Occupational burns in Washington State, 1989-1993

Epidemiology of work-related burn injuries: A ten-year retrospective study of 429 patients at a referral burn centre in the north of Iran

Work-related burns can have a destructive impact; however, knowledge of the epidemiology of work-related burn injuries in Iran is limited. This study aimed to describe epidemiological characteristics of work-related burn injuries in a burn centre in the north of Iran. This study was a retrospective single-centre study of the medical records of work-related burns between 2011 and 2020. Data collection was done using the hospital information system (HIS). The data were analysed by using descriptive statistical methods and SPSS 24.0 software. Of the 9220 cases treated in the burn centre, 429 (4.65%) had work-related burns. There was an increasing trend of work-related burns during the ten years. The mean age of patients was 37.53 (SD = 13.72). Most patients were male (n = 377, 87.9%), with a male-to-female ratio of 7.25/1. The mean total body surface area burn was 23.39% (SD = 20.03). Most work-related burns occurred in the summer season (46.9%, n = 201), and the upper limb was the most common anatomical site of burns (n = 123, 28.7%). The most common mechanism of injury was fire & flames (266, 62.0%). Inhalation injury was observed in 52 (12.1%) patients, and mechanical ventilation was undertaken in 71 (16.6%) patients. The mean length of stay in the hospital was 10.38 (SD = 10.37) days, and the overall mortality rate was 11.2%. The most common activities associated with burns at the time of the incidents were food preparation and serving related (108, 25.2%), followed by welders (n = 71, 16.6%) and electricians (n = 61, 14.2%). This research is the basis for evaluating work-related burns and identifying the causes of these injuries to develop education and prevention programmes, especially for young male workers.

Work-Related Burn Injuries in a Tertiary Care Burn Center, 2013 to 2018

The features of work-related burn (WRB) injuries are not well defined in the literature and they vary depending on geographical location. We wanted to describe these characteristics among patients treated in the UNC Burn Center to evaluate the potential impact of commonly accepted prevention efforts. Adults of working age, admitted between January 1, 2013, and December 31, 2018, were identified using our Burn Center Registry. Demographic data, characteristics of injury, course of treatment, and patients' outcomes were described. Differences between work-related and non-work-related injuries were evaluated using the Chi-square test and Student t-test where appropriate. Three thousand five hundred and forty-five patients were included. WRB cases constituted 18% of the study population, and this proportion remained relatively stable during the study timeframe. Young white males were the majority of this group. When compared with non-WRB patients, they were characterized by fewer co-morbidities, decreased TBSA burns, decreased risk of inhalation injury, shorter time of intensive care treatment, shorter lengths of hospital stay, and lower treatment cost. In contrast to non-WRB, among which flame injuries were the main reason for admission, work-related patients most often suffered scald burns. They also had a dramatically increased proportion of chemical and electrical burns, making the latter the most common cause of death in that group. WRB are characterized by a characteristic patient profile, burn etiologies, and outcomes. Learning specific patterns at this group may contribute to optimize work safety regulations and medical interventions.

Inpatient Data of Occupational Burn Injuries Treated at a Tertiary Burn Center

Occupational burns are among the important causes of work-related injuries. We aimed to investigate the epidemiology and reasons of occupational burns and thereby to emphasize preventive measures. Between January 2017 and December 2018, the data of major occupational burn injury patients admitted to our burn center were evaluated in this cross-sectional retrospective study. During the study period 342 patients older than 16 years were admitted to the burn center. Among them 80 patients with occupational burns (23.4%) were identified. The mean age of the patients was 34.73 ± 12.3 years. Seventy-eight patients (97.5%) were male. Electrical burns and flame burns were the two leading type of occupational burns. The most common occupation of our patients was construction work. Dangerous behavior, carelessness, lack of protective equipment, and failure to follow instructions were causes of injury. Only 14 patients (17.5%) experienced unavoidable accident. Thirty-seven patients (46.3%) worked on temporary basis. Occupational experience was under 5 years in majority of the cases (62.5%). For the occupational burns the percentage of burned TBSA was 17.08 ± 14.5 (1-60) and the length of hospital stay was 23.94 ± 21.9 days (2-106). There were no significant differences between occupational and nonoccupational burn injuries considering TBSA, total length of hospital stay, and complications (P > .05). Occupational burn injuries are common in less experienced and younger workers. Therefore, recognition of the problem and maintaining awareness is important. In order to prevent occupational accidents and burns, occupational health and safety rules must be obeyed.

