World report on child injury prevention

Children and
burns
Children are naturally curious. As soon as they are mobile they
want to explore their surroundings and play with new objects.
What is a burn?
Yet this natural learning process means they come into contact A burn is defined as an injury to the skin or other
human tissue caused by heat. It occurs when
with objects that can cause burns. Playing with fire or touching some or all of the cells in the skin or other tissues
hot objects can result in burns, causing intense pain and often are destroyed by hot liquids (scalds), hot solids
long-term consequences. This creates suffering not just for the (contact burns), or flames (flame burns). Injuries
from radiation, radioactivity, electricity, friction or
children but also for their families and the broader community. contact with chemicals are also regarded as burns.

Scale of the problem

Mortality
n Globally, nearly 96 000 children under the age of burns, mostly from fires in the home. For children over
fact sheet

20 were fatally injured as a result of a fire-related burn three years of age, smoke inhalation is strongly associated
in 2004 alone. with mortality, despite improvements in the care of
n The death rate in low-income and middle-income burns.
countries is eleven times higher than that in high-income n Infants have the highest death rates, while those aged

countries – 4.3 per 100 000 as against 0.4 per 100 000. between 10 and 14 years have the lowest. The death rate
n Most of the deaths occur in poorer regions of the world climbs again for 15–19 year olds.
– Africa and South-East Asia, and the low-income and n Burns are the only type of unintentional injury where

middle-income countries of the Eastern Mediterranean females have a higher rate of injury than males. The fire-
Region. related death rate for girls worldwide is 4.9 per 100 000
n Studies from high-income countries suggest that smoke population versus 3.0 per 100 000 for boys.
inhalation is the strongest determinant of mortality from

Child mortality rates resulting from fire-related burns per 100 000 populationa, by WHO region and income level, 2004

South- Eastern
Africa Americas East Asia Europe Mediterranean Western Pacific a These data refer to those under 20 years of age.
LMIC HIC LMIC LMIC HIC LMIC HIC LMIC HIC LMIC HIC = High-income countries;
LMIC = Low-income and middle-income countries.
8.7 0.7 0.6 6.1 0.2 1.1 0.4 4.7 0.3 0.6 Source: WHO (2008), Global Burden of Disease: 2004 update.

Morbidity
n While fire causes the majority of burn-related deaths in n Burns place a heavy economic load on health-care
children, scalds and contact burns are an important cause services. A study from the United States found that the
in overall morbidity from burns, and a significant cause cost of hospitalization from burns ranged from US$ 1187
of disability. for scalds to US$ 4102 per burn resulting from a fire.
n In high-income countries, children under the age of n There are also costs to the children and their families

five have the highest rate of hospitalization from burns, in terms of repeat hospitalization, the need for long-
followed by 15–19-year-olds. term rehabilitation, lost school days, possible future
n Nearly 75% of burns in young children are from hot
unemployment, social rejection and other psychosocial
liquid, hot tap water or steam. Infants under the age of issues.
one run a significant risk from burns, even in developed n A Canadian study found that through a combination of
countries. educational and legislative measures, preventing scald
burns could save 531 Canadian dollars (US$ 507) per
scald.
 Risk factors
n Burns are the only type of fatal injury that occurs more n Flammable substances such as kerosene and paraffin are
frequently among girls than boys in the South-East dangerous when stored in the home.
Asia Region and in low-income and middle-income n Fireworks pose a significant risk for children, particularly

countries in the Eastern Mediterranean and Western adolescent boys. Fireworks have been banned in many
Pacific Regions. high-income countries, but in most low- and middle-
n Mortality and morbidity from burns are strongly income countries, there are no laws restricting their use.
associated with poverty, with a higher incidence of burns n Socioeconomic factors that increase the risk of childhood

among children in low-income and middle-income burns include: low rate of literacy within the family;
countries and poorer families in high-income countries. living in overcrowded dwellings or with cluttered areas in
n Heating and lighting sources and cooking equipment, the home; failure to properly supervise children; a history
especially those relying on fossil fuels, all carry risks. In of burns among siblings; and the absence of laws and
particular, heating or cooking on open fires that are at regulations relating to building codes, smoke detectors
ground level pose significant dangers to children. and flammable clothing.

Fatal fire-related burn rates among children per 100 000 populationa by sex, WHO region and country income level, World, 2004
fact sheet

South- Eastern a These data refer to those under 20 years of

Africa Americas East Asia Europe Mediterranean Western Pacific age.
LMIC HIC LMIC HIC HIC LMIC HIC LMIC HIC LMIC HIC = High-income countries;
LMIC = Low-income and middle-income
Boys 8.9 0.7 0.7 3.3 0.2 1.3 0.6 3.6 0.3 0.4 countries.
Source: WHO (2008), Global Burden of Disease:
Girls 8.5 0.6 0.6 9.1 0.2 1.0 0.1 5.8 0.3 0.8 2004 update.

Interventions
Burns can be prevented or minimized by implementing the
following strategies.

Proven effective approaches to

reducing burns —
“Thermal burns are a common cause of
3 Establishing and enforcing 3 Developing and enforcing accidental death in children worldwide.
legislation requiring the installation
of working smoke alarms on all
legislation requiring the regulation
of the temperature of hot water
Despite various methods of prevention
levels, including the sleeping areas, from household taps. and care, such injuries are on the rise.
of homes.
3 Establishing, operating and Only through a deeper understanding
3 Developing and enforcing standards
for the design and provision of
maintaining dedicated burn centres
to attain better outcomes and less
of the underlying causes can we develop
child-resistant lighters. costly management. truly viable alternative solutions. If the
proposals outlined in this report are
implemented correctly, they can bring
What does not work? about the necessary changes.”
Mehmet Haberal
7 There is insufficient evidence to promote the use of community-based campaigns President of the International Society for Burn Injuries
and interventions such as the distribution of smoke alarms (without accompanying
laws), installing residential sprinklers and other home modifications, and home
visitation programmes for at-risk families.
7 Butter, sugar, oil and other traditional remedies should not be used on burns.

Source: This fact sheet is based on the World report on child injury prevention.
To download a copy of the report please go to http://www.who.int/violence_injury_prevention/child/en/
Copies of this document are available from: Department of Violence and Injury Prevention and Disability, World Health Organization, 20 Avenue Appia, 1211 Geneva 27,
Switzerland, Email: childinjury@who.int