Holidays are a time of joy and festivity, but as popular films like "Home Alone" and "National Lampoon's Christmas Vacation" humorously depict, holiday decorations can sometimes lead to mishaps. In reality, these seasonal embellishments are responsible for a significant number of injuries that require medical attention. According to an analysis of data from the US Consumer Product Safety Commission (CPSC), approximately 16,000 individuals in the United States seek emergency care each year due to accidents related to holiday decorations. Over the past two decades, this has resulted in an estimated 312,000 visits to the emergency room.

The CSPC's National Electronic Injury Surveillance System monitors emergency department visits across a selection of approximately 100 hospitals nationwide, providing annual estimates of consumer product-related injuries. The analysis, which reviewed both projected and actual emergency room visits from 2004 to 2023, focused on products directly associated with Christmas decorations, including artificial trees, tree lights, and both non-electric and electric ornaments.

Trends in the data indicate a gradual increase in Christmas decoration-related injuries. In 2004, there were an estimated 14,400 hospitalizations, a figure that rose to 15,600 in 2022. The CSPC suggests that population growth in the US could contribute to the increase in patient numbers over extended periods. Notably, the year with the highest number of injuries was 2020, the first year of the Covid-19 pandemic, with the CSPC estimating over 20,000 hospitalizations.

Traditional, simple Christmas decorations were the primary cause of accidents. Among the four Christmas product categories, non-electric decorations—such as tree ornaments, stockings, or wreaths—accounted for an average of 8,000 emergency department visits annually over the past two decades. Artificial Christmas trees were associated with the fewest injuries, at 1,600 per season. Many injuries from non-electric decorations were lacerations, with approximately 22% of the estimated ER visits involving cuts from sharp objects, often glass ornaments.

Examining the records of actual ER visits, it becomes clear that what may seem like harmless decorations can become dangerous. In addition to slips, trips, and scrapes, pets, alcohol, and various other factors have contributed to injuries. The most common injuries linked to Christmas decorations are strains and sprains, followed by lacerations, fractures, contusions/abrasions, and ingested objects. The lower back is the most frequent location for injuries, with the head, upper back, internal body, and shoulders also being common sites.

Fortunately, the majority of Christmas decoration mishaps result in relatively minor injuries, with most individuals being treated in the emergency department and then released. Since 2004, there have been only two recorded deaths out of over 7,000 actual hospital trips observed. Women are more likely to be injured than men, accounting for 54% of hospital visits over the past two decades compared to 46% for men. The reason for this discrepancy is unclear, but it may be related to women engaging in more holiday decorating activities.

The records also document other consumer products associated with Christmas decoration-related injuries. Ladders topped the list, contributing to 17% of the estimated hospital visits. While women were more likely to be injured overall, men were twice as likely to be involved in accidents with ladders. Other frequently cited products included containers (such as baskets, boxes, or crates), stairs or steps, chairs, and floors or flooring materials (e.g., carpet dividers).

Injuries tend to occur when one might expect them to. The most dangerous period is after Thanksgiving, when many people begin to set up decorations. Accidents decrease as Christmas approaches, only to increase again around New Year's Day, when trees are typically taken down and holiday items are packed away. One key takeaway from the accident reports is to keep festive decorations out of reach of toddlers and pets. There were numerous reports of young children under four swallowing holiday decorations, and pets can also cause Christmas chaos, as exemplified by a 2023 report stating, "A 46-year-old female reports a dog bite to her thumb. The bite was provoked by removing a Christmas ornament from the dog's mouth."

Methodology for the analysis was adjusted to better reflect the holiday season. Annual injury statistics were calculated using a June 30 year-end. For instance, the 2022 holiday season includes injuries from July 1, 2022, to June 30, 2023, capturing the six-month period before and after Christmas. The data spanned 19 years from July 1, 2004, to June 30, 2023.

Injuries from Christmas tree stands or supports were excluded from this analysis due to the low number of cases making national estimates unreliable. Christmas decor categories are mutually exclusive; for example, electric decor excludes tree lights. Some injuries involved multiple Christmas products; the injury records used to calculate national estimates can contain information on up to three consumer products. To avoid overcounting, in cases with multiple Christmas products, the record was associated with the first Christmas product listed. Out of 7,233 observed hospital records, this applied to 59 cases—less than 1%.