%PILEPSY CANBEEXPECTEDTOSURVIVEWITHASATISFACTORYFUNCTIONALOUTCOMEWHILEIN

5NTREATEDEPILEPSYISAPRECIPITATINGFACTORFORBURNSINMANYDEVELOPINGCOUN .EPALNOPATIENTSSURVIVEWHOHAVEBURNSONMORETHANOFTHEIRBODY
TRIES4HESITUATIONMAYBEEXACERBATEDBYTHECOMMONBELIEFTHATTHECONDI
TIONISASSOCIATEDWITHEVILSPIRITSWHICHMAYDELAYTHERESCUEOFVICTIMS&OR
EXAMPLEINAN%THIOPIANHOSPITALEPILEPSYISASSOCIATEDWITHOFBURNAD #OSTOFBURNS
MISSIONS)NTHEHIGHLANDSOF0APUA.EW'UINEAMORTALITYRATESFROMlREAND
,ITTLEDATAEXISTSOFTHEMEDICALCOSTOFBURNSINLOW ANDMIDDLE INCOMECOUN
mAMESAREHIGHANDEPILEPSYISONEOFTHEMOSTCOMMONRISKFACTORSFORBURNS
TRIES4HEREISNODOUBTHOWEVERTHATTHESOCIALANDMEDICALCOSTSOFBURNSARE
SIGNIlCANTFORSOCIETIESANDFAMILIES)NTHE53!THEMEDICALCOSTOFPRIMARY
HEALTHCAREFORONEINPATIENTWITHBURNSRANGESFROM53TO53A
0REVENTION DAY4HESEEXPENSESMAYACCOUNTFORONLYOFTHETOTALCOSTS4HEECONOM
!LTHOUGHSURVIVALFROMSERIOUSBURNSHASBEENIMPROVINGINSEVERALREGIONS ICIMPACTOFBURNSALSOINCLUDESLOSSOFWAGESANDTHECOSTSRELATINGTODEFORMI
PRIMARYPREVENTIONSTILLREMAINSTHEBESTWAYTOCOPEWITHTHEPROBLEM&ORIN TIESRESULTINGFROMBURNSINTERMSOFEMOTIONALTRAUMAANDLOSSOFSKILLS
STANCEITHASBEENFOUNDIN)SRAELTHATSCHOOL BASEDBURNPREVENTIONPROGRAMS
SIGNIlCANTLYIMPROVECHILDRENSRISKKNOWLEDGEANDINJURY CONTROLBELIEFS)N
GENERALHOWEVEREFFORTSTOIMPROVETHESAFETYOFTHEENVIRONMENTREMAINMORE 2OLEOFPUBLICHEALTH
EFFECTIVETHANEFFORTSTOCHANGEBEHAVIOUR
4ODESCRIBETHEMAGNITUDEOFTHEPROBLEMBYCOLLECTINGDATAONMORTALITY
02%6%.4)/./&&)2%"52.3 ANDMORBIDITYFROMBURNINJURIES
%NCLOSEOPENlRESANDLIMITTHEHEIGHTOFOPENmAMESINHOMESINDEVELOP 4OSTUDYTHERISKFACTORSANDPROTECTIVEFACTORS
INGCOUNTRIES 4OSHOWTHEECONOMICIMPACTOFBURNSONTHECOMMUNITYINORDERTOPRO
0ROMOTETHEUSEOFSAFERSTOVESANDLESSHAZARDOUSFUELS VIDEABASISFORCOST BENElTANALYSISOFSAFETYIMPROVEMENTS
!PPLYSAFETYREGULATIONSTOHOUSINGDESIGNSANDMATERIALSANDENCOURAGE 4OENSUREAPPROPRIATEPRE HOSPITALANDHOSPITALCAREANDREHABILITATIONOFPA
HOMEINSPECTIONS TIENTSWITHBURNS
0ROMOTElRESAFETYEDUCATION 4OPROMOTESAFETYEDUCATION
