The Political and Human Impact of Major Burn Incidents: A Global Analysis of Mass Casualty Events Between 2010 and 2020.

Introduction: Worldwide, burn injuries cause approximately 180,000 deaths annually. Contributing to these figures are those deaths that occur following major burn incidents and explosions. Morbidity and mortality can be significantly high following such events, and well-equipped, specialized burns services are crucial to minimizing the human impact. Notably, major burn incidents are not merely medical emergencies, but catalysts for significant social and political change. We aimed to explore the human and political consequences of major burn incidents, with a view to highlighting the true significance of specialized burn care as a crucial component of disaster preparedness.

Methods: We screened the gray literature for reports of major burn incidents across the globe over a 10-year period from 2010 to 2020. We gathered data on the nature of the incident, the geographical location, the number of resulting injuries and deaths, and any resultant political fallout.

Results: Twenty-three major burn incidents were identified, across 15 different countries. Incidents included chemical plant explosions, factory and warehouse fires, wildfires, housing block fires, and shopping center fires. The total number of deaths across the 23 reports was 2321. The median number of deaths per incident was 78 (interquartile range, 39-127), whereas the median number of injuries was 321 (interquartile range, 148-557). Eight of these 23 incidents (35%) resulted in the resignation of entire governments or key figures within the government, evidencing the major political fallout from such disasters. Collation of the individual reports revealed many instances of insufficient resource allocation and highlighted broader issues of institutional weakness and the need for comprehensive political reforms.

Conclusion: Major burn incidents are often pivotal moments that can expose systemic safety failures, highlight critical infrastructure vulnerabilities, demand comprehensive preventative strategies, and ultimately trigger governmental accountability. Governmental recognition of burn care as a crucial component of disaster preparedness as well as improved resource allocation for burn centers is crucial to ensuring they are better equipped to handle mass casualty events, thereby reducing morbidity and mortality and reducing government accountability following such events. Governments would be well advised to maintain healthy funding and staffing of burn services.