Elsevier

Burns

Volume 30, Issue 6, September 2004, Pages 569-572
Burns

Epidemiology of 377 patients with chemical burns in Guangdong province

https://doi.org/10.1016/j.burns.2004.01.028Get rights and content

Abstract

A total of 377 patients with chemical burns from all over Guangdong province were admitted to the Guangzhou Red Cross Hospital during the period from January 1987 to December 2001. There were 296 males and 81 females with a male to female ratio of 3.65:1. The mean age of the patients was 26 years. The majority of patients (89.2%) were in the age range of 15–60 years. Professionally, 244 patients (64.7%) were workers, of whom, 232 (95%) of patients were peasant workers. Most of the chemical burns occurred at places away from home (94.4%), especially in the working environment (67.8%). Only 20 patients (5.5%) were injured at home. Chemical burns by accident and by criminal assault were 337 (88.5%) and 40 (10.5%). Strong acids (60.8%), mainly sulfuric acid, nitric acid, hydrofluoric acid, alkali (33.9%), mainly lime and sodium hydroxide were common causative agents. There was a relationship between the incidence of chemical burns and the season, with more patients in July–September and October–December. There were 215 (57.1%) patients who washed the burnsite with water immediately, but the volumes of water and time of washing were not adequate. Patients with total burn surface area (TBSA) of less than 10% comprised the majority of patients (72.7%), with 188 (65.7%) deep partial thickness burns, 116 (40.6%) with full thickness burns, and 60 (21%) with superficial burns. Extremities (lower limb 56.6% and upper limb 51.4%) were the most frequent area of injury. Ocular burns were the most common accompanying injury (14.7%). Operations of autografts and conjunctival flap were carried out on 159 (42.2%) patients. The average period of hospitalization was 22 days. Only 2 (0.7%) deaths occurred in this study. Counter measures to improve this situation must include safety productive education and professional training, use of protective clothing at work, enhancing the concept of legal responsibility, and restricting management and use of corrosive chemicals. Irrigation of the burnsite promptly with substantial volumes of water and an adequately long time will help reduce the morbidity from chemical burns.

Introduction

Chemical burn after thermal injury (fire and scald, etc.) is the second must common cause of burns in China [1]. Cutaneous damage in chemical burns is much more severe than in thermal injury with greater potential for progressive tissue destruction [2]. Only a prompt skin rinse will lessen the depth of injury. Additionally, delay in applying of the rinse may lead to systemic toxicity. Caution is therefore the best way to prevent this type of danger or tragedy.

The aetiology of chemical burns varies according to the population, geographical location, surrounding industry, and social environment [3], [4], [5], [6], [7]. Guangdong province, lying in the south of China, is one of the first Chinese regions open to the rest of the world. The economic development level and living standards are much higher than in other regions of the continent, partly due to the fast increase of private and collective enterprise. Chemicals are used widely in industry production and daily life activity, but the rules and regulations for managing chemicals are not complete enough and accidents producing chemical burns commonly occur. This paper will present the epidemiology and results of 377 patients admitted with chemical burns to this hospital over the period of 1987–2001.

Section snippets

Materials and methods

Data were collected from 4435 consecutive patients with burns, admitted to the Red Cross Hospital, the largest burn treatment center in Guangdong province. The hospital has 68 beds and 10 ICU beds for burned patients from most areas of the province. Patients studied were admitted from January 1987 to December 2001. Of the 4435 patients, 377 (8.5%) were chemical burns. The findings were reviewed for sex, age, occupation, origin, and location of burn, causes, and type of chemicals, involved. In

Sex, age, and occupation

There were 296 male and 81 female burned patients, with a male to female ratio of 3.65:1. The mean age of patients was 26 years, with a range of 11 months–78 years. 89.2% of the patients were 15–60 years old (Table 1). The occupation of these patients included worker, farmer, students, pre-school children, managing clerk (administrator and professional technician), military, retired people, and others. The majority of patients were workers (64.7%), and the second most common group was farmers

Discussion

Chemical burn is a common type of burn injury in China. There was 6.6% of chemical burns in a major series of 48978 cases of burn patients, based on data collected from 15 large burn treatment center. The rate of chemical burns reached 11.8% at one large burn treatment center in Shanghai [1]. The rate of chemical burns in this study was 8.5%, the second most common cause of burns among all patients. This rate was greater than the reported rate in the Hong Kong area [8]. The economy has been

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