0ROMOTEINTRODUCTIONOFANDCOMPLIANCEWITHINDUSTRIALSAFETYREGULATIONS 4OMONITORANDEVALUATEINTERVENTIONS
0ROMOTETHEUSEOFSMOKEDETECTORSlRESPRINKLERSANDlRE ESCAPESYSTEMS 4OPROMOTEPREVENTIONMEASURESANDPOLICIES
INRESIDENTIALDWELLINGS
2EFERENCESAVAILABLEONREQUEST
0ROMOTETHEUSEOFlRE RETARDANTFABRICSFORCHILDRENSSLEEPWEARANDEDUCATE
REGARDINGTHEWEARINGOFLOOSEmOWINGGARMENTS
!VOIDSMOKINGINBEDANDENCOURAGETHEUSEOFCHILD RESISTANTLIGHTERS &IRSTAID
0ROMOTETHEDEVELOPMENTOFlRE SAFECIGARETTES $/.43 $/3
)MPROVETHETREATMENTOFEPILEPSYPARTICULARLYINDEVELOPINGCOUNTRIES $ONOTCOMMENCElRSTAIDBEFOREENSUR 3TOPTHEBURNINGPROCESSBYREMOVING
INGYOUROWNSAFETYSWITCHOFFELECTRICAL CLOTHING
02%6%.4)/./&3#!,$3
CURRENTWEARGLOVESFORCHEMICALSETC
,OWERTHETEMPERATUREINHOTWATERTAPS !PPLYCOLDWATERORALLOWTHEburned area
$ONOTAPPLYPASTEOILKUMKUM TOREMAININCONTACTWITHCOLDWATERFOR
)MPROVETHEDESIGNOFKITCHENUTENSILSANDSTOVEMANUFACTUREINCLUDINGMORE TURMERIC ORRAWCOTTONTOTHEBURNTAREA
STABLECOOKINGSURFACESANDDEVICESTOPROTECTANDPREVENTACCESSBYCHILDREN SOMETIME
$ONOTAPPLYICE
0ROMOTESAFETYEDUCATION )NmAMEINJURIESEXTINGUISHTHEmAMESBY
$ONOTOPENTHEBLISTERS ALLOWINGTHEPATIENTTOROLLONTHEGROUND
$ONOTAPPLYANYMATERIALDIRECTLYTO ORBYAPPLYINGABLANKETORUSINGWATEROR
THEWOUNDASTHISINCREASESTHERISKOF OTHERlRE EXTINGUISHINGLIQUIDS
#AREOFBURNS INFECTION
)NCHEMICALBURNSREMOVEORDILUTETHE
2EMARKABLEDIFFERENCESINBURNOUTCOMESCANBEOBSERVEDBETWEENHIGH !VOIDAPPLICATIONOFTOPICALMEDICATION CHEMICALAGENTBYCOPIOUSLYIRRIGATINGTHE
INCOMEANDLOW ANDMIDDLE INCOMECOUNTRIES4HISISPROBABLYRELATEDTOTHE UNTILTHEPATIENTHASBEENPLACEDUNDER WOUNDWITHWATER
DIFlCULTIESINPROVIDINGADEQUATEBURNCAREINTHEDEVELOPINGWORLDWHERE APPROPRIATEMEDICALCARE
EVENASMALLBUTDEEPBURNCANRESULTINSEVEREANDDISABLINGSEQUELAE)N!US /BTAINMEDICALCARE
TRALIAFOREXAMPLEAPATIENTWITHABURNOFOFTHETOTALBODYSURFACEAREA

 
-AGNITUDEOFTHE0ROBLEM 4HESENON LETHALBURNSAREALEADINGCAUSEOFMORBIDITYESPECIALLYINCOMMUNI BILITIES)NARURALAREAOF3OUTH!FRICAFOREXAMPLETHEAVERAGEINTERVALFROMTHE
