How Not To Get Blown Up (the Old-Fashioned Way) on July Fourth

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As befits any birthday celebration, Americans will celebrate this July 4 with food, music, pageantry, and, of course: fireworks!

Who cannot remember the thrill of their first fireworks display, the childish wonder that is rekindled each Fourth? Indeed, many would argue that fireworks are what make this holiday special.

But would anyone say that such celebrations are worth the nearly 100 million fireworks-related injuries cost Americans annually?

Last year, approximately 11,000 Americans sought treatment in emergency departments and ten persons died from fireworks-related injuries. Nearly half or 6,600 of these injuries occurred during the July 4th holiday.

Most frequently, fireworks-related injuries involve the eyes on average, 30% of people require emergency room treatment for serious eye injury from fireworks. And 33% of ocular fireworks injuries result in a permanently blind eye (U.S. Eye Injury Registry Data).

What do these statistics tell us? Unfortunately, nearly 50% of the victims are children, and if you add up the numbers, about seventy-five children lose an eye each July 4th weekend because of fireworks. But we respond to people, not to statistics.

Carleen was your average, happy fifteen year-old when some of her friends were playing with bottle rockets in a tube and lit them. Two rockets went up. When Carleen glanced over to see the third rocket didn't launch, it exploded, crushing her left eye.

She was brought to the hospital for emergency surgery. Despite the heroic efforts of her eye doctors, who labored through five years and seven surgeries to save her eye, she never saw again. Eventually, because of constant pain from uncontrolled glaucoma, her eye had to be removed and replaced with a prosthetic eye.

What does this case illustrate? The enormous danger of bottle rockets. Although they account for only a small fraction of all fireworks, bottle rockets caused 70% of all ocular fireworks injuries in the year 2000 and half of these resulted in permanent blindness.

In a seven-year analysis by the Eye Injury Registry of Alabama, bottle rockets accounted for 100% of fireworks injuries requiring surgical removal of an eye. The average age of the victims: thirteen.

Bottle rockets were invented by the Chinese in the thirteenth century, not for entertainment but as a weapon of war. A small Class C bottle rocket consists of a two-inch firecracker. It can take off at seventy-five miles per hour, carrying a significant explosive payload. Yet twenty-five states still allow the sale and use of bottle rockets, according to the U.S. Consumer Product Safety Commission.

The American Academy of Ophthalmology has for years advocated legislation banning the sale, resale, use, and possession of bottle rockets, except by trained professionals. A wide range of organizations support a bottle rocket ban, including the American Medical Association, the American Academy of Pediatrics, Helen Keller International, the National Fire Protection Council, and the National Safety Council.

While Americans do not want to see an end to fireworks, most would support a specific bottle rocket ban; twenty-five states have already adopted such legislation. A uniform ban in every state would be much more effective by preventing individuals from purchasing bottle rockets in neighboring states.

What can one do as a parent? Write, call, or fax your elected representatives, telling them you support a bottle rocket ban. Encourage your children to attend only professional fireworks displays, rather than using fireworks themselves. If your child must use fireworks, while nothing can eliminate the danger, the following guidelines (adapted from the American Academy of Ophthalmology) can help decrease risk:

Always have adult supervision and use protective eyewear.

Use a specially-designed stick, or "punk," rather than a match to light fireworks.

Have a bucket of water ready.

Always follow manufacturers' directions and dispose of used fireworks properly.

Never give a firecracker to a child.

Never use a bottle rocket.

Do not light firecrackers bigger than your pinkie or light them indoors, and avoid relighting duds.

Never put fireworks in your pocket, throw them while lit, or make homemade firecrackers.

In case of eye injury, do not touch the eye. Immediately seek medical attention.

As a first-generation Chinese-American ophthalmologist, I have a unique perspective. A beautiful fireworks display can be among the most moving of cultural expressions, evoking a visceral reaction, whether on Chinese New Year or the Fourth of July.

At the same time, fireworks, invented for war, hold great destructive potential, which I am unfortunate enough to witness each year. I am proud of my ancestors for their invention. I would be many times as proud of my fellow Americans if they joined together to end needless blindness from fireworks.

Emil Chynn, M.D., performs eye surgery, including Lasik vision correction, and is an ACSH Advisor.