In the latest installment of our occasional conversations with Fort Worth newsmakers, Dr. Erik Ledig, medical director of the emergency department at Texas Health Neighborhood Care & Wellness Burleson and Texas Health Neighborhood Care & Wellness Willow Park, discusses what an emergency room looks like on the Fourth of July — and why thousands of people across the U.S. may visit because of firework-related injuries. 

This conversation has been edited for length and clarity. For more, please listen to the audio file attached to this article.

Alexis Allison: So, Dr. Ledig. Fireworks are federally classified as hazardous substances. But why are they so dangerous?

Dr. Erik Ledig: The main ingredient in fireworks is gunpowder. It’s classified as a hazardous substance under the Federal Hazardous Substances Act because of that. They’re explosive, and they’re unpredictable, and thus they can cause harm to people and animals.

Allison: You mentioned gunpowder — what makes something a firework? Is there a formal definition?

Ledig: So, fireworks are defined by having explosive nature to produce either an audible or visual experience for people, usually in terms of enjoyment, but it’s that explosive chemical that kind of defines the firework. There are many different types of devices and how they work and why they classify as a firework.

Allison: Can you tell us a little bit about some of those different types of fireworks and maybe some of the dangers related to those specific types?

Ledig: Definitely. I’ll first categorize them the way that they are legally. They’re kind of categorized between display fireworks and consumer fireworks. And it’s dependent on how much of that explosive material that gunpowder is put into it. If looking at half an aspirin tablet, that’s about the max amount of gunpowder that can be in a consumer-marketed firework. 

Those that are above (that max amount) are either illegal or only used by professionals. Those display fireworks normally sold with a brown paper covering are only for individuals that are professionals that follow specific guidelines and regulatory rules and structures upon how they’re used and how to manage. Whereas consumer fireworks they’re sold, they have packaging, and they should have details and instructions on them. 

I would worry about any fireworks that are unlabeled. They can be illegal and dangerous and hazardous and unpredictable. So don’t ever buy any unlabeled firework and be sure you’re purchasing one designed for consumers. 

Then, of the different types of fireworks, there’s many and I’ll only mention several of the main categories: sparklers Roman candles, ground spinners, fountains, firecrackers, bottle rockets, novelty fireworks, smoke bombs, just to name a few of the categories.

The majority of injuries that visit the ER, or the top two concerning ones, are firecrackers and sparklers. It’s interesting: Sparklers are considered less harmful because they have less energy associated (with them), but they can be a form of considerable danger to people, especially burns. The chemical ingredients in the sparklers burn at around 1,200 degrees. To give some relation, water boils at 212. So if handled improperly, they can cause a degree of harm to somebody, especially burns. 

Well, we found that, (from June 21 – July 21, 2020), 900 ER visits were from sparklers — 400 of them being kids under the age of 5. So it’s not a harmless device. Of course, firecrackers, being the No. 1, have a lot of explosive damage and, when handled improperly, can result in the wounds of lacerations, foreign body injury, soft-tissue amputations of (fingers and toes).

Allison: You mentioned the ER. As an emergency room physician, what does the ER look like on the Fourth of July typically?

Ledig: I’ll begin by saying unpredictable. However, injuries from fireworks are somewhat predictable. We know that about 44% of those are going to be from burns. That’s the majority of injuries that we see from fireworks, whether second-degree, third-degree, requiring specific burn centers involved in treatment. And then you have hand injuries — the (most common) area that people get injured with lacerations, amputations, contusions. Next facial injuries and then eyes and ears, which is why we recommend safety eyewear for people close to fireworks and then of course, earplugs. Decibels with some of these fireworks can rival those of a jet plane. 

Allison: I’m glad you brought up prevention. Besides eyewear and earwear, what are some of the other strategies that people could pursue to prevent injury?

Ledig: I’ve got a list of several recommendations: First, don’t allow children to ignite or play with fireworks. And then supervise all children when they’re around fireworks. Make sure they’re not getting into something that they shouldn’t be getting into.

Light fireworks one at a time. Allow (the firework) to result — manage that one before going to the next one — and keep a safe distance from fireworks. The higher the explosive nature, the further away that you want to be from that firework. 

Don’t use fireworks while impaired. Our judgment is affected when on certain alcohol or other medicines. So you don’t want to impair your judgment or reflexes when working with fireworks. 

Never point or throw fireworks toward people, houses or flammable objects. In that regard, be aware of what you’re wearing: your clothing, lotions, what you’re holding, in addition to anything on your body, those things can come and play. 

Never relight or handle malfunctioning or non-functioning fireworks. Just let them sit for about 20 minutes, then douse them with water, because water is going to deaden the chemicals that cause the explosive nature. Wait again, 10-20 minutes. And then, before disposing of it, let it soak in water. That way you know that the active ingredients are non-functioning. 

Keep a bucket of water or some water access, whether it be a hose or something nearby just in case something were to occur. 

And lastly, back to wearing safety eyewear and earplugs to prevent any injury to your eyes or your ears. 

Allison: Those are really practical tips. Thank you for that. One quick follow-up question. Why do people need to be aware of the lotion that they wear?

Ledig: Just because some things that they put on themselves can be flammable, especially if there’s anything alcohol-based. Perfumes and whatnot. 

Allison: Is there anything else that you’d like to share when it comes to how we approach fireworks?

Ledig: I would. It’s all about prevention. So I would keep yourself safe, keep others safe, keep the environment safe. For children, there are other safety things that they can involve themselves in: glow sticks, confetti, poppers, color streamers, some very safe ways of enjoying the holiday. And lastly, probably the safest measure of enjoying the displays: Let the professionals do it. Enjoy their lavish performances of fireworks when they follow all the safety procedures and enjoy it with your family and friends in safety.

Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her by email or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

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Alexis Allison

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....