Epidemiology and prevention of burns throughout the world

Introduction

Injury is the physical damage that results when a human body is suddenly subjected to energy in amounts that exceed the threshold of physiological tolerance [23]. Injury is public health problem – out of every ten deaths in the world, one is due to injury [232]. Injuries are the fourth leading cause of death in men throughout the world (nearly 12 % of total deaths) after cardiovascular, infectious and neoplastic diseases. For example, injuries are the leading cause of death in men aged 15–59 in Latin America and the Caribbean [232]. Although progress is being made against many illnesses, the incidence of injuries is decreasing at rate slower than the reduction in illness in high-income countries (HIC). In lowand middle-income countries (LMIC), both death and disability from injuries is increasing very rapidly. In LMIC of Americas, Europe and Eastern Mediterranean Regions, more than 30 % of DALYs among men aged 15–44 years was from injury.1 [232]

Injury is a burden on the young, taking more productive life-years than cancer or heart disease. Firerelated burns are among the leading causes of DALYs lost in LMIC [232]. For example, burns under 20 %

1Income categories for 2004 as defined by the World Bank by 2004 gross national income per capita. Low US$285 or less; lower middle US$285-3255; upper middle US$325610,065; high US$10,066 or more.

Marc G. Jeschke et al. (eds.), Handbook of Burns

are approximately 6 % of all unintentional injuries in children under 15 years of age [232]. Injuries are also the most common cause of DALYs (Disability-Ad- justed Life Year – the loss due either to death or disability of the equivalent of one year of good health) lost worldwide: injuries accounted for 17 % of disa- bility-adjusted life years (DALY’s) lost in adults aged 15–59 in 2004 [232].

Burns fall within this spectrum of mechanism of injury. Unintentional injuries include not only burns but traffic incidents, drowning, poisonings, and falls. Intentional injuries result from homicide, suicide, legal interventions, and conflicts; burns and fires are occasionally the mechanism for assault or self-harm. Without question, burns cause a significant proportion of the morbidity and mortality attributed to injuries throughout the world.

A burn is an injury to the skin or other organic tissue primarily caused by thermal or other acute trauma, according to the International Society of Burn Injuries. It occurs 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). Injuries to the skin or other organic tissues due to radiation, radioactivity, electricity, friction or contact with chemicals are also identified as burns.

In 2004, incidence of burns severe enough to require medical attention was nearly 11 million people [232], fourth in all injuries behind road traffic acci-

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