Tuesday, July 5, 2016

Is It Time To Restrict Fireworks To The Professionals Only.

They are dangerous, dirty, smelly, and very noisy. Fireworks are loved, and hated by many, including pets. Has the time come to ban them from the general public everywhere?
The vast majority of the world’s fireworks come from China. And sometimes they explode early, with deadly consequences. Many times they are mishandled by adults and children without an understanding of what could happen.
As firework laws are relaxed in the U.S., injuries are increasing, and in some instances, death. Many adults still allow children to handle them, even though it is not recommended.
According to CNN: "Since 2000, there's been a trend toward relaxing firework restrictions. The latest state to loosen its laws is New York. As of 2015, the state went from an outright ban to legalizing novelty items such as sparklers, party poppers and cone fountains in some counties. Only three states have laws that maintain total prohibition of all consumer fireworks: Delaware, Massachusetts and New Jersey."
New Research:
[4135.266] Effect of Fireworks Laws on Pediatric Fireworks Related Burn Injuries
John Myers, Charles Woods, Yana Feygin, Carlee Lehna. University of Louisville, Louisville, KY.
BACKGROUND: Changes in US fireworks laws have allowed younger children to purchase fireworks; and allowed individuals to purchase more powerful ones. To date, no study has evaluated the effect these changes have had on medical outcomes. OBJECTIVE: The purpose of this study is to examine the epidemiology of pediatric fireworks-related burn injuries among a nationally representative sample of the US for the years 2006-2012.
DESIGN/METHODS: We examined inpatient admissions for pediatric (<20 years of age) firework-related burn patients from 2006-2012 using the Nationwide Inpatient Sample; and examined ED admissions using the Nationwide Emergency Department Sample. Both data sources are part of the Healthcare Cost and Utilization Project (HCUP). Trajectories over time were evaluated.
RESULTS: A total of 3193 injuries represented an estimated 90,257 firework-related burn injuries treated in the US from 2006 to 2012. A majority of injuries were managed in the ED, 62.9%. The incidence modestly increased over time; increasing from 4.28 per 100,000 population in 2006 to 5.12 per 100,000 population in 2012. However, definitively, the proportion of injuries requiring inpatient admission (28.9% in 2006 to 50.0% in 2012), and mean length of stay (LOS) in the hospital (3.12 days in 2006 to 7.35 days in 2012), significantly increased over time, while the mean age decreased over time (12.1 years old in 2006 to 11.4 years old in 2012).
CONCLUSIONS: Pediatric fireworks-related burn injuries have increased in incidence, apparent severity of injury, the proportion requiring hospitalization and LOS (in the hospital) in a time period of relaxed fireworks laws in the US. Fireworks laws may need to be revisited by policy-makers.
Session: Poster Session: Emergency Medicine: Epidemiology (7:00 AM - 11:00 AM) Date/Time: Tuesday, May 3, 2016 - 7:00 am
Room: Exhibit Hall F - Baltimore Convention Center
Board: 266
Course Code: 4135
Myers' research used discharge data from inpatient hospitals and emergency departments. His findings were presented at the Pediatrics Academic Societies meeting in Baltimore in May. The research has not been published or peer-reviewed.
"In terms of severity of injuries requiring hospital treatment, we are very concerned about the misuse of fireworks and have seen an increase in injuries among youth..."
The University of Louisville research team measured the number of firework-related injuries for youths aged 20 and under from 2006 to 2012. While the number of minor burns and related injuries (estimated at 90,257) increased only slightly over that time period, the amount of serious injuries requiring hospitalization jumped from 28.9% to 50%. The means that the length of a hospital stay related to a significant firework-related injury also increased, from 3.12 days in 2006 to 7.35 days in 2012.
Fireworks by the numbers:
From 2009-2013, U.S. fire departments responded to an average of 18,500 fires caused by fireworks. These fires included 1,300 structure fires, 300 vehicle fires and 16,900 outside and other fires. An estimated two people were killed in these fires.
In 2014, U.S. hospital emergency rooms treated an estimated 10,500 people for fireworks related injuries; 51% of those injuries were to the extremities and 38% were to the head. These injury estimates were obtained or derived from the Consumer Product Safety Commission’s 2014 Fireworks Annual Report by Yongling Tu and Demar Granados.
The risk of fireworks injury is highest for young people ages 5-9, followed by children 10-19.
More than one-quarter (28%) of fires started by fireworks in 2009-2013 were reported on July 4th. Almost half (47%) of the reported fires on the Fourth of July were started by fireworks.
Source: NFPA’s Fireworks report, by Marty Ahrens, June 2016
*To minimize risk of injury, the U.S. Consumer Product Safety Commission recommends never allowing young children to play with or ignite fireworks and to always have an adult supervise fireworks activities.

4th of July fireworks linked to spike in pollution:
In addition to the debris that is often left behind following displays, studies have linked fireworks to water contamination, particularly by perchlorate, a chemical used in fireworks to create bright flashes of light. Perchlorate exposure can cause thyroid problems, and is considered a “likely human carcinogen” by the US Environmental Protection Agency. It can also harm wildlife.
This pollution doesn’t have to happen. There are methods of preventing, or at least minimizing, pollution from fireworks. Some cities are already doing this. In San Diego, for example, companies putting on fireworks displays are required to use practices that give maximum protection to the body of water below.
Levels of tiny pollutants are 42% higher on the holiday than on a typical day, one study says:
Fireworks on the Fourth of July dramatically increase air pollution, boosting exposure to potentially dangerous pollutants for millions of onlookers, according to a recent study in the journal Atmospheric Environment.
The level of particulate matter, or small pollutants like dust, dirt and soot present in the air, increased by 42% on average across the U.S. on the Fourth of July, according to the study. Air conditions are at their worst between 9 and to 10 p.m. on the day of the holiday. The researchers, who looked at data from 315 sites across the country, found that ten of the sites met a threshold deemed unsafe by the Environmental Protection Agency (EPA) when sustained for a prolonged period of time.
“Particles tend to stay suspended in the air for days,” says Schwartz. “They’re going to drift whichever way the winds goes, so it’s not just going to be the people sitting in the park watching the fireworks.”
For years, the National Oceanic and Atmospheric Administration scientists observed sites across the United States on July 4 and 5, to determine hourly concentrations of fine particulate matter.
“These results will help improve air quality predictions, which currently don’t account for fireworks as a source of air pollution,” says Dian Seidel, author of the study and a scientist at the NOAA.
Short and long-term exposure to air pollutants from fireworks can lead to numerous health issues including:
Shortness of breath
Heart attack
The Environmental Protection Agency encourages those who are sensitive to particle pollution to watch the fireworks from a distance.
“We chose the holiday, not to put a damper on celebrations of America’s independence, but because it is the best way to do a nationwide study of the effects of fireworks on air quality,” Seidel says.

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