Burns are a global public health problem,WHO

Burns

Fact sheet N°365
May 2012

Key facts
An estimated 195 000 deaths every year are caused by burns –
the vast majority occur in low- and middle-income countries.
Non-fatal burn injuries are a leading cause of morbidity.
Women in the WHO South-East Asia Region have the highest
rate of burns, accounting for 27% of global burn deaths and
nearly 70% of burn deaths in the region.
Burns occur mainly in the home and workplace.
Burns are preventable.
A burn is an injury to the skin or other organic tissue primarily
caused by heat or due to radiation, radioactivity, electricity,
friction or contact with chemicals.
Thermal (heat) burns occur 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).
The problem

Burns are a global public health problem, accounting for an
estimated 195 000 deaths annually. The majority of these occur
in low- and middle-income countries and almost half occur in the
WHO South-East Asia Region.
In many high-income countries, burn death rates have been
decreasing, and the rate of child deaths from burns is currently
over seven times higher in low- and middle-income countries
than in high-income countries.
Non-fatal burns are a leading cause of morbidity, including
prolonged hospitalization, disfigurement and disability, often with
resulting stigma and rejection.
Burns are among the leading causes of disability-adjusted

life-years (DALYs) lost in low- and middle-income countries.
In 2004, nearly 11 million people worldwide were burned

severely enough to require medical attention.
Some country data

In India, over 1 000 000 people are moderately or severely

burnt every year.
Nearly 173 000 Bangladeshi children are moderately or

severely burnt every year.
In Bangladesh, Colombia, Egypt and Pakistan, 17% of children

with burns have a temporary disability and 18% have a

permanent disability.
Burns are the second most common injury in rural Nepal,

accounting for 5% of disabilities.
In 2008, over 410 000 burn injuries occurred in the United

States of America, with approximately 40 000 requiring

hospitalization.
Economic impact

For 2000, direct costs for care of children with burns in the

United States of America exceeded US$ 211 million. In Norway,

costs for hospital burn management in 2007 exceeded €10.5

million.

In South Africa an estimated US$ 26 million is spent annually for
care of burns from kerosene (paraffin) cookstove incidents.
Indirect costs such as lost wages, prolonged care for
deformities and emotional trauma, and commitment of family
resources, also contribute to the socioeconomic impact.
Who is at risk?

Gender
Females suffer burns more frequently than males. Women in
the WHO South-East Asia Region have the highest rate of
burns, accounting for 27% of global burn deaths and nearly 70%
of burn deaths in the region. The high risk for females is
associated with open fire cooking, or inherently unsafe
cookstoves, which can ignite loose clothing. Open flames used
for heating and lighting also pose risks, and self-directed or

interpersonal violence are also factors (although understudied).

Age
Along with adult women, children are particularly vulnerable to

burns. Burns are the 11th leading cause of death of children

aged 1–9 years and are also the fifth most common cause of

non-fatal childhood injuries. While a major risk is improper adult

supervision, a considerable number of burn injuries in children

result from child maltreatment.

Regional factors
There are important regional differences in burn rates.
Infants in the WHO African Region have three times the
incidence of burn deaths than infants worldwide.
Boys under five years of age living in low- and middle-income
countries of the WHO Eastern Mediterranean Region are almost
twice as likely to die from burns as boys living in low- and
middle-income countries of the WHO European Region.
The incidence of burn injuries requiring medical care is nearly
20 times higher in the WHO Western Pacific Region than in the

WHO Region of the Americas.
Socioeconomic factors
People living in low- and middle-income countries are at higher

risk for burns than people living in high-income countries. Within

all countries however, burn risk correlates with socioeconomic

status.

Other risk factors
There are a number of other risk factors for burns, including:

occupations that increase exposure to fire;
poverty, overcrowding and lack of proper safety measures;
placement of young girls in household roles such as cooking

and care of small children;
underlying medical conditions, including epilepsy, peripheral

neuropathy, and physical and cognitive disabilities;
alcohol abuse and smoking;
easy access to chemicals used for assault (such as in acid

violence attacks);
use of kerosene (paraffin) as a fuel source for non-electric

domestic appliances;
inadequate safety measures for liquefied petroleum gas and

electricity.
In which settings do burns occur?

