The liberalization of fireworks legislation and its effects on firework-related injuries in West Virginia

Abstract

Abstract Background Fifteen states, including West Virginia, have liberalized their laws concerning fireworks possession and sale. Effective June 1, 2016, House Bill 2852 enabled all Class C fireworks to be sold within the state. The effects of this policy on fireworks-related injuries requiring immediate medical care are unknown. The purpose of this study was to determine whether this policy may have affected the fireworks-related injury rate and/or injury severity. Methods Data were collected from the electronic medical records of patients treated by West Virginia University Medicine between June 1, 2015-May 31, 2017. The pre and post law periods were defined as June 1, 2015-May 31, 2016 and June 1, 2016-May 31, 2017, respectively. Fireworks-related injuries were identified via International Classification of Disease Clinical Modification codes and by free text searches of the electronic medical records. The rate of injuries pre and post-legislation were compared by Exact Poisson Regression, while demographic characteristics and injury severity were compared via Fisher’s Exact tests. Results 56 individuals were treated for fireworks-related injuries during the study period. The majority of patients were over 25 years of age (64%) and male (77%). Most of the injuries occurred within 7 days of a celebrated U.S. holiday (64%), and 28% were severe in nature. Age, sex, and injury severity did not significantly differ pre and post law passage. The injury rate per 100,000 patients was 39% higher after the law was enacted (p = 0.3475; incidence rate ratio 1.39, 95% Confidence Interval 0.74, 2.68). Conclusion The law increasing access to Class C fireworks may have affected the injury rate, but not injury severity among treated patients. Effective, evidence-based, public health interventions applicable to all age groups may be warranted particularly around national holidays. This study may inform other states looking to amend their legislation.