ReviewEpidemiology of burns throughout the World. Part II: Intentional burns in adults
Introduction
Intentional burns are those in which the act that led to the injury has the purpose of causing harm. The immediate aim of the assailant is to use chemicals or thermal energy to inflict damage, resulting in pain, scarring and occasionally death. This review article will discuss the cause of burns stemming from interpersonal violence (assaults, spouse abuse, and elder abuse) as well as self-inflicted violence (suicide, suicide attempts, and self-mutilation). Child abuse by burning has been covered elsewhere [1].
Section snippets
Epidemiology
This article summarizes the available data, gathered from hospital-based studies from low- and high-income countries in regard to intentional injury. Although data reflect a preponderance of first world experience, I have attempted to use sources of information from around the world as much as possible. Further information and data regarding the more general incidence and epidemiology of burns and deaths from fires are available in Part I of this series (Burns 37 (2011), 1087–1100).
The vast
Chemical attacks
Although scald burns by women against men are most often the result an impetuous act prompted by a flare of temper during a quarrel, chemical assaults are often premeditated. Chemical assaults are less common than scalds but they are much more devastating because of the depth and extent of injuries they incur. A review at Prince of Wales Hospital covering the period 1991 through 2001 showed that less than 1% (19/2319) of admissions were for chemical assaults. However, this percentage represents
Elder abuse
It is suspected that elder abuse in general often goes unreported, and elder abuse by burning is probably no exception [33]. Of 28 patients aged 60 years or older who were admitted to the US Army Institute of Surgical Research in 1996, three had been neglected (11%) and one (4%) had been abused. The neglected elders had a mean burn size of 72% and all three died [34]. In another series from the District of Columbia, 10% of burned-and-battered adults were nursing home abuse victims [9].
At
Self-inflicted violence
Suicide from all causes occurs in the US at an annual rate of almost 12 per 100,000, or approximately 94 deaths per day [36]. However, in 2007 the number of suicides by fire and flames in the US (157) was very small compared to those by poisoning (6358) or firearms (17,352) [37]. Moreover, in the same year, non-fatal self-harm by fire or burns was committed by 1591 people, compared to 197,733 by poisoning and 77,024 by cutting and piercing [38]. Nonetheless, deliberate self-harm by burning
Acknowledgements
The author would like to acknowledge the review and insightful commentary by Drs. Andrew Burd (Hong Kong), Shobha Chamania (Indore), and Rajeev Ahuja (New Delhi). As well, he would like to express his appreciation for the editorial skills of Ms. Andrea Sattinger.
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