TIESWHEREOPENmAMESAREUSEDFORCOOKINGHEATINGANDLIGHTING3UCHNON TIMEOFTHEBURNTOARRIVALINTHEHOSPITALWASESTIMATEDTOBEHOURS
LETHALBURNSMAYREQUIRECOSTLYANDPROLONGEDHOSPITALISATIONANDFREQUENTLY
-ORTALITY RESULTINDISlGUREMENTANDDISABILITY
&IRE RELATEDBURNSINJURIESDUETOEXPOSURETOSMOKElREANDmAMES WERERE
%ACHYEARBURNINJURIESINTHE53!RESULTINABOUTHOSPITALIZATIONS 2ISKFACTORS
SPONSIBLEFORANESTIMATEDDEATHSINTHEWORLDINTHEGREATMAJORITY
-ORETHANONEMILLIONPEOPLESUFFERFROMMODERATETOSEVEREBURNSIN)NDIA &ACTORSASSOCIATEDWITHlRE RELATEDBURNINJURIESINCLUDESUBSTANCEABUSEVIO
OFWHICHOCCURREDINDEVELOPINGCOUNTRIES4ABLEBELOWSHOWSTHEDISTRIBUTIONOF
EACHYEARESTIMATEFOR  LENCEMEDICALCO MORBIDITIESANDOTHERSOCIALECONOMICANDCULTURALFACTORS
THESEDEATHSINTHE7(/2EGIONSn!FRICA!&2 THE!MERICAS!-2 %ASTERN-EDI
TERRANEAN%-2 %UROPE%52 3OUTH %AST!SIA3%!2 AND7ESTERN0ACIlC702  )N&RANCECHILDHOODBURNSACCOUNTFORBETWEENANDOFALLINJURIESIN
CHILDRENANDARETHESECONDCAUSEOFCHILDHOODDEATHSAFTERDROWNING !LCOHOLANDSMOKING
)NRURAL.EPALBURNSWEREFOUNDTOBETHESECONDMOSTCOMMONINJURY&OR !LCOHOLABUSEANDSMOKINGPARTICULARLYINCOMBINATIONREPRESENTTHEMAIN
EXAMPLEOFTHEOFTHEPOPULATIONESTIMATEDTOBEDISABLEDINTHATCOUN CAUSEOFDOMESTIClRESINDEVELOPEDCOUNTRIES&OREXAMPLECARELESSSMOKING
4ABLE%STIMATEDNUMBEROFDEATHSANDMORTALITYRATESDUETOlREBY7(/2EGION
AND
INCOMEGROUPHIGHANDLOWMIDDLE  TRYOFTHOSEWEREDUETOBURNS ACCOUNTSFORONEINFOURDEATHSOFALLFATALlRESINTHE53!ANDTHECOMBINATION
OFSMOKINGANDALCOHOLABUSEACCOUNTSFORNEARLYHALFTHEDEATHS
2%')/. !&2 !-2 %-2 %52 3%!2 702 7/2,$
'LOBALBURDENOFDISEASE
).#/-%'2/50 ,/7
-)$$,%
()'( ,/7
-)$$,%
()'( ,/7
-)$$,%
()'( ,/7
-)$$,%
,/7
-)$$,%
()'( ,/7
-)$$,% 5SINGTHEBURDENOFDISEASEMEASUREDISABILITYADJUSTEDLIFEYEARS$!,93 FROM ,OCALCULTURALPRACTICES
"URNDEATHS            THE7(/'LOBAL"URDENOF$ISEASESTUDYOFSHOWSTHATBURNSRANKSEC 4HEUSEOFOPENlRESFORCOOKINGHEATINGANDLIGHTINGARERISKFACTORSFOR
X ONDFORWOMENASACAUSEOFUNINTENTIONALINJURY)N3OUTH %AST!SIATHEBURDEN BURNS$OMESTICKEROSENEAPPLIANCESARERESPONSIBLEFORMANYBURNINJURIES
