Firework related burns in adults: A New South Wales statewide review

Dr Jason Diab1,2,3,4, Mr Zachias Hopkins3, Ms Vanessa Diab4,  Dr Jeon Cha 5, Prof Peter Maitz1,2,3, Dr Andrea Issler-Fisher1,2,3

1Concord Repatriation General Hospital, Australia, 2ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia., 3University of Sydney, Sydney, Australia, 4School of Medicine, The University of Notre Dame, Sydney, Australia. 5 Royal North Shore Hospital, Australia.


Fireworks are commonly used for celebrations and recreational purposes. They have the potential to cause serious burns and associated injuries to different parts of the body. Our aim was to identify and classify epidemiological trends of firework related burn injuries in adults across New South Wales (NSW), Australia.

Patients were identified using the NSW Statewide Burn Injury Service (SBIS) database from 2010 – 2020, together with medical records from the Burn Units (BU) at Royal North Shore and Concord Repatriation General Hospitals. All patients who suffered a burn secondary from fireworks were included and data was extracted on mechanism of injury, severity of injury and management.

There were 203 patients with a firework related burn injury. The male to female ratio was 4:1 with an average age of 32.2 years. Men were 5.2 years younger than women (31.2 vs 36.4, p=0.010). Men were more likely to have firework related injuries on non-holidays, whereas women were more likely on holidays (p=0.050). Men were more likely to consume alcohol and operate fireworks resulting in burns than women (34.4% vs 12.5%, p=0.007). Sparklers were more common amongst women, whereas fireworks had higher proportions amongst men (p=0.009). The most common site of injury was the hands. The most frequent type of injury was a mid-dermal burn (61.6%), followed by superficial (25.2%) and full thickness (13.2%) respectively. The operative rate was 17.7% with a mean total length of stay of 2.2 days (range:1-12).

Firework related burns have distinct patterns of use and injuries amongst men and women. Educational awareness, legislation, and harm minimisation are critical to the reduction of injury.


Jason is a surgical registrar with an interest in burn prevention and education.

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