Firework injuries around New Year's Eve - epidemiology, injury patterns and risk factors.

Introduction: This study aims to determine key demographic and behavioural risk factors contributing to firework-related injuries and their outcomes.

Methods: A retrospective study was conducted on pediatric and adult patients treated for firework-related injuries at the University Hospital Leipzig from December 28th to January 3rd over 10 years (2013-2023). Data were collected on demographics, injury details, weather conditions and classification of fireworks.

Results: A total of 155 patients (mean age 24 years, 80% male) were included. Injuries predominantly occurred within two hours after midnight, and all incidents involved violation of safety regulations. Most injuries were self-inflicted (48.4%), with hands being the most frequently affected body part (52.9%). Burn injuries were common (43.9%) but were less likely during rainy weather (OR 0.4, 95% CI 0.2-0.7, p = 0.004). Surgical intervention was required in 23.9% of cases, with significant risk factors being associated bone injuries (OR 107.1, 95% CI 22.7 to 505.6), male sex (OR 5.7, 95% CI 1.3-25.0) and multiple body region injuries (OR 4.9, 95% CI 2.1-11.7). Permanent loss of function was observed in 46.5% of all patients.

Conclusion: Firework-related injuries around New Year's Eve are associated with significant morbidity, particularly affecting the hands and often requiring surgical intervention. Bone injuries, male sex and multiple body region injuries were associated with higher need for surgical treatment. Despite most fireworks being purchased legally, there is widespread disregard to age restrictions and safety protocols. These findings highlight the necessity of public health initiatives to reduce the incidence and severity of such injuries, rather than stricter regulations.