Burns occur mainly in the home and workplace. Community
surveys in Bangladesh and Ethiopia show that 80–90% of burns
occur at home. Children and women are usually burned in
domestic kitchens, from upset receptacles containing hot liquids
or flames, or from cookstove explosions. Men are most likely to
be burned in the workplace due to fire, scalds, chemical and
electrical burns.

Prevention
Burns are preventable. High-income countries have made
considerable progress in lowering rates of burn deaths, through
a combination of prevention strategies and improvements in the
care of people affected by burns. Most of these advances in
prevention and care have been incompletely applied in low- and
middle-income countries. Increased efforts to do so would likely
lead to significant reductions in rates of burn-related death and

disability.

Prevention strategies should address the hazards for specific

burn injuries, education for vulnerable populations and training of

communities in first aid. An effective burn prevention plan

should be multisectoral and include broad efforts to:

improve awareness
develop and enforce effective policy
describe burden and identify risk factors
set research priorities with promotion of promising interventions
provide burn prevention programmes
strengthen burn care
strengthen capacities to carry out all of the above.
The document A WHO plan for burn prevention and care

discusses these seven components in detail.
In addition, there are a number of specific recommendations for
individuals, communities and public health officials to reduce
burn risk.
Enclose fires and limit the height of open flames in domestic
environments.
Promote safer cookstoves and less hazardous fuels, and
educate regarding loose clothing.
Apply safety regulations to housing designs and materials, and
encourage home inspections.
Improve the design of cookstoves, particularly with regard to
stability and prevention of access by children.
Lower the temperature in hot water taps.
Promote fire safety education and the use of smoke detectors,
fire sprinklers, and fire-escape systems in homes.
Promote the introduction of and compliance with industrial
safety regulations, and the use of fire-retardant fabrics for
children’s sleepwear.
Avoid smoking in bed and encourage the use of child-resistant
lighters.
Promote legislation mandating the production of fire-safe
cigarettes.
Improve treatment of epilepsy, particularly in developing
countries.
Encourage further development of burn-care systems, including
the training of health-care providers in the appropriate triage and
management of people with burns.
Support the development and distribution of fire-retardant
aprons to be used while cooking around an open flame or
kerosene stove.

First aid

Do's
Stop the burning process by removing clothing and irrigating the
burns.
Use cool running water to reduce the temperature of the burn.
Extinguish flames by allowing the patient to roll on the ground, or

by applying a blanket, or by using water or other
fire-extinguishing liquids.
In chemical burns, remove or dilute the chemical agent by
irrigating with large volumes of water.
Wrap the patient in a clean cloth or sheet and transport to the
nearest appropriate facility for medical care.
Don'ts
Do not start first aid before ensuring your own safety (switch off
electrical current, wear gloves for chemicals etc.)
Do not apply paste, oil, haldi (turmeric) or raw cotton to the burn.
Do not apply ice because it deepens the injury.
Avoid prolonged cooling with water because it will lead to
hypothermia.
Do not open blisters until topical antimicrobials can be applied,

such as by a health-care provider.
Do not apply any material directly to the wound as it might
become infected.
Avoid application of topical medication until the patient has been
placed under appropriate medical care.
WHO response

WHO is promoting the interventions that have been shown to be

successful in reducing burns. WHO is also supporting

increased collaboration within and across global and national

networks of stakeholders to increase the number of effective

programmes for burn prevention.

Burn

A burn is a type of injury to flesh caused by heat, electricity,
chemicals, light, radiation or friction. Most burns affect only the
skin (epidermal tissue and dermis). Rarely, deeper tissues,
such as muscle, bone, and blood vessels can also be injured.
Burns may be treated with first aid, in an out-of-hospital setting,
or may require more specialized treatment such as those
available at specialized burn centers.
Managing burn injuries properly is important because they are
common, painful and can result in disfiguring and disabling
scarring, amputation of affected parts or death in severe cases.
Complications such as shock, infection, multiple organ
dysfunction syndrome, electrolyte imbalance and respiratory
distress may occur. The treatment of burns may include the
removal of dead tissue (debridement), applying dressings to the
wound, fluid resuscitation, administering antibiotics, and skin
grafting.
While large burns can be fatal, modern treatments developed in
the last 60 years have significantly improved the prognosis of
such burns, especially in children and young adults. In the
United States, approximately 1 out of every 25 people to suffer
burns will die from their injuries. The majority of these fatalities
occur either at the scene or on the way to hospital.