown
admitted for device 2021, the victim was given stitches for consequences improper
hospitalization outside in an open the laceration although still a preparation
field near their home under his eye, as possibility due to
with his father, friend, well as a the eye still
and friends’ father bandage/dressing hemorrhaging.
watching “Older boys” for the burns.
light off fireworks.
One of the
participants lit a
multiple tube device
and burned
themselves causing
them to drop the
device. The device
then shot off into the
crowd. The firework
hit the victim in the
left eye and exploded.
Due to the nature of
the victim’s injuries,
they were taken via
ambulance to a
nearby field to be
airlifted.
2 15 F Burns, Upper Treated and Multiple tube On an evening in July The victim was No long-term Malfunction Store
Thermal Leg admitted for device 2021, the victim was admitted into the consequences ,
hospitalization watching fireworks hospital overnight other than errant
being shot off and and was scarring flightpath
was sitting with their discharged after
parent 40-50 feet 24 hours; the
away. One device victim took three
shot out from the side weeks to recover
landing on the
victim’s lap and fully with bad
exploding. The scarring.
explosion lit the
victims shorts on fire
which the parent
promptly removed.
After applying a cold
compress, the parent
decided to take the
victim to the hospital.
The victim was
admitted to the
hospital with 3rd
degree burns from
the victim’s inner
thigh to the
intergluteal cleft.
3 33 F Burns, Upper Treated and Roman On an evening in July The victim was Doctor mentioned Misuse, Unknown
thermal leg admitted for candle 2021, the victim was required to it may take up to improper
hospitalization sitting in a lawn chair undergo skin two years for the preparation
at a park, when she grafting surgery, injured area to be
noticed a group given staples after fully healed. The
standing nearby. She surgery, and victim must wear
then heard the group attended physical compression
shout “Oh man I therapy shorts to prevent
kicked it over”. The the scars on their
victim turned around leg from
and the firework becoming “raw”.
landed on her lap and The victim also
exploded. The victims experiences
dress and underwear numbness in the
caught on fire, area.
burning the victim’s
inner thighs and part
of her genital area.

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4 59 M Burns, Lower Treated and Reloadable On an evening in July The wound was No long-term Misuse, Store
thermal arm admitted for 2021, the victim was bandaged and consequences improper
hospitalization purchasing fireworks dressed. aside from preparation
from a stand. While scarring.
the victim was looking
around someone shot
off a reloadable
device. The fireworks
flew at the victim
striking him on the left
arm and chest area,
then exploded. The
firework “Knocked the
wind out” of the victim
causing him to
collapse. The victim
also caught on fire
due to the explosion.
A nearby police
officer as well as the
victim’s wife were
able to extinguish the
fire.
5 3 F Burns, Face Treated and Roman On an evening in July The victim was No long-term Malfunction Unknown
Thermal released candle 2021, the victim was given an ointment consequences ,
being held by their and bandages to Errant
mother when a family cover the wound; flightpath
friend was lighting off the victim fully
fireworks in the yard. recovered after
After the first firework one week.
went off with no
incident the device
then began shooting
off in random
directions. The
mother tried to run
away but the firework
flew over her

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shoulder striking the
victim in the face.

6 6 F Laceration Mouth Treated and Unknown On an evening in July The victim was Difficulties Malfunction Unknown
released 2021, the victim and sedated and chewing, ,
her family were given seven significant errant
watching a firework stitches to sew scarring to the flightpath
show being ran by a the bottom of her face
family member in lip back as well as
their yard. After one close a hole in her
firework detonated cheek; After one
the victim turned month the victim
around to their recovered with
mother with a scarring as well
bleeding mouth. The as problem
grandmother took the chewing which
victim to the garage they plan to visit
to see the extent of the dentist to
the injuries. The address.
grandmother could
not see the specific
injury due to the
amount of blood and
decided to rush the
victim to the hospital.
7 7 M Burns, Lower Treated and Rocket On an evening in July The victim was No long-term Malfunction Store
thermal arm released 2021, the victim was cleaned up, given consequences ,
outside his home in a antibiotic beyond a fear of tip over
field lighting off ointment, and was fireworks/
fireworks with his wrapped up with sparkler devices.
father and cousin. bandages; the
After his cousin lit a victim made a full
firework, the device recovery after one
fell over and shot week.
towards the victim.

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The victim attempted
to run but tripped and
the firework struck
him in the head. The
firework then
exploded hitting the
victims face, head,
and both arms.
8 12 M Traumatic Eyeball Treated and Rocket Mid-day in July 2021, The victim was The victim is Misuse, Unknown
cataract released the victim was with given an antibiotic scheduled for a improper
his friends lighting off ointment for his surgery to remove preparation
fireworks in the yard eye as well as a the cataract as
outside of his home. laser treatment. well as a second
Someone lit a rocket He was also surgery to repair
nearby which struck referred to a the lens. After
the victim in the left specialist as both surgeries the
eye. The victim went surgery would be victim should
inside to tell his required to fix the have his sight
mother what had victim’s eye. restored.
happened who then
called 911 for
emergency room
transport.
9 17 M Burns, Face Treated and Rocket Just after midnight in The victim was No long-term Misuse, Unknown
Thermal released June 2021, the given an ointment consequences improper
victim’s brother lit a to put on the burn; preparation
rocket type firework the victim fully
and proceeded to aim recovered after
it at the victim. The three days with
sparks from the only a small scar.
device hit the victim in
his right eye. The
victim then ran his
eye under cold water
then travelled to the
emergency
department.

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10 30 F Cellulitis Eye Treated and Reloadable On an evening in July The victim was Unsure of long- Malfunction Store
released 2021, the victim was given IV term , early
watching her antibiotics as well consequences, detonation
neighbors light off as antibiotics to but the victim
fireworks with her take after her states that she
family. As the release. The still has a knot on
neighbor lit a mortar victim was told to their eye from the
style firework the follow up with an infection.
device exploded from eye specialist.
the bottom of the
tube, never taking
flight. The victim was
hit from underneath
her left arm and bits
of fireworks debris got
into the victims left
eye. The victim felt
fine after the incident
only having singed
hair on her left arm
and pain in her eye. A
few days later the
victim noticed an
infection in her eye.
The victim removed
her contacts thinking
they could be the
cause, but the
infection continued to
get worse. Eight days
after the incident the
victim visited the
emergency
department.

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11 45 M Traumatic Eyeball Treated and Reloadable On an evening in July The victim was No long-term Malfunction Store
hyphema released 2021, the victim was seen by an eye consequences ,
at a friend’s house specialist at the early
supervising teenagers emergency detonation
in lighting reloadable department and
mortar fireworks. given eye drops,
After one mortar was pain medication,
lit it detonated on the and steroids for
ground never taking his eye; the victim
off. The victim was made a full
struck by the debris recovery after
on his right eye and three weeks.
taken to the
emergency
department by
someone who was
with him.

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