Acute chemical skin injuries in the United States: a review

The objective was to perform a thorough review of published and other available data to elucidate the extent of chemical skin injuries in the US. Chemical skin injuries differ significantly from skin lesions produced by other injury mechanisms, so this review was restricted to the former. Retrieval of relevant published data was performed in PubMed and Google. Other data were retrieved from the American College of Surgeons National Trauma Databank, American Burn Association National Burn Repository, US Department of Labor Bureau of Labor Statistics, websites of all 50 US States Departments of Health, and the National Poison Data System of the American Association of Poison Control Centers. Two areas of significance in disfiguring skin burn injuries and particularly of chemical skin injuries, psychosocial issues and the associated financial burden, have been briefly reviewed. Because of the paucity of published data, international as well as US data have been included. A brief description of an active flushing fluid as an alternative to potable water, Diphoterine^® solution, has also been included. Chemical skin injuries generally comprise approximately 2-5% of all skin burns, but sometimes higher percentages have been reported. Data analysis shows that while there are various sources regarding the epidemiology of chemical skin injuries, the total annual number cannot be determined because there is no centralized US national reporting mechanism. Literature and clinical experience demonstrate the importance of chemical skin injuries in USA. Dermal exposures to chemicals can result in mortality and morbidity. Chemical skin injuries can be avoided or ameliorated and preventive advanced measures should be taken to reduce or ameliorate them.

Work-Related Burn Injuries Hospitalized in US Burn Centers: 2002 to 2011

OBJECTIVE

To develop a comprehensive definition to identify work-related burns in the National Burn Repository (NBR) based on multiple fields and describes injuries by occupation.

METHODS

The NBR, which is an inpatient dataset, was used to compare type and severity of burn injuries by occupation.

RESULTS

Using the definition developed for this analysis, 22,969 burn injuries were identified as work-related. In contrast, the single work-related field intended to capture occupational injuries only captured 4696 cases. The highest numbers of burns were observed in construction/extraction, food preparation, and durable goods production occupations. Occupations with a mean total body surface area (TBSA) burned greater than 10% include transportation and material-moving, architecture and engineering, and arts/design/entertainment/sports/media occupations.

CONCLUSIONS

The NBR dataset should be further utilized for occupational burn injury investigations and multiple fields should be considered for case ascertainment.

Occupational burns treated in emergency departments

BACKGROUND

Despite reported declines, occupational burn injuries remain a workplace safety concern. More severe burns may result in costly medical treatment and long-term physical and psychological consequences.

METHODS

We used the National Electronic Injury Surveillance System-Occupational Supplement to produce national estimates of burns treated in emergency departments (EDs). We analyzed data trends from 1999 to 2008 and provided detailed descriptions of 2008 data.

RESULTS

From 1999 to 2008 there were 1,132,000 (95% CI: ±192,300) nonfatal occupational burns treated in EDs. Burn numbers and rates declined approximately 40% over the 10 years. In 2008, men and younger workers 15-24 years old had the highest rates. Scalds and thermal burns accounted for more than 60% of burns. Accommodation and food service, manufacturing, and construction industries had the largest number of burns.

CONCLUSIONS

Despite declining burn rates, emphasis is needed on reducing burn hazards to young food service workers and using job specific hazard analyses to prevent burns.

A clinico-epidemiologic study of 892 patients with burn injuries at a tertiary care hospital in Punjab, India

Aim:

To analyze the causes, demographic and socio-cultural aspects, and the magnitude of burn injuries prospectively and to evaluate the outcome of treatment of patients admitted to burns ICU of tertiary care hospital.

Materials and Methods:

A total of 892 burn patients admitted over a period of 6 years from January 2002 to December 2007 at tertiary care hospital in Punjab, India, were analyzed.

