Fireworks: 10 Things Hand Surgeons Wish You Knew

July 4^th is one of my favorite holidays and a holiday worth celebrating in a big way. As a hand surgeon, I love the family barbecues, going to baseball games, and going to local lakes and parks. If you enjoy fireworks, the best option is to leave the fireworks to the trained professionals and attend town-sponsored fireworks displays supervised by local fire departments.

Having your own fireworks display can be dangerous, not to mention illegal in Vermont, Massachusetts, and New York. But if you are travelling out of state or are considering purchasing sparklers or other legal fireworks locally, here is some information to help keep you safe:

Fireworks cause life-altering injuries, especially during the weeks around July 4, and they are on the rise. According to the Consumer Product Safety Commission, in 2016 there were 11,000 fireworks-related injuries. By 2020, that number was up to 15,600.
Fireworks injuries have gotten more serious too. In 2019, 12 percent of people injured by fireworks were admitted to a hospital, and in 2020, that number went up to 21 percent. And 18 people died in fireworks incidents in 2020, compared to 12 deaths in 2019.
Most injuries are to the hands and fingers. Fireworks can also cause serious injuries to your head, face, ears, and eyes. Injuries include burns, scaring, and amputation of the hand. Fireworks injuries often require surgeries and hospitalization.
Smaller fireworks cause the most injuries. In 2020, firecrackers were the biggest source of ER-treated fireworks injuries. There were more than 1,600 people injured by firecrackers. Sparklers were related to 900 injuries. Sparklers can burn at about 2,000 degrees Fahrenheit, hot enough to melt metal and about twice as hot as other fireworks!
If you do choose to use fireworks, make sure they are legal in your area, and only purchase and set off fireworks that are labeled for consumer (not professional) use. Avoid buying fireworks that are packaged in brown paper. This is often a sign that the fireworks were made for professional displays and could be dangerous.
Never use drugs or alcohol while using fireworks. Of the 18 firework-related deaths in 2020, eight of the victims (44 percent) had used alcohol or drugs prior to the incident.
Never allow children to play with or ignite fireworks. Period.
Read the instructions and follow them carefully. Light one at a time from a standing position outside. Never point or throw fireworks (including sparklers) at anyone.
Never place any part of your body directly over a fireworks device when lighting the fuse. Back up to a safe distance immediately after lighting fireworks. Never try to re-light or pick up fireworks that have not ignited fully. Wait 20 minutes before placing them in a bucket of water.
Wear eye protection and keep a bucket of water or a garden hose handy in case of fire. After fireworks complete their burning, douse them with plenty of water from a bucket or hose before discarding it to prevent a trash fire.

I wish you a fun and festive Independence Day, one without a firework-related injury. More information about fireworks safety is available from the American Society for Surgery of the Hand, National Council on Firework Safety, and the Consumer Product Safety Commission. Be safe and have fun!

David Veltre, MD, is a hand surgeon with SVMC Orthopedics, part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care, in Bennington.