Fireworks are an underestimated danger to public health, warn experts

Experts warn that fireworks are an underestimated threat to public health, necessitating stricter regulations and ongoing public education efforts to prevent injuries that are entirely avoidable. According to U.S. specialists, fireworks-related harm is a significant cause of vision and limb loss worldwide, disproportionately affecting marginalized populations.

In England, for instance, nearly 4,500 individuals visited emergency departments with firework injuries in 2017, a number that had doubled since 2009-2010. In Los Angeles, trauma center statistics indicate a 147% increase in firework injuries from 0.19 per 100,000 in 2015 to 0.47 in 2022, primarily among young men aged 15-34. Common injuries include burns, eye trauma, and finger amputations, with 79% of these cases requiring surgical intervention.

In India, during the Diwali festival, fireworks contribute to nearly 20% of eye trauma cases, and such injuries can lead to complete blindness in 15% of patients, predominantly affecting young boys in rural areas. Additional risks associated with fireworks encompass fires, widespread air and noise pollution, and the threat of heavy metal poisoning, skin burns, inhalation injuries, and fatalities among individuals involved in the production of fireworks, particularly in low- and middle-income countries.

While some nations, such as the Netherlands, Ireland, Chile, and Australia, have prohibited the consumer use of fireworks, many countries without such bans, including India, the U.K., and the U.S., still face a pressing need for education and regulation. In the United States, sales of consumer fireworks have more than doubled from $1 billion in 2019 to $2.3 billion in 2025.

Firework regulations also differ between states and countries, and policies have become less restrictive over time in certain regions, despite evidence demonstrating that firework injuries are more prevalent in areas with fewer restrictions.

The authors advocate for enhanced regulations and continuous public education campaigns in the U.S. and globally. They urge stronger regulations and sustained public education initiatives worldwide to improve data collection, regulation, and public safety regarding fireworks usage and injuries. Medical organizations and public health bodies should promote attendance at public displays instead of private fireworks use.

Warning labels with graphic depictions of injuries on firework packaging, akin to those on cigarette packages, may also prove effective. Furthermore, harm reduction campaigns targeting children in primary and secondary schools, utilizing the stories and images of individuals whose lives have been impacted, are crucial for conveying the real-life consequences of improper fireworks handling.

Ultimately, the article emphasizes that fireworks pose an underestimated danger to public health, and stronger regulation, sustained public education, and improved injury surveillance are essential to mitigate preventable harm.