$EATHRATEPER            AMONGWOMENISDOUBLETHATFROMROADTRAFlCINJURY INTHEDEVELOPINGWORLD,OOSE lTTINGCLOTHINGHASALSOBEENASSOCIATED
 WITHBURNINJURYAMONGWOMENINTHESUB CONTINENT4HEUSEOFmOOR LEVEL
OFGLOBAL            STOVESBEDSIDElRESANDmAMMABLEMATERIALSINBUILDINGCONSTRUCTIONAREFUR
MORTALITYDUE
THEREXAMPLESOFCULTURALLY RELATEDRISKFACTORSFORBURNINJURIES4HETANDIRA
TOlRES 7HOISAFFECTED TYPICALUNDERGROUNDOVENIN4URKEYISASIGNIlCANTCAUSEOFBURNSPARTICULARLY
3OURCE7(/'LOBAL"URDENOF$ISEASE$ATABASE &IRE RELATEDBURNSAFFECTARANGEOFGROUPSBUTINPARTICULARWOMENIN!SIAAND INCHILDREN"ATH RELATEDSCALDSAREMOREFREQUENTIN*APANTHANINANYOTHER

7(/2EGIONSDONOTCORRESPONDEXACTLYWITHGEOGRAPHICREGIONS4HEYAREMADEUPOFCOUNTRIESANDAREAS THE%ASTERN-EDITERRANEANASWELLASCHILDRENTHEELDERLYMENINPARTICULAR COUNTRY4HISHASBEENATTRIBUTEDTOTHEIRLIFESTYLEANDBATHINGSYSTEMSASWELL
UNDERTHESIX7(/REGIONALADMINISTRATORS INDUSTRIESANDTHEPOOR!HIGHPERCENTAGEOFPATIENTSADMITTEDTOBURNSUNITS ASANINCREASINGELDERLYPOPULATION
WORLDWIDEARECHILDRENUNDERYEARSOFAGE!3AUDI!RABIANSTUDYSHOWED
THATCHILDRENUNDERTWELVEACCOUNTFORABOUTOFBURNSADMISSIONS4HE 3OCIOECONOMICSTATUS
-ORETHANHALFOFALLlRE RELATEDBURNDEATHSOCCURIN3OUTH %AST!SIATWOOUT ELDERLYREPRESENTASIGNIlCANTPERCENTAGEOFBURNVICTIMSANDHAVEHIGHRATESOF
OFTHREEOFTHESEDEATHSAREAMONGFEMALES7OMENIN3OUTH %AST!SIAHAVETHE BURNDEATHTHEYAREOFTENINJUREDATHOME!DULTMENINDEVELOPINGCOUN ,OWSOCIOECONOMICSTATUSISAWIDELYACKNOWLEDGEDRISKFACTORFORBURNSIN
HIGHESTRATEOFBURNMORTALITYWORLDWIDETHOSEAGEDTOYEARSACCOUNTFOR TRIESIN%UROPEHAVEHIGHRATESOFBURNDEATH BOTHDEVELOPEDANDDEVELOPINGCOUNTRIESn/VERCROWDEDLIVINGCONDITIONS
OFGLOBALlREDEATHSANDTHOSEAGEDTOHAVEADEATHRATEOFPER LACKOFPROPERSAFETYMEASURESANDINSUFlCIENTPARENTALSUPERVISIONOFCHILDREN
7OMENINLOW ANDMIDDLE INCOMEREGIONSOFTHE%ASTERN-EDITERRANE )NSOMECOUNTRIESFEMALESAREATHIGHRISKFORBURNSBECAUSEOFTHEUSEOFOPEN ARESOMEOFTHEFACTORSASSOCIATEDWITHLOWSOCIOECONOMICSTATUSTHATCONTRIBUTE
ANALSOHAVEHIGHRATES!DULTMALESINLOW ANDMIDDLE INCOMEAREASOF%UROPE lRESFORCOOKINGHEATINGANDLIGHTINGWHICHCANEASILYSETALIGHTTHELOOSE TOTHEOCCURRENCEOFBURNS
