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

  • Rudisill, Toni M.1
  • Preamble, Katarina2
  • Pilkerton, Courtney3
  • 1 West Virginia University, School of Public Health, Morgantown, WV, 26506, USA , Morgantown (United States)
  • 2 West Virginia University, Morgantown, WV, 26506, USA , Morgantown (United States)
  • 3 West Virginia University, Morgantown, WV, 2506, USA , Morgantown (United States)
Published Article
BMC Public Health
Springer (Biomed Central Ltd.)
Publication Date
Jan 30, 2020
DOI: 10.1186/s12889-020-8249-0
Springer Nature


BackgroundFifteen 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.MethodsData 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.Results56 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).ConclusionThe 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.

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