Results:

54% patients were males. A majority of the patients, 704(79%), were in the age group of 15-45 years. Six hundred and thirty-four patients (72%) sustained flame burns, while 17% and 7% sustained electrical and scald burns, respectively. A total of 470(53%) patients sustained major two to three degree flame burns involving more than 45% of total body surface area (TBSA). The mortality rate was 40%, i.e. 357 patients died of burns and its related problems, in our study. Six hundred and thirty-nine patients (72%) sustained burns in closed space of which 331 patients (52%) sustained burns in kitchen. Seven hundred and seventy-nine patients sustained accidental burns. Burn victims were mainly Hindus and Sikhs. The mean hospital stay varied depending upon the percentage of burns. On an average, a patient with > 45% TBSA burns received 15 whole blood transfusions. Split skin grafting was done in 416 patients. Most common complication encountered during their hospital stay was wound infection which was seen in 671 patients, followed by ARDS in 221 patients. The most common organisms causing wound infection were Pseudomonas and Acinetobacter.

Conclusion:

Developing country like India need an aggressive public education program so that people become more literate about various etiological factors causing burns and means of preventing them. Also needed are burn care hospitals which are easily accessible and affordable.

Electrical flash burns due to switchboard explosions in New South Wales--a 9-year experience

PURPOSE

To document the incidence and outcome of flash burns due to electrical switchboard explosions presenting to Concord Hospital Burns Unit, from January 2000 to December 2008.

METHODS

The Concord Hospital Burns Unit Database was reviewed for admissions due to electrical burns from January 2000 to December 2008.

RESULTS

There were 119 electrical burns admitted during the study period, 20 of which were due to high voltage current. Ninety-nine others were low voltage injuries and included 37 cases of electrical burns due to low voltage electrical switchboard explosions. All of the electrical switchboard burns occurred in male electricians. Twenty-one of the 37 low voltage injuries required admission and 7 of them required skin grafting. The mean LOS was 9.95 days. Twenty cases suffered serious complications including major psychological problems and ocular injuries.

CONCLUSIONS

Flash burns resulting from switchboard explosions account for a significant proportion of all electrical burns presenting to our institution. These burns may highlight deficits in taking safety precautions and the use of personal protection equipment. Despite the small area of injury the long term psychological sequelae were significant resulting in a delayed return to employment, and there was a high incidence of eye injuries. Additional efforts are therefore required towards the prevention of such injuries.

GIS and injury prevention and control: history, challenges, and opportunities

Intentional and unintentional injury is the leading cause of death and potential years of life lost in the first four decades of life in industrialized countries around the world. Despite surgical innovations and improved access to emergency care, research has shown that certain populations remain particularly vulnerable to the risks and consequences of injury. Recent evidence has shown that the analytical, data linkage, and mapping tools of geographic information systems (GIS) technology provide can further address these determinants and identify populations in need. This paper traces the history of injury prevention and discusses current and future challenges in furthering our understanding of the determinants of injury through the use of GIS.

Chemical burns: pathophysiology and treatment

Chemical burns continue to pose a variety of dilemmas to the clinician managing such cases. Assessment of burn depth is often difficult and the decision whether to excise the wound early is not always clear-cut. In this updated review, common agents are classified and the basic principles of management and specific recommendations are examined. The complications arising from exposure to these chemicals and the supportive measures needed during treatment are also described.

Characteristics of occupational burns in Oregon, 2001-2006

BACKGROUND

Occupational burns are known to be a serious public health concern. This article describes work-related burns in Oregon between 2001 and 2006.

METHODS

Oregon Workers' Compensation (WC) burn claims were analyzed; data from a commercial insurance carrier (CIC) was used to characterize non-disabling burn claims. To ensure that our primary data source (WC) captures as many burn cases as possible, we compared hospitalized cases to a regional burn center (RBC) and Oregon hospital discharge index (HDI) data.

RESULTS

The WC burn injury rate ranged from a high of 1.8 per 10,000 workers in 2001 to a low of 1.4 per 10,000 in 2004. We identified 2,165 accepted burn claims in CIC data, of which 85% were non-disabling. We matched data from a regional burn center to a subset of hospitalized claims from WC data and found an additional 44 cases of occupational hospitalized burns representing a 3% increase in total cases captured.

