Narrative review of injuries occurring during artistic performances involving fire and pyrotechnic materials

This narrative review summarises the health and safety risks associated with artistic performances that involve open flames, pyrotechnic materials, and performance props such as poi, stilts, and levistick. Fire-based performance may cause thermal burns, chemical injuries, and mechanical trauma. Published case reports describe the aspiration of flammable liquids during fire breathing, leading to hydrocarbon pneumonitis („fire eater’s lung”) and, in severe cases, acute respiratory distress syndrome (ARDS). We also highlight traumatic and overuse injuries among performers, particularly on stilt walking and poi, related to falls, equipment failure, and inadequate safety procedures. Finally, we outline selected Polish legal acts that regulate public shows and discuss implications for prehospital care, hospital management, and prevention. More research and standardized reporting is needed to better characterize risk and inform practical safety protocols for fire-based performance.