Firework and sparkler burns in paediatric patients

Background: While the consumer sale of fireworks is illegal in New South Wales, the sale of sparklers is legal—however, both still pose a significant risk of harm in the paediatric population. Anecdotally, burns services are aware that the misuse of sparklers can result in burns but there appears to be a paucity of studies examining this incidence in the paediatric population in Australia. Method: A retrospective review of all burns related to the use of fireworks or sparklers referred to the Children’s Hospital at Westmead (CHW) Burns Unit (BU) from January 2004 to December 2019. Results: 96 patients were referred to the CHW BU with a burn as a result of a firework or sparkler. Sparklers accounted for 69 (72%) of burns, compared with 27 (28%) from fireworks. The mean age of those injured by sparklers was five years compared with eight years in the firework group. Average total body surface area (TBSA) affected for both mechanisms was similar—for sparkler burns (2.0%) firework burns (2.4%), with a range of 0.1–15 per cent. Hands were the most common area burnt in both groups comprising 41 (59%) of sparkler burns and 13 (48%) of firework burns. Twenty patients required a total of 32 visits to the operating theatre for acute management of their burns. Conclusion: This study demonstrates the potential for significant injuries as a result of fireworks and sparklers. These findings can be used to raise awareness regarding their dangers, direct targeted educational campaigns and guide safety advice regarding their use