Fireworks pose an underestimated danger to public health and require stronger regulations and sustained public education campaigns to help prevent devastating, yet entirely avoidable injuries, warn US experts in The BMJ today.
Fireworks related injuries are a major cause of vision and limb loss globally, largely affecting already marginalised communities, explain Indu Subramanian and colleagues.
In the UK, for example, almost 4,500 people in England attended emergency departments with firework injuries in 2017, double the number in 2009-10, while a Los Angeles trauma center study found that firework injuries rose 142% from 0.19 per 100,000 in 2015 to 0.66 in 2021, mostly in young men aged 15-34. Typical injuries included burns, eye trauma, and finger amputations, with 79% requiring surgery.
And according to research published in the Indian Journal of Ophthalmology, during Diwali in India, fireworks account for nearly 20% of eye trauma, and firework related eye injuries result in complete blindness in 15% of patients, mainly affecting young boys in rural communities.
Other negative effects of fireworks include fires, substantial air and noise pollution, and risk of heavy metal poisoning, skin burns, inhalation injuries, and death among workers producing fireworks, mostly in low and middle-income countries, they add.
They note that some countries, such as the Netherlands, Ireland, Chile, and Australia have banned consumer use of fireworks, but in many countries, where consumer bans are not in place, including India, UK, and US, there remains a critical need for education and regulation.
In the US, sales of consumer fireworks more than doubled from $1 billion in 2019 to $2.3 billion in 2025. Firework regulations also vary between states and countries, and policies have become less restrictive over time in some places, despite research showing that firework injuries are more common in states with fewer restrictions.
The authors call for stronger regulations and sustained public education campaigns in the US and internationally.
Global action is needed to increase data collection, regulation, and public safety of fireworks usage and injuries, while medical organisations and public health bodies should encourage people to attend public displays rather than using fireworks at home, they write. Warning labels with graphic images of injuries on firework packaging similar to those on cigarettes may also be impactful.
Harm reduction campaigns for children in primary and secondary schools, using the stories and images of people whose lives have been affected, is also critical to warn of the real-life consequences of mishandling fireworks, they add.
The BMJ
Commentary/editorial
People
Fireworks are an underestimated danger to public health
4-Nov-2026