Burn Injuries: Causes, Types, and Prevention

Burn injuries constitute a critical public health concern with implications for individuals and communities. Burns are more than just painful wounds; they can have long-term physical, emotional, and financial consequences.

Understanding the causes and types of burns is important in preventing these devastating incidents. We’ll delve into the various causes of burns, explore the different types of burns, and provide practical guidance on prevention and safety measures.

Burn Injuries Statistics

A clinical study in the International Journal of Environmental Research and Public Health revealed that the World Health Organization (WHO) estimated that around 11 million people annually experience burn injuries. Among them, approximately 180,000 individuals lost their lives due to these injuries.

According to information from the City of Leduc, burns continue to be the third most common cause of accidental injuries at home. In Canada, approximately 45,000 burn injuries occur annually, with about 2,000 requiring hospitalization. 

Between 2010 and 2014, an average of 110 Canadians tragically lost their lives each year due to burns sustained in fires, and ten times as many people were hospitalized annually due to fire-related injuries during that same period.

Causes of Burn Injuries

Burn injuries vary in severity and require different approaches to treatment and healing. Here, we provide an overview of the various kinds of burn injuries and their respective causes.

1. Thermal Burns

Thermal burns result from exposure to excessive heat or flames. They occur when the skin and underlying tissues are damaged due to contact with hot objects, fire, or scalding liquids. 

Common Sources of Thermal Burns:

Source 

Description

Fire

Flames from various sources (e.g., house fires, wildfires).

Hot Liquids

Spills from boiling water, hot oil, or beverages.

Heated Objects

Contact with hot stovetops, irons, or cookware.

Steam

Exposure to pressurized steam, often in industrial settings.

Radiant Heat

Prolonged exposure to intense heat sources like furnaces.

StatPearls, a company specializing in healthcare education and technology, reports that every year, approximately 450,000 patients need treatment for burns, with around 30,000 requiring admission to burn centers. Among these cases, thermal burns comprise the majority at 86%, including 43% from fire or flame, 34% from scalds, and 9% from contact with hot objects.

2. Chemical Burns

Chemical burns occur when the skin or mucous membranes come into contact with harmful chemicals, causing damage to the affected area. They result from corrosive substances such as acids, alkalis (bases), solvents, or household cleaning products. 

Source 

Description

Acids

Strong acids like sulfuric, hydrochloric, or nitric acids.

Alkalis (Bases)

Caustic substances such as sodium hydroxide (lye) or potassium hydroxide.

Solvents

Chemicals found in paint thinners, nail polish remover, and industrial solvents.

Household Cleaners

Common household cleaning products like bleach or drain cleaners.

Industrial Chemicals

Exposure to chemicals in workplaces, such as acids used in manufacturing.

Statistics

A review from the National Library of Medicine found that while chemical burns make up a small portion (up to 10.7%) of all skin burns, they can be responsible for a significant number of burn-related deaths, accounting for as much as 30%. The incidence of chemical burns, as reported in various studies, ranges from 2.4% to 10.7%, and they are more common among males.

In eight years, they identified 185 cases of chemical burns, which amounted to 7.9% of all burn cases. The average age of the patients was 40 years, ranging from 16 to 81 years, and there were 6.4 males for every female patient in this group.

3. Electrical Burns

Electrical burns result from contact with an electric current, causing damage to the body’s tissues. These burns possess unique characteristics due to the nature of electricity:

  • Causes damage beneath the skin, affecting muscles, nerves, and even internal organs.
  • Severity varies depending on voltage, duration of contact, and the path the electric current takes through the body.
  • Can lead to cardiac arrest, fractures, and neurological damage.

Causes of Electrical Burns

Cause

Description

Faulty Wiring

Damaged or exposed wires in buildings or appliances.

Electrical Appliances

Accidental contact with malfunctioning or wet electrical devices.

Power Lines

Contact with overhead or buried power lines.

Lightning Strikes

Direct or indirect strikes by lightning.

Industrial Equipment

Mishandling or accidents involving electrical machinery.

Based on data from the Electrical Safety Authority’s Ontario Electrical Safety Report (OESR) in 2021, the five-year average rate of electrocution, burn fatalities, and electrical fire fatalities has been consistently low, with less than one per million population since 2014. While there has been a general decrease in electrical fire and electrocution fatalities over the years, the most recent five-year average did show a slight increase.

4. Radiation Burns

Radiation burns result from exposure to different types of radiation, not heat or flames. Common sources include sunlight (UV rays) and medical X-rays.

Source

Description

Ultraviolet (UV) Rays

From the sun and tanning beds cause sunburn and skin cancer risks.

X-rays

Used in medical imaging; extended exposure can lead to radiation burns.

Nuclear Radiation

From nuclear accidents, radiation therapy, or radioactive materials.

Microwave Radiation

Rare but can cause mild skin damage when accidents occur.

