Extent, nature and hospital costs of fireworks-related injuries during the Wednesday Eve Festival in Iran

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Abstract:

Background:

Fireworks are commonly used in local and national celebrations. The aim of this study is to explore the extent, nature and hospital costs of injuries related to the Persian Wednesday Eve festival in Iran.

Methods:

Data for injuries caused by fireworks during the 2009 Persian Wednesday Eve festival were collected from the national Ministry of Health database. Injuries were divided into nine groups and the average and total hospital costs were estimated for each group. The cost of care for patients with burns was estimated by reviewing a sample of 100 patients randomly selected from a large burn center in Tehran. Other costs were estimated by conducting semi structured interviews with expert managers at two large government hospitals.

Results:

1817 people were injured by fireworks during the 2009 Wednesday Eve festival. The most frequently injured sites were the hand (43.3%), eye (24.5%) and face (13.2%), and the most common types of injury were burns (39.9%), contusions/abrasions (24.6%) and lacerations (12.7%). The mean length of hospital stay was 8.15 days for patients with burns, 10.7 days for those with amputations, and 3 days for those with other types of injury. The total hospital cost of injuries was US$ 284 000 and the average cost per injury was US$ 156. The total hospital cost of patients with amputations was US$ 48 598. Most of the costs were related to burns (56.6%) followed by amputations (12.2%).

Conclusions:

Injuries related to the Persian Wednesday Eve festival are common and lead to extensive morbidity and medical costs.

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Most cited references 25

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Unintentional childhood injury patterns, odds, and outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit

Milton Mutto, Stephen Lawoko, Catherine Nansamba … (2011)

Abstract: Background: Unintentional Childhood Injuries pose a major public health challenge in Africa and Uganda. Previous estimates of the problem may have underestimated the childhood problem. We set to determine unintentional childhood injury pattern, odds, and outcomes at the National Paediatric Emergency unit in Kampala city using surveillance data. Methods: Incident proportions, odds and proportional rates were calculated and used to determine unintentional injury patterns across childhood (1-12 years). Results: A total of 556 cases recorded between January and May 2008 were analyzed: majority had been transported to hospital by mothers using mini-buses, private cars, and motorcycles. Median distance from injury location to hospital was 5 km. Homes, roads, and schools were leading injury locations. Males constituted 60% of the cases. Play and daily living activities were commonest injury time activities. Falls, burns and traffic accounted for 70.5% of unintentional childhood injuries. Burns, open wounds, fractures were commonest injury types. Motorcycles, buses and passenger-cars caused most crashes. Play grounds, furniture, stairs and trees were commonest source of falls. Most burn injuries were caused by liquids, fires and hot objects. 43.8% of cases were admitted. 30% were discharged without disability; 10%, were disabled; 1%, died. Injury odds and proportional incidence rates varied with age, place and cause. Poisoning and drowning were rare. Local pediatric injury priorities should include home, road and school safety. Conclusions: Unintentional injuries are common causes of hospital visit by children under 13 years especially boys. Homes, roads and educational facilities are commonest unintentional injury sites. Significant age and gender differences exist in intentional injury causation, characteristics and outcomes. In its current form, our surveillance system seems inefficient in capturing poisoning and drowning. The local prevention priorities could include home, road and school safety; especially dissemination and uptake of proven interventions. Burns should be focus of domestic injury prevention among under-fives. Commercial passenger motorcycles require better regulation and control.

