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Prevention of fire and burn injuries

Michael D Peck, MD, ScD, FACS
Section Editor
Marc G Jeschke, MD, PhD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Burn injuries are one of the most devastating of all injuries and a major global public health concern [1-3]. In 2015, the incidence of burns severe enough to require hospital outpatient presentation or an admission to hospital was 31 million people [4]. Approximately 90 percent of burns occur in low- to middle-income countries, regions that generally lack the necessary infrastructure to reduce the incidence and severity of burns [5]. Burn injury prevention includes four stages: surveillance, analysis, intervention, and evaluation and involves the three E's: education, engineering, and enforcement. Through a combination of prevention and care strategies, high-income countries have made progress reducing the incidence of burn injuries and burn severity and lowering rates of burn deaths and length of hospital stay [6-10].

This topic reviews the interventions that are effective and necessary to reduce the risk of burns. The epidemiology and costs of burn injuries are discussed elsewhere. (See "Epidemiology of burn injuries globally" and "Global costs of fires and burns".)


The approach to burn injury prevention includes surveillance, analysis, intervention, and evaluation. A precise description of the magnitude of the risks for burn injuries is the basis for planning effective interventions. Accurate data on the incidence of burns and the causes are scarce for many low- to low-middle-income countries. A lack of reliable data on risk factors further hampers the development and enactment of effective burn prevention strategies. Incomplete reporting of burn incidents leads to an underestimate of the magnitude of the public health problem.

Collection of data specific to etiologies of burns has been challenging. The most efficient approach is to join modules specific for injury causation with existing data collection systems. As an example, software was developed to use the comprehensive categorization of multiple facets of injury events as described by the International Classification of External Causes of Injury (ICECI). This software was then used by registrars collecting and entering data into the National Burn Repository of the American Burn association. Use of this tool significantly augmented the quality and quantity of etiologic data entered into the existing data repository [11]. A global registry has been developed through collaboration among the World Health Organization, Global Alliance for Clean Cookstoves, and the United States (US) Centers for Disease Control. A process evaluation in 30 countries showed good user acceptance and the potential to prioritize the selection, development, and testing of primary prevention interventions throughout the world [12].

The Childhood Burn Foundation in Taiwan is an excellent example of a model surveillance system [13]. The foundation provided resources to 43 hospitals to collect data on hospitalized burn patients. This comprehensive database, which utilizes the internet for data entry, captured information on over 12,000 patients from 1997 to 2003 [13]. The leading causes of all burn injuries include scald (43.2 percent), flame (32.5 percent), contact (11.2 percent), chemical (6.6 percent), and electrical (5.6 percent). The most common locations for incurring a burn injury include occupational setting (32.1 percent) and domestic setting (31.8 percent). The ultimate goal of a surveillance program is to convert the results into an action plan to prevent burn injuries.

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Literature review current through: Nov 2017. | This topic last updated: Nov 30, 2017.
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