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Video

Pediatric Otolaryngology

(A923) Explosive Risks: A Decade of Pediatric Fireworks-Related Head and Neck Injuries in the U.S

Monday, October 13, 2025
12:00 PM - 1:00 PM EDT
Location: OTO EXPO, Posters

    Presenting Author(s)

  • Rachel N. Grimes, BS

    Medical Student
    Medical College of Georgia At Augusta University
    Decatur, Georgia, United States

    • Co-Author(s)

  • Osayamen A. Atekha, BA

    M.D. Candidate
    Medical College of Georgia at Augusta University
    Augusta, Georgia, United States

    • Senior Author(s)

  • HK

    Heather Koehn, MD

    Associate Professor
    Medical College of Georgia at Augusta University
    Augusta, Georgia, United States

Disclosure(s):
Rachel N. Grimes, BS: No relevant relationships to disclose.
Osayamen A. Atekha, BA: No relevant relationships to disclose.
Heather Koehn, MD: No relevant relationships to disclose.


Introduction: Fireworks-related injuries are a significant public health concern, particularly among children. This study describes the epidemiology of head and neck injuries related to fireworks in pediatric patients in the U.S.

Methods: Retrospective cohort study utilizing 2014-2023 National Electronic Injury Surveillance System (NEISS) data. Children aged 1-18 with fireworks-related injuries to the head, neck, mouth, eye, face, or ear were included. Variables were analyzed using independent t-tests for continuous variables and chi-square tests for categorical variables.

Results: 564 pediatric fireworks-related head and neck injuries were identified. Most cases were male (68.97%, n=389) with mean age of 9.64 years (95% CI 9.24-10.04). There was an association between gender and race, with white males disproportionately affected (p=0.0051). Thermal burns were the most common injury (31.56%, n=178), followed by contusions/abrasions (23.76%) and lacerations (7.80%). Younger children were more prone to burns and foreign body injuries, while older children more often sustained lacerations (p < 0.001). No significant differences in mean age were found based on gender (p=0.94) or race (p=0.62). The eyeball was the most frequently injured site (43.97%, n=248), followed by the face (29.96%) and ear (8.33%). Injury sites varied by age (p < 0.0001) and injury type (p < 0.0001). 70.21% of injuries occurred in July, and 9.57% involved fire. No injuries involved alcohol, and drug use contributed to one incident. 86.17% of patients were treated and discharged from the emergency department.

Conclusions: Pediatric fireworks-related head and neck injuries primarily affect young males, especially in July, with thermal burns and ocular injuries being the most common. Demographic factors are associated with injury patterns, including higher rates of burns and foreign body injuries in younger children. Despite most injuries resulting in same-day discharges, their severity highlights the need for targeted prevention to reduce the impact of these head and neck injuries in children.