Fireworks can be beautiful against the night sky on July 4th, but a Washington University emergency medicine specialist at St. Louis Children's Hospital says, for safety's sake, parents and children should leave the fireworks to professionals.

All fireworks are dangerous, especially to children. In 2003, the last year for which numbers are available, 9,300 people were treated in U.S. emergency departments for fireworks-related injuries. Five percent required hospitalization. Four of those people died. Typically, about two-thirds of all fireworks injuries occur in the days around the July 4th holiday.

"Firecrackers, rockets and sparklers account for most of the injuries we see during that period," says Bo Kennedy, M.D., associate professor of pediatrics and associate director of the Emergency Department at St. Louis Children's Hospital.

"Sparklers actually cause the highest number of injuries in children under 5. Sparklers burn at more than 1,000 degrees, and when a sparkler is burning, what it's releasing is essentially molten metal. That can cause some very serious burns."

According to figures from the Centers for Disease Control and Prevention, 63 percent of fireworks injuries involve burns. About 45 percent of fireworks injuries occur in children 14 or younger, and boys make up 72 percent of the kids who require some form of treatment at the hospital.

About a quarter of all injuries involve the hands and fingers. Some 21 percent are eye injuries. The head and face are involved 18 percent of the time, and most of the injuries occur at homes.

"Backyard fireworks displays are a bad idea on a couple of levels," Kennedy says. "There's not only the potential for injury, but the fireworks also can go astray and start fires."

In 1999, there were 24,200 reported fires started by fireworks, causing $17.2 million in property damage. Most fires were outdoor brush or refuse fires, but most of the losses occurred in fires that involved buildings like houses, garages and barns. Those fires tend to start when something such as a bottle rocket lands on a roof, or another hard-to-reach location, where it can ignite combustibles before anyone can retrieve it.

Kennedy notes that bystanders at backyard displays can be injured, too. But fires and fireworks injuries aren't the only problems associated with July 4th.

"We tend to see a lot of children that come in with burns who get them from the grills where people have been barbecuing," he says. "Bruises and scrapes also are common on Independence Day, and occasionally serious injuries result from excited children who run out in front of cars and get hit."

If a child or an adult is burned, Kennedy reminds us that proper first aid for a burn is to keep it covered. He says butter or other greasy ointments should be avoided, as should prolonged or excessive application of ice, which can cause further injury by freezing the tissue. For serious burns, he says it's important to get to a hospital as soon as possible.

Although he recommends that families avoid backyard fireworks, Kennedy realizes that some people will ignore warnings. In those cases, he advises that only adults be allowed to set off fireworks. Even then, he says many of the injuries seen in emergency departments involve children standing by watching others ignite the fireworks.

"Children simply should not be allowed to ignite or be close to the fireworks," he says. "It's just too dangerous. The injuries can be permanent and severe."