The Fourth of July conjures up images of hot dogs, family and friends, outdoor activities and of course, the ever-present fireworks displays.

Unfortunately, it also reminds us that when fireworks are used in an unsafe manner, they can take all the fun out of the day.

The Santa Monica Fire Department issued a recent reminder that all types of fireworks are illegal in the city, and these include what are called “safe and sane” fireworks.

“Safe and sane fireworks don’t exist,” says Dr. John Hall, National Fire Protection Association (NFPA) assistant vice president of Fire Analysis and Research. “When things go wrong with fireworks, they go very wrong, very fast, far faster than any fire protection provisions can reliably respond to.”

Permanent scarring, loss of vision and dismemberment are effects that can occur when amateurs use Roman candles and rockets. The nonprofit NFPA urges everyone to treat fireworks, whether legal or illegal for consumers, as suitable only for use by trained professionals. Pyrotechnic devices ranging from sparklers to aerial rockets cause thousands of fires and serious injuries each year.

Dr. Thomas Togioka, who specializes in cardiology and internal medicine at Marina Del Rey Hospital, agrees that injuries caused by illegal fireworks are still a concern among the medical community, although the rate of emergency room accidents has gone down over the years as the public has become more aware of the dangers of illegal fireworks and cities have taken over the holiday displays.

“They are dangerous objects by nature,” the doctor said. “Although much has been done to alleviate the number of injuries due to the fact that they are now outlawed, we still unfortunately see a number of burns caused by fireworks each year to the face and hands.”

External fireworks-related injuries are not the only potential dangers that should be considered when watching a display put on by a local entity. Studies have shown that those who suffer from respiratory ailments can have their conditions exacerbated if they stand too close to a fireworks display.

“There is significant evidence that particulates that emanate from the rockets and sparklers can be attributed to increased pulmonary disorders,” Togioka said. “There have also been near deaths from the particulate matter in the air due to a fireworks show that can cause short and long term asthma and other respiratory disorders.”

Jean Evans, executive director of the American Lung Association of Hawaii, wrote an editorial in February that appears to support Togioka’s findings.

“Short-term exposure to particle pollution can kill — maybe not the next day, but maybe in months or years,” Evans wrote. “Particulate pollution is the worst type because particles become embedded deep in the lung, decreasing lung efficiency and capacity.

“The public should remember that with the number of fireworks shows that take place in a city like Los Angeles on the Fourth of July it can collectively feel like there is a bomb going off all over the city.”

Togioka says that those who suffer from pulmonary ailments can still enjoys brightly-lit aerial displays, but they must take certain precautions to ensure that the experience does not make them less healthy.

“One of the safest ways would be to view fireworks shows on the water, like there are in Marina del Rey,” he advised. “The wind can often take away many of the particulate that can be harmful.”

In addition, standing farther away from the display can also decrease the possibilities of inhaling any potential pollutants.