WHO Releases Fact Sheet on Burns
Burns are a global public health problem, accounting for an estimated 195,000 deaths annually, according to the World Health Organization (WHO).
A burn is an injury to the skin or other organic tissue primarily caused by heat or due to radiation, radioactivity, electricity, friction, or contact with chemicals.
Thermal (heat) burns occur when some or all of the cells in the skin or other tissues are destroyed by:
- hot liquids (scalds)
- hot solids (contact burns), or
- flames (flame burns).
Burns are a global public health problem, accounting for an estimated 195,000 deaths annually, according to the World Health Organization (WHO). The majority of these occur in low- and middle-income countries and almost half occur in the Southeast Asia Region.
In many high-income countries, burn death rates have been decreasing, and the rate of child deaths from burns is currently seven times higher in low- and middle-income countries than in high-income countries.
Nonfatal burns are a leading cause of morbidity, including prolonged hospitalization, disfigurement, and disability, often with resulting stigma and rejection.
- Burns are among the leading causes of disability-adjusted life-years (DALYs) lost in low- and middle-income countries.
- In 2004, nearly 11 million people worldwide were burned severely enough to require medical attention.
Some country data
- In India, more than 1 million people are moderately or severely burnt every year.
- In 2008, more than 410,000 burn injuries occurred in the United States, with approximately 40,000 requiring hospitalization.
- For 2000, direct costs for care of children with burns in the U.S. exceeded $211 million.
Who is at risk?
Females suffer burns more frequently than males. Women in the WHO Southeast Asia Region have the highest rate of burns, accounting for 27 percent of global burn deaths and nearly 70 percent of burn deaths in the region. The high risk for females is associated with open fire cooking or inherently unsafe cook stoves, which can ignite loose clothing. Open flames used for heating and lighting also pose risks and self-directed or interpersonal violence are also factors (although understudied).
Along with adult women, children are particularly vulnerable to burns. Burns are the 11th leading cause of death of children aged 1-9 years and are also the fifth most common cause of nonfatal childhood injuries. While a major risk is improper adult supervision, a considerable number of burn injuries in children result from child maltreatment.
There are a number of other risk factors for burns, including:
- occupations that increase exposure to fire;
- poverty, overcrowding, and lack of proper safety measures;
- placement of young girls in household roles such as cooking and care of small children;
- underlying medical conditions, including epilepsy, peripheral neuropathy, and physical and cognitive disabilities;
- alcohol abuse and smoking;
- easy access to chemicals used for assault (such as in acid violence attacks);
- use of kerosene (paraffin) as a fuel source for non-electric domestic appliances;
- inadequate safety measures for liquefied petroleum gas and electricity.
Burns occur mainly in the home and workplace. Community surveys in Bangladesh and Ethiopia show that 80-90 percent of burns occur at home. Children and women are usually burned in domestic kitchens, from upset receptacles containing hot liquids or flames, or from cook stove explosions. Men are most likely to be burned in the workplace due to fire, scalds, and chemical and electrical burns.
Burns are preventable. High-income countries have made considerable progress in lowering rates of burn deaths through a combination of prevention strategies and improvements in the care of people affected by burns. Most of these advances in prevention and care have been incompletely applied in low- and middle-income countries. Increased efforts to do so would likely lead to significant reductions in rates of burn-related death and disability.
Prevention strategies should address the hazards for specific burn injuries, education for vulnerable populations, and training of communities in first aid.
There are a number of specific recommendations for individuals, communities, and public health officials to reduce burn risk.
- Enclose fires and limit the height of open flames in domestic environments.
- Promote safer cook stoves and less hazardous fuels and educate regarding loose clothing.
- Apply safety regulations to housing designs and materials and encourage home inspections.
- Improve the design of cook stoves, particularly with regard to stability and prevention of access by children.
- Lower the temperature in hot water taps.
- Promote fire safety education and the use of smoke detectors, fire sprinklers, and fire-escape systems in homes.
- Promote the introduction of and compliance with industrial safety regulations and the use of fire-retardant fabrics for children’s sleepwear.
- Avoid smoking in bed and encourage the use of child-resistant lighters.
- Promote legislation mandating the production of fire-safe cigarettes.
- Improve treatment of epilepsy, particularly in developing countries.
- Encourage further development of burn-care systems, including the training of health care providers in the appropriate triage and management of people with burns.
- Support the development and distribution of fire-retardant aprons to be used while cooking around an open flame or kerosene stove.
- Stop the burning process by removing clothing and irrigating the burns.
- Use cool running water to reduce the temperature of the burn.
- Extinguish flames by allowing the patient to roll on the ground, apply a blanket, or use water or other fire-extinguishing liquids.
- In chemical burns, remove or dilute the chemical agent by irrigating with large volumes of water.
- Wrap the patient in a clean cloth or sheet and transport to the nearest appropriate facility for medical care.
- Do not start first aid before ensuring your own safety (switch off electrical current, wear gloves for chemicals, etc.)
- Do not apply paste, oil, haldi (turmeric), or raw cotton to the burn.
- Do not apply ice because it deepens the injury.
- Avoid prolonged cooling with water because it will lead to hypothermia.
- Do not open blisters until topical antimicrobials can be applied, preferably by a health care provider.
- Do not apply any material directly to the wound because it might become infected.
- Avoid application of topical medication until the patient has been placed under appropriate medical care.