Emergency department surveillance of burns and scalds, electronic Canadian Hospitals Injury Reporting and Prevention Program, 2013 - HPCDP: Volume 37-1, January 2017

Volume 37 · Number 1 · January 2017

 

At-a-glance

Emergency department surveillance of thermal burns and scalds, electronic Canadian Hospitals Injury Reporting and Prevention Program, 2013

Jennifer Crain, MAFootnote 1. ; Steven McFaull, MScFootnote 1. ; Deepa P. Rao, PhDFootnote 1. ; Minh T. Do, PhDFootnote 1. ,Footnote 2. ; Wendy Thompson, MScFootnote 1. 

https://doi.org/10.24095/hpcdp.37.1.03

Author references:

Correspondence: Jennifer Crain, Surveillance and Epidemiology Division, Public Health Agency of Canada, 785 Carling Avenue, 7th floor, AL 6807B, Ottawa, ON K1A 0K9; Tel: 613-799-4096; Fax: 613-941-2057; Email: Jennifer.Crain@phac-aspc.gc.ca

Introduction

Although fatality and hospitalization rates for burns in Canada have declined over time,Footnote 1,Footnote 2 less serious cases still commonly present to the emergency department (ED).

Methods

The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system administered by the Public Health Agency of Canada, operating in emergency departments of 17 hospitals.Footnote 3 We searched the electronic CHIRPP (eCHIRPP) database for ED visits by people of all ages for thermal burns and scalds sustained in 2013. Burns from friction, chemical/caustic agents, and direct contact with lightning were excluded because they present unique circumstances.

Results

Overall, 1682 cases were identified, representing 1.2% (1682/137 245; 1226/100 000 eCHIRPP cases) of injuries reported in 2013. Half were scalds (52.3%; 879/1682) and 29.9% (503/1682) were contact burns from hot objects (Figure 1). The two leading direct causes of scalds were hot beverages at 34.1% (292/856; n = 23 missing) and hot water (not from the tap) at 28.9% (247/856; n = 23 missing). The two leading direct causes of contact burns were stoves/ovens (22.0%; 109/495; n = 8 missing), and fireplaces/accessories (19.6%; 97/495; n = 8 missing). Overall, 13.0% of cases (218/1682) were serious enough to require hospital admission; the highest proportion of hospitalizations was among those exposed to fire/flame/smoke, at 38.9% (72/185).

Figure 1
Distribution of burn injuries by mechanism, frequency and percent, all ages, eCHIRPP 2013

 

Figure 1. Select to view enlarged image.

Abbreviation: eCHIRPP, electronic Canadian Hospitals Injury Reporting and Prevention Program.

Text Equivalent - Figure 1

Figure 1
Distribution of burn injuries by mechanism, frequency and percent, all ages, eCHIRPP 2013

Figure 1 shows the distribution of burn injuries by mechanism, frequency and percent, all ages, eCHIRPP 2013.

We can see that of the 1682 cases identified, representing 1.2% (1682/137 245; 1226/100 000 eCHIRPP cases) of injuries reported in 2013, half were scalds (52.3%; 879/1682) and 29.9% (503/1682) were contact burns from hot objects.

While the overall proportion of burns was highest among females, males comprised a higher proportion of burns from all mechanisms except scalds (Table 1). Figures 2 and 3 show age and sex distributions among scalds and contact burns, respectively. Young children were the most prominent age group for both types of burn.

Table 1
Distribution of burns by mechanism and sex, proportion per 100 000 records,Footnote 1.1 eCHIRPP 2013
Thermal mechanism Males Females
Scald 544.7 767.4
Hot object 393.5 331.3
Fire/flame/smokeFootnote 1.2 169.2 89.6
Electrical 71.8 40.6
Sun 20.5 11.8
Unknown 7.7 10.1
Total 1207.4 1250.8

Abbreviation: eCHIRPP, electronic Canadian Hospitals Injury Reporting and Prevention Program.

Figure 2
Distribution of scaldsFigure 2 - Note a by age group and sex, frequency and proportion per 100 000Figure 2 - Note b records, eCHIRPP 2013

Figure 2. Select to view enlarged image.

Abbreviation: eCHIRPP, electronic Canadian Hospitals Injury Reporting and Prevention Program; F, females; M, males.

Note: The coloured bars represent the proportion of males/females involved in scaldings per 100 000 eCHIRPP injuries of all types.

Text Equivalent - Figure 2

Figure 2
Distribution of scalds by age group and sex, frequency and proportion per 100 000 records, eCHIRPP 2013

Figure 2 illustrates the distribution of scalds by age group and sex, frequency and proportion per 100 000 records in eCHIRPP in 2013. It is clear that young children were the most prominent age group for scalds, particularly children aged 1 and under.

Figure 3
Distribution of burns from contact with hot objects, by age group and sex, frequency and proportion per 100 000Figure 3 - Note a records, eCHIRPP 2013

Figure 3. Select to view enlarged image.

Abbreviations: eCHIRPP, electronic Canadian Hospitals Injury Reporting and Prevention Program; F, females; M, males.

Note: The coloured bars represent the proportion of males/females involved in scaldings per 100 000 eCHIRPP injuries of all types.

Text Equivalent - Figure 3

Figure 3
Distribution of burns from contact with hot objects, by age group and sex, frequency and proportion per 100 000 records, eCHIRPP 2013

Figure 3 illustrates the distribution of burns from contact with hot objects, by age group and sex, frequency and proportion per 100 000 records in eCHIRPP in 2013. Young children were the most prominent age groups for burns from contact with hot objects, in particular children aged 1 and under. A significant decrease is observed starting with the 5-9 age group.

Among burns from fire/flame/smoke, the highest proportion based on age and sex was within males aged 50 to 64 years (n = 16; 782/100 000 eCHIRPP cases), whereas the highest count was among males aged 15 to 19 years (n = 21; 209.1/100 000 eCHIRPP cases). The highest proportion of burns from fire/flame/smoke among females occurred among those aged 20 to 29 years (n = 6; 302.3/100 000 eCHIRPP cases).

Males and females aged 20 to 29 years shared the highest proportions of sun burns (64.8 and 151.1/100 000 eCHIRPP cases, respectively). The proportion of electrical burns was highest among males aged under one year (n = 7; 219.0/100 000 eCHIRPP cases), whereas the highest count was among males aged 2 to 4 years, at 13 cases. Among adults with electrical burns, the proportion was highest among males aged 20 to 29 years (n = 5; 162.0/100 000 eCHIRPP cases).

Discussion

Burns appear consistently in the CHIRPP. The high proportion of scalds and contact burns to young children points to social and biological risk factors, including more time spent at home (where most burns occur), and younger, thinner skin that is more prone to burning. Improved awareness of these risk factors and appropriate safety measures are recommended.

Limitations

The results for less common burn mechanisms may be subject to random variation due to small sample sizes. The cases described also do not represent all thermal burns and scalds in Canada, as only some hospitals participate in the CHIRPP. Along with older teens and adults, Aboriginal persons and rural inhabitants are underrepresented because most CHIRPP sites are pediatric hospitals in major cities. Fatalities are also underrepresented because emergency department data do not capture people who died before being taken to hospital or after being admitted.

References

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