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JAMA Revisited |

A Safe and Sane Fourth

JAMA. 2016;316(8):885. doi:10.1001/jama.2015.17099.
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In 1903 The Journal began the collection of statistics regarding deaths and injuries resulting from the use of fireworks in the celebration of the Fourth of July, and for fourteen years has fought for a betterment of conditions. In addition to securing data through news-clipping bureaus, blanks were sent to physicians, health officers and hospitals, requesting lists of casualties. From the beginning special efforts were made to obtain information as to cases of tetanus resulting from these injuries. The tabulated figures of injuries and the enormous proportion of deaths from lockjaw in that first year were appalling. In the 1903 report it was shown that 4,449 persons had been injured, and that 466 had died. Of those injured, many had lost their sight, had legs, arms or hands blown off, or were otherwise mutilated for life. Of those fatally injured, 406, mostly children, died from tetanus, or lockjaw. In the report particular attention was called to the fact that the great majority of lockjaw cases had resulted from blank cartridge injuries, and prohibition of their use was urged. Special directions were also given regarding the care of all blank cartridge and other puncture wounds, and the early use of tetanus antitoxin as a prophylactic was strongly advocated. Reprints of the report were circulated, but not to so great an extent as was done a few years later.

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