ALSOHAVEVERYHIGHRATESOFlRE RELATEDDEATHASDOCHILDRENUNDERYEARSIN CLOTHINGTHEYWEAR6IOLENCEAGAINSTWOMENWHICHISRELATEDTOGENDERIN
!FRICA EQUALITYISANOTHERFACTOR
'ENDERINEQUALITY
)NADDITION )NSOME!SIANCOUNTRIESSUCHAS"ANGLADESH)NDIAAND0AKISTANTHEDISlGUR
INGOFWOMENBYTHROWINGACIDORBURNINGTHEMTODEATHAREFREQUENTFORMSOF
"URNSRANKFOURTHASACAUSEOFUNINTENTIONALCHILDINJURYDEATHINTHE5NITED 7HEREDOBURNSOCCUR VIOLENCEAGAINSTWOMEN4HEREPORTEDREASONSFORTHISPHENOMENONWHICHIS
3TATESOF!MERICA53!  "URNSOCCURMAINLYINTHEHOMEANDINTHEWORKPLACE-OSTBURNINJURIESPAR ROOTEDINGENDERINEQUALITYINCLUDEDISPUTESCONCERNINGMARRIAGEANDDOWRY

"URNSARETHELEADINGCAUSEOFADULTDEATHSINTHESLUMSOF+ARACHI0AKISTAN  TICULARLYAMONGCHILDRENANDWOMENOCCURINTHEDOMESTICENVIRONMENT4HE
"URNSCAUSEANESTIMATEDDEATHSANNUALLYIN.EPALSEVENDEATHSPER KITCHENISREPORTEDTOBETHEMOSTCOMMONPLACEWHERECHILDRENUPSETRECEPTA 6IOLENCE
POPULATION  CLESCONTAININGHOTLIQUIDSANDWHEREWOMENAREINJUREDBYHOTCOOKINGOILOR
!CONSIDERABLENUMBEROFBURNINJURIESINCHILDRENRESULTFROMABUSEANDNE
BYSTOVEEXPLOSIONS-ENINBOTHTHEDEVELOPINGANDDEVELOPEDWORLDAREAT
(OUSElRESARETHETHIRDLEADINGCAUSEOFUNINTENTIONALINJURYDEATHINABORIGI GLECT!REVIEWOFTHELITERATURESHOWSTHATCHILDABUSEBYBURNINGMAKESUP
RISKFROMBURNSINTHEWORKPLACEDUETOlREANDmAMESSCALDSCHEMICALBURNS
NALCOMMUNITIESIN'REENLANDAND.ORTH!MERICA APPROXIMATELYTOOFALLCHILDABUSECASESANDTHEINCIDENCEOFCHILD
ANDELECTRICALBURNSESPECIALLYDUETOHIGHVOLTAGECURRENTS 
ABUSEAMONGCHILDRENHOSPITALIZEDFORTHETREATMENTOFBURNSRANGESFROMTO
-OSTBURNSOCCURINANURBANENVIRONMENTFOREXAMPLEIN)NDIAAND 
-ORBIDITY IN3PAIN (OWEVERADVERSECONSEQUENCESAREMORECOMMONINRURALAREAS
(OUSElRESCONmAGRATIONSANDCLOTHINGlRESARERESPONSIBLEFORMOSTLETHAL 4HEUSEOFCHEMICALSINASSAULTSORASDEFENSIVEWEAPONSISALEADINGCAUSEOF
WHEREINADEQUATEPRE HOSPITALCARELEADSTOMORESEVEREMORBIDITIESANDDISA
EVENTSBUTAREMUCHLESSFREQUENTTHANSCALDSANDOTHERMILDTOMODERATEBURNS BURNSINSOMECOUNTRIESSUCHAS*AMAICA