Legislation as a tool to prevent firework-related eye injuries

Abstract

Editor, The use of fireworks is banned in Norway except for on New Year’s Eve, the party day when intoxicated young men are allowed to set off these explosives while huge gatherings of people stay close to watch. It is a long tradition associated with many and serious eye injuries. In Denmark (Thygesen 2000) and Sweden (Sundelin & Norrsell 2000), there has been focus on these injuries, but not in Norway until 2002, when preventive measures were initiated because our department of ophthalmology received many young men with injured eyes on New Year’s Eve. This letter examines the effect of these measures, especially legislation. Information on all firework-related injuries was collected by telephone contact to all 17 departments of ophthalmology in Norway on New Year’s Day from 2005/2006 to 2008/2009. Injuries were classified by sex and by degree of seriousness as moderately serious and very serious. Minor injuries, which are rarely referred to departments, were not included. Minor injuries were defined as abrasions of cornea and mild burn injuries of eyelids. Very serious injuries were defined as penetrating or blunt trauma probably causing permanent blindness. Injuries in between minor and very serious were classified as moderately serious. Information was disseminated to the public on the risk of and how to prevent eye injuries by contacting the mass media during the week before New Year’s Eve, informing about the injuries the previous years and disseminating photographs of eyes injured. Local and national newspapers and radio and television stations were contacted. Special focus was given to the use of protective eyewear that from 2006 was distributed free of charge upon purchase of fireworks. The injury data collected from the departments of ophthalmology during New Year’s Day were broadcasted by the main national television station the same day. In 2007, a new focus on a proposal banning the private use of fireworks was introduced, constantly reminding the public authorities of their responsibility for fireworks-related injuries by not implementing effective preventive measures. In 2008, bottle rockets were banned in Norway. The effect of banning bottle rockets before New Year’s Eve 2008 was calculated using the mean annual injuries from 2005/2006 to 2007/2008 compared with the total injuries in 2008/2009. The Pearson chi-square test was performed using injured versus noninjured inhabitants in Norway in the various years. Mainly men were injured (Table 1). The incidence of firework-related eye injuries was relatively stable from 2005/2006 to 2007/2008 despite successful propaganda in the mass media about the risk of and how to prevent eye injuries (Table 2). The incidence decreased in 2006 after protective eyewear began to be offered free of charge upon purchase of fireworks, but this was not statistically significant. A breakthrough in reduction was accomplished in 2008 when bottle rockets were banned. The incidence was reduced by half (p = 0.03) compared with the mean incidence in the previous 3 years (Fig. 1). Incidence of firework-related eye injuries on New Year’s Eve in Norway, 2005–2008. Information about the risk of eye injuries and the use of protective eyewear seems to reach the people who already have low-risk behaviour. Young men, often intoxicated by alcohol while they use fireworks, seem to be out of reach of being influenced to handle fireworks safely and use protective eyewear. The banning of bottle rockets in this study removed the availability of fireworks considered more dangerous and thereby reduced injuries in both the low-risk and high-risk groups, similar to findings from the United Kingdom (Vernon 1988) and from the United States (Wilson 1982). Legislative removal from the market of the type of firework considered the most dangerous was definitely the most effective measure in reducing injury.