Types of Burns

Burn injuries range in severity based on the depth of tissue damage, which in turn dictates the level of medical intervention required. To better grasp these distinctions and categorize them effectively, let’s explore the various types of burns:

1. First-Degree Burns

First-degree burns are superficial burns that affect only the outermost layer of skin, known as the epidermis. They are characterized by:

  • Redness
  • Pain
  • Skin Texture
  • Minimal Tissue Damage

Symptom

Example

Pain and discomfort

Sunburn: 

Overexposure to UV rays from the sun.

Redness and warmth at the burn site.

Mild Scalds:

 Brief contact with hot liquids or steam.

Mild swelling

Superficial Thermal Burns: 

Contact with a hot object for a short duration.

2. Second-Degree Burns

Second-degree burns, also known as partial-thickness burns, extend beyond the top layer (epidermis) and affect the skin’s second layer (dermis). Key characteristics include:

  • Formation of Blisters
  • Redness and Swelling
  • Intense Pain
  • Increased Tissue Damage

Symptom

Example

Intense Pain

Severe Sunburn: Prolonged sun exposure causing blistering.

Blisters

Scalds: Contact with hot liquids or steam causing partial-thickness burns.

Swelling

Deep Thermal Burns: Contact with hot objects, open flames, or scalding substances.

Severity levels of second-degree burns can be classified into two categories:

Superficial

Deep

  • Affect the upper dermis.
  • Blisters typically contain clear fluid.
  • Painful and red.
  • Commonly seen in sunburns and minor scalds.
  • Extend into the deeper dermis.
  • Blisters can contain blood or other fluids.
  • Severe pain and pronounced redness.
  • Typically caused by prolonged exposure to hot objects, open flames, or more severe scalds.

3. Third-Degree Burns

These burns extend through the entire thickness of the skin, damaging not only the epidermis and dermis but also underlying tissues, including muscles and bones. Key characteristics include:

  • Charred Appearance
  • Numbness
  • Little to No Pain
  • High Risk of Complications.

Symptoms:

  • The burn area can appear charred, white, or leathery.
  • Numbness due to nerve damage.
  • Minimal to no pain (although surrounding areas can be painful).

Common Examples:

  • Severe house fires with prolonged exposure.
  • Electrical burns.
  • Contact with extremely hot objects or substances.
  • Prolonged exposure to flames.

Extent of Tissue Damage in Third-Degree Burns

Tissue Damage Level

Extent of Tissue Damage

Epidermis

Completely destroyed.

Dermis

Completely destroyed.

Subcutaneous Tissue

Partial to complete damage.

Muscle

Partial to complete damage.

Bone

Partial to complete damage.

4. Fourth-Degree Burns

Fourth-degree burns are extremely rare but represent the most severe form of burn injury, extending beyond the skin layers to affect deeper tissues, muscles, and even bones. Fourth-degree burns are characterized by:

  • Complete Tissue Destruction
  • Charring and Numbness
  • High Complication Risk
  • Surgical Intervention
  • Life-Threatening

Comparison to Other Burn Types

Burn Type

Characteristics

Outcomes

Fourth-Degree Burns

Most severe, deep tissue damage, life-threatening

Extensive tissue damage, high risk of complications, surgical intervention needed.

Third-Degree Burns

Deep skin and tissue damage, potential complications

Severe tissue damage, numbness, risk of complications, and can require surgery.

Second-Degree Burns

Blistering, moderate pain

Pain, blistering, risk of infection, potential for scarring.

First-Degree Burns

Superficial, mild pain, minimal tissue damage

Mild pain, redness, minimal tissue damage, typically heals without scarring.

Prevention and Safety Measures

While first aid is valuable, prevention remains the most effective strategy. Creating a safe environment is far superior rather than dealing with the complexities of fire damage afterward. The following information outlines proactive measures to minimize the risk of a fire outbreak:

Home Safety

Preventing Burns

Fire Safety Measures

  • Install smoke detectors and check batteries.
  • Keep hot objects away from children.
  • Adjust water heater to prevent scalds.
  • Use oven mitts and pot holders.
  • Safely store flammable materials.
  • Install stove guards.
  • Be cautious with candles and heaters.
  • Maintain fire extinguishers.
  • Practice a fire escape plan.
  • Ensure everyone knows emergency numbers.
  • Keep flammable materials away from heat sources.
  • Regularly inspect and clean chimneys.

Workplace Safety

Hazards and Prevention

Electrical Safety Precautions

  • Identify and mitigate workplace burn hazards.
  • Implement safety protocols.
  • Provide burn prevention training.
  • Use proper electrical equipment.
  • Inspect cords and plugs.
  • Follow lockout/tagout procedures.
  • Wear personal protective equipment.

Child Safety

Childproofing Strategies:

  1. Use safety gates and outlet covers.
  2. Keep hot items out of children’s reach.
  3. Secure heavy furniture.
  4. Use safety locks on cabinets.
  5. Supervise near hot appliances.

Immediate Response to Burns:

  1. Remove from burn source.
  2. Cool with cold, running water.
  3. Cover with clean cloth.
  4. Seek medical help for severe burns.

 

Protective Gear Examples:

  • Helmets for sports and biking.
  • Safety goggles for work.
  • Fire-resistant clothing for firefighters.
  • Gloves for hot objects.
  • Reflective vests for roadside workers.
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