by Laurie Holloway
Contributor

With the Fourth of July just one day away, children injured by fireworks already have begun appearing at the Monroe Carell Jr. Children's Hospital at Vanderbilt.

David Morrison, M.D., assistant professor of Ophthalmology and Pediatrics with the Tennessee Lion's Eye Center at Children's Hospital, has seen two serious injuries already.

Fireworks-related injuries run from burns and abrasions to serious eye damage and even blindness. National statistics show 10 percent of firework injuries are sustained by toddlers, and injuries are most likely to occur when children have fireworks without adequate supervision.

"About 40 percent of injuries from fireworks involve the eye or face, and of those, bottle rockets are responsible for more than half," Morrison said.

The concussive force of a bottle rocket explosion in or around the eye can cause lacerations to the eyelid, damage to the cornea, bleeding within the eye, as well as complete rupture of the globe, he said.

"About one-third of those injuries will progress to permanent vision loss," Morrison said. "In rare cases, the inflammation caused by injury to one eye can trigger a person's own immune system to attack the healthy eye as well. In those cases, we have to remove the damaged eye to save the remaining eye."

While older children are the usual victims of bottle rocket injuries, Children's Hospital physicians have even treated toddlers injured as bystanders by bottle rockets that misfire or are poorly aimed. Children are also at high risk of burn injuries from sparklers and other types of fireworks.

A much better alternative to home explosives is a family trip to a professional fireworks show, doctors say.

"Class C fireworks are available commercially in Tennessee, so there is more potential for danger in this state than others," Morrison said. "But the risk of vision loss alone is such that we say no firework is a safe firework, and all should be handled by professionals. However, if a parent does decide to go against this advice, close supervision is an absolute necessity."

Tips to reduce injuries

• Never let a child handle any fireworks without direct adult supervision.

• Don't hand sparklers to children under age 5.

• Make children stand still with sparklers.

• Keep a bucket of water for immersing all fireworks after use.

• Dispose of any unused fireworks to decrease the possibility children can use them unsupervised.