Fireworks-related injuries continue to rise in Iowa, children among hardest hit

Stock photograph of a fireworks display

Emergency and trauma personnel at Iowa’s two largest trauma centers continue to see significant increases in fireworks-related injuries – and in the severity of those injuries – since the Iowa Legislature legalized the sale of fireworks in May 2017. Injuries to children nearly tripled.

A report compiled by researchers from University of Iowa Hospitals & Clinics and the University’s College of Public Health, along with emergency personnel from Iowa Methodist Medical Center and the University of Iowa Injury Prevention Research Center, shows that fireworks-related injuries more than doubled in the period between 2017 and 2019 from 2014 through the first half of 2017.

In the two-year period following legalization, the two trauma centers saw a combined 107 fireworks-related injuries; in the three years prior, that combined total was 43. For patients under the age of 18, the number of injuries rose from 11.3% to 30.8% after the legalization of fireworks.

Additionally, the severity of injuries increased. Since legalization, 18% of injuries required amputation, mostly fingers, while there were no amputation recorded in the three years prior to legalization.

“Fourth of July is such a festive occasion, and it’s been ingrained in people that fireworks go with the holiday,” says Colette Galet, PhD, ELS, associate research scientist in the trauma center at UI Hospitals & Clinics and one of the authors of the report. “People believe that now that they’ve been legalized, they can safely set fireworks off in their backyard or in their driveway.”

“I think people believe that since they’ve been legalized they must be safe,” adds Michael Takacs, MD, FAAEM, professor of emergency medicine at UI Carver College of Medicine and one of the report’s authors. “You see other people buying them, or you’re at a park or family gathering and other people are setting off fireworks so you want to be part of the celebration. It gives people a false sense of security.”

In the report, which is a follow up to a previous report published in 2017, researchers note that fireworks-related injuries were relatively consistent – 10 to 20 each year – in the years before legalization, and that those injuries more than doubled to just under 40 in 2017. The number of injuries remained high through 2019.

Another area of note is that the number of people handling fireworks and being injured increased, from 52% before legalization to 64% after.

To lower the risk of injury related to fireworks, researchers recommend the establishment of safety campaigns targeting high-risk populations and funding statewide research and a statewide firework-injury surveillance system with annual reporting.

While public displays of fireworks are usually safe and enjoyable, children and adults must remember that using fireworks at home can be dangerous. While many injuries associated with fireworks occur to the person lighting the fireworks, almost half of those injured by fireworks are bystanders and observers, and many of those are children.