Here’s hoping we’ll clearly see the danger of fireworks’ improper use.

Forty-five of the 50 U.S. states allow the sale of consumer fireworks, a major cause of the sharp rise in hospital emergency room activity each year in the period around Independence Day. It is the time when plastic surgeons are busiest. About 70% of fireworks injuries treated in hospitals occur between June 20 and July 20.

Other notoriously dangerous periods include Mardi Gras, Christmas and the New Year holidays, as well as the Chinese New Year in certain areas. These holidays also are noted for a sharp rise in alcohol sales. The annual U.S. fireworks-related injury toll averaged 11,500 between 1992 and 1996, and 9,200 injuries from 2002 through 2004. An annual average of six of these proved to be fatal.

As noted in last month’s column, few fireworks injuries ever result from fireworks launched at public firework shows by trained technicians. The lion’s share of fireworks injuries is the direct result of the use of consumer fireworks by the general public, typically juveniles. The U.S. Consumer Product Safety Commission has reported that the majority of victims of fireworks injuries are under age 20, with about 50% being under the age of 15.

The Children’s National Medical Center in Washington, D.C., reported that half of the 1,500 people injured by sparklers in 2002 were younger than 5 years old. Considered a harmless novelty by many, sparklers reach temperatures exceeding 1,000°F. Jon Hirshon, MD, of the American College of Emergency Physicians, stated that “the toll of these (sparkler and firecracker) injuries on a person’s quality of life is immeasurable.” The use of amateur pyrotechnic devices all too often leads to third-degree burns, loss of vision or permanent scarring.

Backyard fireworks such as bottle rockets and fountains also cause a multitude of vehicle and structure fires each year, totaling around $50 million in property damage. Fireworks are the leading cause of all fires occurring during the 4th of July holiday. Approximately 24,200 U.S. fires were started by fireworks in 1999 alone - and yet, only Rhode Island, New Jersey, New York, Delaware and Massachusetts ban all consumer fireworks.

In Tennessee, Arkansas, Texas, Mississippi and North Dakota, a 12-year-old can buy them. These devices typically injure the head, hands and eyes. Seventy-five percent of those injured are males. The typical female victim is a bystander, not a setter. And about 500 children each year under the age of five are victims.

Of the 9,000 people in the U.S. treated each year in hospital emergency rooms due to injuries caused by consumer fireworks, 21% to 24% are eye injuries. Purveyors of firework novelties need to be reminded that thousands of injuries occur each year when a device explodes while still in the hand of the user, or when attempting to relight a “dead” firecracker that went out before fusing.

Children should never be allowed to light any sparklers or fireworks. There are wiser ways to demonstrate patriotism and the independence of our country. Interestingly, and strangely, fireworks are a “time-honored” tradition in most countries. What a waste when these pyrotechnics are used unsafely. What must be remembered every 4th of July is that fireworks are not a harmless symbol of celebration, particularly when alcohol is involved.

Jon Kretzmann [see below] can definitely attest to that.

[sidebar] Jon Kretzmann: Real World Victim of Fireworks

During a 4th of July fireworks celebration in Lancaster, OH, several years ago, an “unknown subject” hurled a firecracker with the strength of an M-80 into the crowd. It exploded in front of Jon T. Kretzmann, who permanently lost sight in his left eye as a result (see photo). Detectives were not able to come up with any leads or facts. Recently, Jon told me about the incident in detail and how it has changed his life:

“Six people had shrapnel injuries from that firecracker. Mine was one of the smallest injuries, but the eye is delicate. We were sitting in two rows on the ground; the blast went off at eye level about two feet in front of me - the middle of the back row.

“The person on the left side of the front row had several burns on his right rear side. The middle person directly in front of me had extensive burns, as the shrapnel shredded his flannel shirt in the lower back and kidney area. The person on the right side of the front row had burns on his left rear side. Rhonda, my girlfriend, had three burns on her face and upper chest.

“The blast severed my lower eyelid, which dangled down my cheek but mercifully stayed connected. I also had a big oval hole in the center of my left eyeball, and the back part of my eyeball, the retina, was damaged. I had a flash-burned face like a bad sunburn, but no other damage to my clothes or body that I recall. The kid to my right had burns on his lower chest and waist.

“The hot shrapnel did not pack a lot of punch or penetrating power, so my guess is that it was not in a rigid container like a bottle or can or metal tube. Hot cardboard at the speed of an explosion can and does affect its surroundings. I’m not real familiar with fireworks, but I was blown backwards onto my back, then got to my feet a bit perturbed that someone would be so careless.

“My face hurt and my left eye felt weird. A flood of dark red blood came down semi-slowly over my ‘eye.’ I staggered around, and in the melee it took Rhonda several minutes with a cop to find me. When he shined his flashlight on my face they were all taken aback - seeing a big bloody hole where a very handsome eye had been for almost 19 years. The cop ordered a 4-wheel drive ambulance over his walkie-talkie to transport the six of us to the hospital.

“As we piled into the open back there weren’t normal seats, we lined up three to a side. The kid who had been immediately in front of me during the blast was not able to sit but leaned stomach down and his bloody shirt was facing me. It was a rough trip down that steep path. We drove through the packed crowds who were gathered to watch Lancaster’s fireworks display from the fairgrounds as they had for generations. As this emergency vehicle sped past the crowd, my parents were right there.

“At the first intersection, we were transferred to a traditional Emergency Van, which sped off through my neighborhood and on to the hospital. I was first in with the most serious injury. A very skillful eye surgeon was on call that night, Dr. Kirpatrick. He beautifully sewed my barely attached but available lower lid back on: no scars and full function. But the extensive damage to the eye was beyond anything he could do. He treated the area, patched me up and sent me home.

“The next day in his office, he carefully examined me and made arrangements with an eye specialist at Ohio State University, Dr. Richard Keats. He took many pictures and when the cornea had healed enough to shut and hold pressure, took readings and gave me the news that no procedures were available to fix the amount of damage my eye sustained. The hope would be many years in the future if an eye transplant could be done, with the thousands of nerves leading from the eye to the brain reattached in the exact right order to survive.

“Dr. Keats asked me if I wanted to use an extended wear soft contact lens. Mine would be hand painted to match my right eye. I’m pleased I could do this, as it puts others more at ease than when I show up ‘au natural’- with the left eye corneal scar tissue a thick whitish-green look.

“All told, I was on fluid reduction medication to keep the pressure in my eye low to try to keep my optic nerve alive. I was confined to bed for 33 days. That medication also took my appetite away and I lost 26 pounds and all muscle tone due to atrophy. When I was released on my 19th birthday, I could not stand for three minutes without my skinny legs shaking. My Dad took me outside to play catch with a softball, which I had done for the previous 16 years or so. On his first throw, I put my glove where my solo right eye thought it would end up… it sailed two feet over my glove.

“I laid out the first semester of my sophomore year of college. Eventually, my brain figured out to use size (only) as the depth perception versus binocular integration. Still, the toughest thing is putting toothpaste on my toothbrush, with one eye (try it yourself).”