CONCLUSIONS

Occupational burns continue to be a problem for working Oregonians, and the use of additional data sources outside of WC augments our surveillance system.

Diphoterine® for Emergent Decontamination of Skin/Eye Chemical Splashes: 24 Cases

Chemical skin/eye splashes can cause burns. Standard references recommend decontamination with water. Diphoterine, a polyvalent, hypertonic, amphoteric, chelating solution is an alternative. Occupational medical records of 24 workers in a German metallurgy firm from 1994 to 1998 were reviewed. There were 11 acid eye splashes, 8 acid skin splashes, 4 base eye splashes, and 1 base skin splash. Following Diphoterine decontamination, no burns developed and there were no requirements for burn treatment or sequelae. Three workers had 1 lost workday each. Diphoterine decontamination successfully prevented skin/eye burns in this group of metallurgy workers.

Water Decontamination of Chemical Skin/Eye Splashes: A Critical Review

Skin/eye chemical splashes are a significant workplace problem. Initial water decontamination is usually recommended, but there are few well-conducted experimental animal and human studies of efficacy. An extensive review of the literature and other available information sources was performed to define the scope of the problem and critically review the evidence for water decontamination efficacy. Although water decontamination can decrease the severity of chemical skin/eye burns, it cannot completely prevent them. An ideal replacement decontamination solution would be sterile, nontoxic, chelating, polyvalent, amphoteric, and slightly hypertonic to retard skin or corneal penetration of the chemical.

Occupational injury among cooks and food service workers in the healthcare sector

BACKGROUND

Incidence of occupational injury is anticipated to be high among cooks and food service workers (CFSWs) because of the nature of their work and the types of raw and finished materials that they handle.

METHOD

Incidents of occupational injury, resulting in lost time or medical care over a period of 1 year in two health regions were extracted from a standardized operational database and with person years obtained from payroll data, detailed analysis was conducted using Poisson regression modeling.

RESULTS

Among the CFSWs the annual injury rate was 38.1 per 100 person years. The risk of contusions [RR, 95% CI 9.66 (1.04, 89.72)], burns [1.79 (1.39, 2.31)], and irritations or allergies [3.84 (2.05, 7.18)] was found to be significantly higher in acute care facilities compared to long-term care facilities. Lower risk was found among older workers for irritations or allergies. Female CFSWs, compared to their male counterparts, were respectively 8 and 20 times more likely to report irritations or allergies and contusions. In respect to outcome, almost all irritations or allergies required medical visits. For MSI incidents, about 67.4% resulted in time-loss from work.

CONCLUSIONS

Prevention policies should be developed to reduce the hazards present in the workplace to promote safer work practices for cooks and food service workers.

Occupational hazards and risks faced by Chinese immigrant restaurant workers

Historically, Chinese immigrants to the United States have worked in restaurants to support their families. Hazards and risks associated with this population's work in restaurants are underrepresented in the literature. This ethnographic study used interviews, participant-observations, and follow-up focus sessions with 18 immigrants from China, Hong Kong, and Taiwan to identify potential physical, biological, enviromechanical, chemical, and psychosocial hazards that they face. Psychosocial hazards were most often mentioned by the participants; biological hazards were not identified in the data. Practice and research implications for addressing health disparities in this population are discussed.

Thermal burn and electrical injuries among electric utility workers, 1995–2004

This study describes the occurrence of work-related injuries from thermal-, electrical- and chemical-burns among electric utility workers. We describe injury trends by occupation, body part injured, age, sex, and circumstances surrounding the injury. This analysis includes all thermal, electric, and chemical injuries included in the Electric Power Research Institute (EPRI) Occupational Health and Safety Database (OHSD). There were a total of 872 thermal burn and electric shock injuries representing 3.7% of all injuries, but accounting for nearly 13% of all medical claim costs, second only to the medical costs associated with sprain- and strain-related injuries (38% of all injuries). The majority of burns involved less than 1 day off of work. The head, hands, and other upper extremities were the body parts most frequently injured by burns or electric shocks. For this industry, electric-related burns accounted for the largest percentage of burn injuries, 399 injuries (45.8%), followed by thermal/heat burns, 345 injuries (39.6%), and chemical burns, 51 injuries (5.8%). These injuries also represented a disproportionate number of fatalities; of the 24 deaths recorded in the database, contact with electric current or with temperature extremes was the source of seven of the fatalities. High-risk occupations included welders, line workers, electricians, meter readers, mechanics, maintenance workers, and plant and equipment operators.

