What Medical Problems Have Been Associated With Fireworks Displays?

It is well known that airborne particulate matter, of the size commonly produced by fireworks, can cause pulmonary problems in people with pre-existing lung disease.

In those with chronic obstructive pulmonary disease (COPD), elevated levels of airborne particulate matter has been strongly associated with worsening dyspnea (shortness of breath), a deterioration in pulmonary function studies, and increased rates of hospitalization and death. While a similar worsening of medical problems has not been directly correlated with fireworks displays, experts believe the airborne products of fireworks can certainly produce the same kinds of problems.

In people with asthma, the air pollution caused by fireworks has pretty clearly been shown to produce symptoms. In particular, wheezing and asthma attacks may occur very quickly during close exposure to a fireworks display. At least one death has been attributed to a severe asthma attack, leading to cardiac arrest, in a woman who was exposed to dense smoke from fireworks.

While heart attacks and other acute cardiac problems have not been proven to result from fireworks-related air pollution, any cause of reduced blood oxygen levels can be dangerous to a person with underlying heart disease. People with poorly controlled angina, or who have heart failure, may be particularly at risk.

How to Avoid Fireworks-Related Medical Issues

There is no doubt that the unique variety of pollutants produced by fireworks seems quite concerning. However, the medical problems actually demonstrated to be caused by air pollution from fireworks are pretty much the same as the medical problems caused by any other air pollution.

The big difference is that, unlike typical air pollution, the pollution produced by fireworks is transient — and better yet, it is scheduled. The transient nature of this pre-scheduled air pollution event usually gives us the opportunity to avoid problems altogether.

Using common sense is the key. If you are a person with asthma or COPD who finds it useful to follow the Air Quality Index (AQI) in order to avoid a worsening of your symptoms, then you are also a person who ought to avoid proximity to fireworks displays. If you find yourself nearby during a fireworks display, you should move as far away as you reasonably can, preferably in the upwind direction. If you can get indoors, do so (preferably in an air-conditioned environment). If you live nearby, try to stay indoors until the next morning.

If you are a person with asthma who simply can’t keep yourself away from a good fireworks display, you should consider using a filter mask (NIOSH-approved N95), to keep particulate matter out of your airways, and make sure you have your rescue inhaler with you.

If you are a person in good health, then your immediate health risk in being exposed to fireworks appears quite minimal. On the other hand, we really don’t know what the long-term consequences might be (if any) of breathing the array of toxic metals and other airborne substances produced by fireworks explosions. This is highly unlikely to be good for you. So it seems prudent to view fireworks displays from a distance, to minimize your exposure. At the very least, experiencing teary eyes and an acrid odor means you are standing in the worst of it—and you should think about moving to a different location.