Link seen between eye injuries, legal access to fireworks

A study shows that the odds of fireworks-related ocular trauma were higher among Washington state residents of areas where the explosives are legal.

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Ophthalmologists, it turns out, get as jumpy as our dogs and cats on the more pyrotechnically festive holidays. 

“It comes from experience every year,” said Dr. Shu Feng, assistant professor of ophthalmology at the University of Washington School of Medicine. “Ophthalmologists just hate the Fourth of July and New Year’s Eve because those are our busiest weeks every year. We get a very substantial number of fireworks injuries, and we see that a lot of them are young kids or younger people. And some of these people lose vision from one eye or both.” 

Noticing these trends at UW Medical Center’s eye clinic led Feng and ophthalmology colleagues to study whether fireworks bans in Washington state municipalities affect related ocular trauma.  

The findings, published Dec. 14 in JAMA Ophthalmology, indicated that the odds of a fireworks-related injury were two times higher among residents of areas where fireworks were legal than among residents of areas with restrictions. 

Washington counties and cities have a range of fireworks laws. Feng began to observe not only the ages of injured people, but also where they lived. While many were from Seattle, a lot of patient transfers came from outlying areas, including Lake Stevens in Snohomish County.  

“We see a large number of fireworks injuries that come from all across the state, sometimes more frequently from certain cities,” she said. “Is it because they have different fireworks laws? We began looking into the local fireworks restrictions and found that there's a huge variation. Even just a city boundary might make a big difference between whether fireworks are permitted or banned, but you can just walk across and buy them and then use them at home.” 

Feng and research colleagues tracked 230 patients who had presented with eye injury in the two weeks surrounding Independence Day over an eight-year span (2016-22). She said more research across national databases would clarify whether the association between fireworks access and the odds of an eye injury extends beyond Washington state.

“You wonder if these fireworks restrictions work at all,” Feng said. “They’re so controversial because fireworks are fun. People love fireworks. If you want to set them off, you can easily drive out to a reservation or to the next county over and get those fireworks, even if they are banned where you live. To actually be able to find that there is a difference between the odds of injury if you're from an area where there's legal fireworks versus banned was a bit surprising to us.” 

This much is certain: Ophthalmologists see fireworks-caused injuries that range from superficial, such as debris in the eye, to burning and scarring that can lead to multiple surgeries to save someone’s vision.  These injuries are easily avoided, Feng said. 

“That's why eye protection is super important when handling fireworks. And maybe just leaving it to experts is the best idea.” 

Related: Download broadcast-ready soundbites with Dr. Shu Feng. 


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