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Study traces impact of bottle rocket injuries on children

BY: JESSICA PASLEY

1/13/2011 - Years of treating patients for eye injuries caused by errant fireworks prompted Vanderbilt Eye Institute's Franco Recchia, M.D., and colleagues to study the impact that bottle rocket injuries had on children and adolescents.

Franco Recchia, M.D.

Franco Recchia, M.D.

The study findings, which show that the majority of patients treated ended up with reduced vision, appear in the online version of the Archives of Ophthalmology, an international peer-reviewed journal of the Journal of the American Medical Association, slated for the May print issue.

Recchia hopes the documentation of ocular injury will lead to educational initiatives or legislative enhancements on firework safety.

“We felt that it was important to educate physicians and others who treat these kinds of injuries as well as provide a public service announcement that this practice causes significant injuries that often lead to permanent vision loss.

“I certainly support someone's efforts to look into legislation concerning firework safety and hope that our study can be used as a reference,” he said. “I firmly believe that if people are going to engage in firework activity, they must take the appropriate precautions like wearing eye protection and using other protective measures.”

Recchia said despite the growing number and severity of injuries, there was limited literature or medical documentation to describe the myriad of ocular injuries or the long-term effects on the patients, their families and society at large.

“This study is a reminder to think twice about engaging in a potentially destructive, yet avoidable, trauma-causing situation,” said Recchia, associate professor of Ophthalmology and Visual Sciences at Vanderbilt.

The study is a four-year, retrospective look at 10 patients age 18 and younger who suffered ocular injuries related to bottle rocket accidents and received treatment through the emergency department of the Monroe Carell Jr. Children's Hospital at Vanderbilt and VEI.

Nationally there were about 9,200 emergency room visits in 2006 as a result of firework injuries, according to the study. An estimated 1,400 cases a year were eye injuries, with a disproportionate number caused by bottle rockets.

“Injuries have ranged from as mild as corneal abrasions to as severe as retinal detachment and irreversible vision loss,” he said. “The majority of the (10) children who were treated ended up with reduced vision and probably half of those were deemed legally blind.”

In one case, a patient's visual acuity was diminished to finger counting, according to study data.

“People need to be aware of the impact this has, especially since the injuries are largely preventable.”

Although the majority of cases involved bottle rocket launchers, several incidences impacted bystanders. None of the patients treated at Vanderbilt wore protective eyewear.

“If children, adolescents and parents choose to launch bottle rockets, it is important for parents not only to supervise children and adolescents in the vicinity of bottle rockets but also to ensure that protective eyewear is being used,” the study stated.

“Studies such as ours can assist in modifying legislation to regulate sales of bottle rockets in an effort to eliminate unnecessary ocular trauma and visual loss,” Recchia said.

Co-authors of the study were Mehnaz Khan, MS, a fourth-year VU medical student, and David Reichstein, M.D., a former resident in Ophthalmology at Vanderbilt.
 

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