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Children with burn injuries-assessment of trauma, neglect, violence and abuse

Michael Toon, Dirk M. Maybauer, Lisa L. Arceneaux … (2011)

Abstract: Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electrical, chemical and intentional injury. Mechanisms of injury are often unique to children and involve exploratory behavior without the requisite comprehension of the dangers in their environment. Assessment of the burnt child includes airway, breathing and circulation stabilization, followed by assessment of the extent of the burn and head to toe examination. The standard rule of 9s for estimating total body surface area (TBSA) of the burn is inaccurate for the pediatric population and modifications include utilizing the Lund and Browder chart, or the child's palm to represent 1% TBSA. Further monitoring may include cardiac assessment, indwelling catheter insertion and evaluation of inhalation injury with or without intubation depending on the context of the injury. Risk factors and features of intentional injury should be known and sought and vital clues can be found in the history, physical examination and common patterns of presentation. Contemporary burn management is underscored by several decades of advancing medical and surgical care however, common to all injuries, it is in the area of prevention that the greatest potential to reduce the burden of these devastating occurrences exists.

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Pediatric fireworks-related injuries in the United States: 1990-2003.

Simon Smith, Lindsay Comstock, Rachel J Witsaman (2006)

Our goal was to describe the epidemiology of pediatric fireworks-related injuries among children aged 19 years and younger by using a nationally representative sample. We performed a retrospective analysis of data from the US Consumer Product Safety Commission's National Electronic Injury Surveillance System from 1990-2003. An estimated 85800 pediatric fireworks-related injuries were treated in US emergency departments during the 14-year study period. Injured children had a mean age of 10.8 years, and 77.9% were male. Fireworks users accounted for 49.5% of the injuries, whereas 22.2% of the injuries were to bystanders; however, user status could not be determined in 28.3% of cases. The overall fireworks-related injury rate decreased significantly during the study period, but subgroup analysis did not indicate consistent declines among all ages and types of fireworks. Injuries were most commonly caused by firecrackers (29.6%), sparklers/novelty devices (20.5%), and aerial devices (17.6%). The most commonly injured body sites were the eyeball (20.8%), face (20.0%), and hands (19.8%), and the most common injury type was burns (60.3%). Approximately 91.6% of all children with fireworks-related injuries were treated and released from hospital emergency departments, 5.3% were admitted, and 2.3% were transferred to another institution. Bystanders accounted for 13.3% of admitted cases and 20.6% of transferred cases. Consumer fireworks cause serious preventable injuries among pediatric fireworks users and bystanders in the United States. Parents should be advised to take their children to safer public fireworks displays rather than allowing consumer fireworks to be used by or near their children. A national restriction of consumer fireworks, in accordance with the policy recommendations of the American Academy of Pediatrics, should be implemented to reduce the burden of fireworks-related injuries among children.

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Author and article information

Journal

Journal ID (nlm-ta): J Inj Violence Res

Journal ID (iso-abbrev): J Inj Violence Res

Journal ID (pmc): kums

Title: Journal of Injury and Violence Research

Publisher: Kermanshah University of Medical Sciences

ISSN (Print): 2008-2053

ISSN (Electronic): 2008-4072

Publication date (Print): January 2013

Volume: 5

Issue: 1

Pages: 11-16

Affiliations

^aDepartment of Health Economics and Management, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

^bInjury Prevention and Safety Promotion Department, Ministry of Health, Tehran, Iran.

^cKnowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Author notes

[* ] Corresponding Author at: Ali Akbari Sari: Assistant Professor, Department of Health Management and Economics School of Public Health, Tehran University of Medical Sciences, Iran, P.O .Box: 14155-6446, Tel: +98-21-88989129, E-mail: akbarisari@ 123456tums.ac.ir (Akbari Sari A.).

Article

DOI: 10.5249/jivr.v5i1.146

PMC ID: 3591727

PubMed ID: 21964162

SO-VID: ee27afb4-5614-438d-b1c5-7f71a0bbbeaa

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution 3.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Extent, nature and hospital costs of fireworks-related injuries during the Wednesday Eve Festival in Iran

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Abstract:

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Irish Journal of Paramedicine

Most cited references 25

Unintentional childhood injury patterns, odds, and outcomes in Kampala City: an analysis of surveillance data from the National Pediatric Emergency Unit

Children with burn injuries-assessment of trauma, neglect, violence and abuse

Pediatric fireworks-related injuries in the United States: 1990-2003.

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