An analysis of occupational burn injuries in Rhode Island: workers' compensation claims, 1998 to 2002

Occupational burns have been determined to be a serious public health concern. The analysis of workplace risks and risk factors associated with burns are critical to developing effective interventions in the future. In this study, we examined accepted Rhode Island workers' compensation claims (n = 5619) from 1998 to 2002 to assess the rates and risks of occupational burns. We used employment data from the Department of Labor's Current Population Survey (CPS) to estimate claim rates and shift analyses. The overall burn rate was estimated to be 24.3 per 10,000 workers. The claim rate for workers younger than 25 years of age was almost double that for all other age groups. The average per-claim disability duration for claims requiring indemnity was 167.9 days, and average annual total cost of claims was dollar 1,010,166. The highest claim rate identified was for workers in food service occupations and an increased risk was found for chemical burns among evening and night-shift workers. Increased interventions are needed to reduce occupational burns in work settings. Particular diligence should be should address occupational burn hazards in restaurant establishments, and preventative should be measures aimed at young employees and late-shift workers.

Quantification and Risk Analysis of Occupational Burns: Oregon Workersʼ Compensation Claims, 1990 to 1997

This study examined all accepted Oregon workers' compensation claims for occupational burn injuries during the period of 1990 to 1997 (N = 3,158). The Current Population Survey was used to derive employee population baselines for establishing rate estimates. It was estimated that the average occupational burn claim rate was 2.89 per 10,000 workers (95% confidence interval [CI] 2.76, 3.02). The majority of claimants (71.7%) were males, the largest proportion (32.6%) was aged 25 years or less, and almost half (48.7%) had less than 1 year of job tenure. The most frequent burn type cited was heat/scald burns (78.9%) followed by chemical burns (19.3%). Costs averaged over 1.6 million dollars annually. The average indemnity period was 16 days. Higher relative risks were found for evening workers (2.97, 95% CI 2.96, 2.98) and night workers (2.13, 95% CI 2.12, 2.13) compared with dayshift workers. Kitchen workers had the highest burn rate of all occupations, with 62.5 claims per 10,000 workers.

Work-related burn injuries in Ontario, Canada: has anything changed in the last 10 years?

BACKGROUND

Many burn injuries occur in the workplace. Previous research from this institution 10 years ago analyzed the incidence and nature of occupation-related burns admitted to our facility.

PURPOSE

To compare the current incidence and patterns of work-related burn injuries treated at our adult regional burn center (Current group) with the findings of a similar study 10 years ago (Early group).

METHODS

Retrospective study of all burn center admissions between 5 December 1998 and 31 December 2000 was completed. The data from the Early and Current groups was analyzed using the Chi-square test of homogeneity.

RESULTS

During the study period, 355 patients were hospitalized. After exclusions, 100 occupational burn cases were identified (28%). The mean age of patients was 39+/-12 years, 90% were male. The mean total body surface area (TBSA) burn was 11+/-13.7%. The most common mechanism of burn was electrical (32%), followed by flame (22%), scald (17%), tar (14%), contact (8%), and chemical (7%). Four patients (4%) died of their injuries. There were no significant differences between the Current group and the Early group in terms of incidence, age, gender, occupation, mechanism of burn, or mortality.

CONCLUSION

In the past 10 years no change was found in the incidence or pattern of work-related burn injuries treated at this institution. This suggests that existing prevention strategies have not been effective.

