Epidemiological and clinical characteristics of burns due to gunpowder explosion in firework factories: A 6-year retrospective study

We investigated epidemiological and clinical characteristics of patients with burns caused by gunpowder explosions in fireworks factories admitted to Liuyang People’s Hospital. Clinical data of 279 patients w3ith burns from gunpowder explosions in factories and admitted to Liuyang People’s Hospital from 2018 to 2023 were retrospectively analyzed. Admission date, age, sex, anatomical site of injury, month of injury, inhalation injury, associated injury, total body surface area (TBSA), burn depth, number of surgeries, length of stay (LOS), and clinical outcome were collected from medical records. Among the 279 cases, 91.8% were male, and 79.6% were aged 41-60 years. The peak incidence of burn injuries occurred between April and June and in November, accounting for 45.2% of cases. The upper limbs were the most commonly injured anatomical sites, followed by the head and neck. Inhalation injury occurred in 189 patients (67.7%). A total of 138 cases (49.5%) were complicated by associated injuries, the most common being ocular burns. The median TBSA was 15% (IQR: 8-43%), median ABSI was 7 (IQR: 6-10), and surgical rate was 63.8%. There were 21 deaths (mortality rate: 7.5%). Acute respiratory distress syndrome (ARDS) was the leading cause of early mortality (≤7 days after injury), while sepsis was the most common cause of late mortality (>7 days). The median LOS was 28 days (IQR, 15-49), and main risk factors for prolonged hospitalization were multiple surgeries and full-thickness burns. Particular attention should be given to workers aged 40-60 years sustaining burns from gunpowder explosions in fireworks factories, especially during summer and before New Year’s Day. Protective equipment should be reinforced for the head, neck, and upper limbs. Moreover, improving mechanization and implementing human-computer interaction could reduce the risks associated with direct operations. Intervention strategies should also consider relevant risk factors to improve outcomes.