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.
E-PAS2016:4135.266
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:
Coughing
Wheezing
Shortness of breath
Asthma
Heart attack
Stroke

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.

Chattanooga Tennessee Shooting Reignites Gun Control Debate

This is what we know about guns in the United States. You may or may not like the data, but you cannot dispute the data, because facts are just that, facts. Facts are not emotional, and facts don't take sides. Let's get started.
We know American gun ownership by far surpasses gun ownership in other countries. “With less than 5 percent of the world’s population, the United States is home to 35-50 percent of the world’s civilian-owned guns,” according to the Small Arms Survey.
Approximately 20% of gun owners own 65% of the guns. The Federal Bureau of Alcohol, Tobacco, and Firearms reports that about 5.5 million new firearms were manufactured in America in 2010. 95% of these were for the U.S. market.
While the number of firearm homicides dropped dramatically over a 20-year period ending in 2011, the percentage of violent crimes involving firearms has stayed fairly constant, according to the 2013 survey.
In 2015 gun deaths are expected to surpass car deaths in the United States. That's according to a Center for American Progress report, which cites CDC data that shows guns will kill more Americans under 25 than cars in 2015. Already more than a quarter of the U.S. teenagers, 15 years old and up, who die of injuries in the United States are killed in gun-related incidents, according to the American Academy of Pediatrics.
Every day in the U.S., an average of 289 people are shot. Eighty-six of them die: 30 are murdered, 53 kill themselves, two die accidentally, and one is shot in a police intervention, the Brady Campaign reports.
Guns and kids:
82 children under five years old died from firearms in 2010 compared with 58 law enforcement officers killed by firearms in the line of duty (sources: CDF, CDC, FBI) More kids ages 0-19 died from firearms every three days in 2010 than died in the 2012 Newtown, Conn., massacre (source:CDF,CDC) Nearly three times more kids (15,576) were injured by firearms in 2010 than the number of U.S. soldiers (5,247) wounded in action that year in the war in Afghanistan (source: CDF, CDC, Department of Defense) Half of all juveniles murdered in 2010 were killed with a firearm (source: Office of Juvenile Justice & Delinquency Prevention)
Shooting sprees are not rare in the United States.
Mother Jones has tracked and mapped every shooting spree in the last three decades. "From 1982 through 2012, there have been at least 61 mass murders carried out with firearms across the country, with the killings unfolding in 30 states from Massachusetts to Hawaii," they found. And in most cases, the killers had obtained their weapons legally. 15 of the 25 worst mass shootings in the last 50 years took place in the United States.
Harvard University researchers say U.S. mass shootings have surged in recent years, contradicting earlier studies.
The Harvard researchers said the rate of mass shootings has increased threefold since 2011, occurring on average every 64 days, compared with an average of every 200 days in the years from 1982 to 2011.
The researchers used a database created by Mother Jones to look at mass shootings, which they defined as attacks that "took place in public, in which the shooter and the victims generally were unrelated and unknown to each other, and in which the shooter murdered four or more people."
Gun Violence in the Home
Claims that guns are used defensively millions times every year have been widely discredited. Using a gun in self-defense is no more likely to reduce the chance of being injured during a crime than various other forms of protective action.
Guns kept in the home are more likely to be involved in a fatal or nonfatal unintentional shooting, criminal assault or suicide attempt than to be used to injure or kill in self-defense. That is, a gun is more likely to be used to kill or injure an innocent person in the home than a threatening intruder.
Though guns may be successfully used in self-defense even when they are not fired, the evidence shows that their presence in the home makes a person more vulnerable, not less. Instead of keeping owners safer from harm, objective studies confirm that firearms in the home place owners and their families at greater risk. Research published in the New England Journal of Medicine found that living in a home where guns are kept increased an individual’s risk of death by homicide by between 40 and 170%. Another study published in the American Journal of Epidemiology similarly found that “persons with guns in the home were at greater risk of dying from a homicide in the home than those without guns in the home.” This study determined that the presence of guns in the home increased an individual’s risk of death by homicide by 90%
The following report which used data from 2012, the most recent year for which national data is available. In that year, 1,706 females were murdered by males in single-victim/single-offender incidents. That's 33 victims every week and more than four every day.
Just as in previous years, it was found the most common weapon men use to murder women is a gun. For homicides in which the murder weapon could be identified, 52 percent of victims were shot and killed with a gun. The most common firearm was a handgun, used in 69 percent of the homicides committed with guns.
States with stricter gun control laws have fewer deaths from gun-related violence.
In 2011 economist Richard Florida studied the correlations between gun deaths and other kinds of social indicators. Some of what he found was, perhaps, unexpected: Higher populations, more stress, more immigrants, and more mental illness were not correlated with more deaths from gun violence. But one thing he found was, perhaps, perfectly predictable: States with tighter gun control laws appear to have fewer gun-related deaths.