Thermal burn fatalities in the workplace, United States, 1992 to 1999

The purpose of this study was to present the epidemiology of thermal burn fatalities in the workplace in the United States between 1992 and 1999. Data on fatal thermal burn injuries in the United States between 1992 through 1999 were obtained from the Bureau of Labor Statistics Census of Fatal Occupational Injuries. Between 1992 and 1999, 1,189 fatal thermal burns occurred in the workplace (0.11 deaths/100,000 workers per year). Mortality increased with age, with those over 65 years of age having the greatest rate of death (0.20/100,000). Workers in the mining industry and transportation and public utilities had the highest rates of fatal thermal burns. Occupational categories with the highest rates included "extractive occupations" (eg, miners, explosives workers) and "transportation and material movers" (eg, truck drivers). The specific occupations with the highest rates were airplane pilots and navigators, furnace, kiln, and oven operators, and firefighters. Most decedents were operating vehicles or involved in "other transportation operations" at the time of the incident. The majority of injurious incidents occurred on "industrial premises" or the "street and highway." Efforts to prevent fatal occupational thermal burn injuries should focus on older workers and those in occupations with frequent exposure to potential sources of thermal injury. Further study of nonfatal thermal burns in the workplace is needed because patterns of fatal burn injury may not reflect patterns of occupational burn injury overall.

Serious occupational burn injuries treated at a regional burn center

This article will present the epidemiology of occupational burn injuries among patients admitted to a regional burn center. Patients admitted to University of Alabama at Birmingham University Hospital Burn Center between November 1994 and December 1999 for occupational burn injuries were studied. Descriptive statistics were generated for demographic, clinical, and outcome characteristics. Approximately one-quarter of all burn center admissions had sustained occupational burn injuries. The most common burns were flame, electrical, and scald burns. The most heavily represented occupations were "manufacturing" (19.1%), "electrician" (16.2%), and "laborer" (16.2%). Burn type varied with occupation. Over $16 million in hospital charges was accrued by patients sustaining occupational burn injuries. Understanding the epidemiology of serious burn injuries in the workplace is crucial to directing prevention efforts toward worker groups at highest risk.

Work-related burns in Washington State, 1994 to 1998

This article describes an investigation of work-related burns in Washington State during 1994-1998. Workers' compensation data were used to describe the general characteristics of burn injuries, estimate industrial claims rates, and compare nonhospitalized and hospitalized burn cases. The completeness of workers' compensation data as a source for surveillance was evaluated. During 1994-1998, a total of 20,213 burn claims were accepted by the workers' compensation system. Hospitalized burn cases represented only 1.5% of burn claims but incurred 55% of the costs. In addition, workers' compensation data underestimated the frequency and rate of burns. Although workers' compensation claims rates decreased during 1994-1998, work-related burns remain a problem in Washington State. Several industries (e.g., roofing, foundries, and aluminum smelting) were identified as priorities for prevention of burn hospitalizations, which incur the greater cost and time loss.

Epidemiology of work-related burn injuries: experience of a state-managed workers' compensation system

BACKGROUND

Population-based incidence rates of work-related burn injuries and associated risk factors specific to anatomic sites and degree of burn are not known.

METHODS

Using a state-managed workers' compensation database, we estimated incidence rates of work-related burn injuries and identified high-risk occupations and associated exposures.

RESULTS

The annual incidence rate of occupational burn was 26.4 per 10,000 workers, with the highest rate observed in the manufacturing sector for males and in the service sector for females. Welders, cooks, laborers, food service workers, and mechanics had higher incidence rates of burn injury compared with other occupations. Wrist and hand burns accounted for a majority of burn injuries, with females experiencing greater incidence of these distal upper extremity burns (8.9 in females and 6.7 in males per 10,000 workers, respectively). Third-degree burns (incidence rate, 1.3 per 10,000 workers) were also most frequently observed in the upper extremities compared with other anatomic sites. The majority of wrist and hand burns were caused by hot liquids/ objects, whereas the majority of eye burns were associated with chemical exposures. Younger cooks and food service workers were at greater risk of burn than older coworkers.

CONCLUSION

Specific occupations are associated with degree of burn, anatomic site, and exposures. This information will be useful for targeted intervention among high-risk occupations and work groups.