Burns

Abstract

Incidence and iEtiology IN England and Wales there are annually between 700 and 8oo deaths from burns and scalds. The majority of these fatal accidents occur in the home, and many of the victims are old ladies. Deaths among children are also disproportionately high for the population at risk. Industrial burns account for about ioo deaths per year, almost all of these among males of working age. For every fatal burn there are about 20 other non-fatal injuries severe enough to require in-patient hospital treatment: a high proportion of these are injuries to children, their most serious burns being caused by clothing catching alight, often from open fires. Hot fluids used in cooking and washing are common causes of scalds. Elderly women also often burn themselves from careless use of open fires and naked lights; quite often other infirmities predispose them to such injuries, for example attacks of unconsciousness or giddiness. At all ages epilepsy predisposes to burns and usually the injuries are particularly deep and disfiguring owing to prolonged exposure to the heat source. Most of the serious domestic burns would be prevented if clothing of lower flammability were used, e.g., to B.S. 3120 or 312I. Another valuable precaution would be the universal guarding of all types of open fire, especially when children and old people are in the room (Bull, I96I). The industrial burns are due to a variety of contacts with hot materials or chemicals; among metal workers burns from molten metal are fairly common and are characteristically of small area but usually affect the full thickness of the skin because of the intense heat of the molten material. Chemical burns are caused by strong acids and alkalis and by phosphorus, metallic sodium and other articles which generate heat on exposure to air or water. Prolonged exposure to a number of relatively innocuous agents can also cause burns, for instance if persons are trapped under vehicles after a road crash, it is possible for them to suffer extensive chemical burns from spilled petrol.