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I would like for you to research either burns in the work place in the work place. Your paper must be at least 2 pages with supporting details on the topic you picked to research. Make sure you list your references, all papers will be scanned and if plagiarize you will receive a ZERO.Attached are handouts that I received in class. This course is PTAC Safety, Health, & Environment. (Processing Technology)The paper should be on burns and hazards that Process technician may receive/encounter working in the field.
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Annals of Burns and Fire Disasters – vol. XXIV – n. 2 – June 2011
WORKPLACE-RELATED BURNS
Mian M.A.H.,1* Mullins R.F.,1,2,3 Alam B.,1 Brandigi C.,1,2,3 Friedman B.C.,1,3,4 Shaver J.R.,3,4
Hassan Z.1,2,3
1
2
3
4
Joseph M. Still Research Foundation at Doctors Hospital, Augusta, Georgia, USA
Joseph M. Still Burn Centers, Inc., Augusta
Joseph M. Still Burn Center at Doctors Hospital, Augusta
Acute Care Consultants, Inc., Augusta
SUMMArY. Introduction. The key element of a safe workplace for employees is the maintenance of fire safety. Thermal, chemical, and electrical burns are common types of burns at the workplace. This study assessed the epidemiology of work-related burn injuries on the basis of the workers treated in a regional burn centre. Methods. Two years’ retrospective data (2005-2006) from the
Trauma Registry of the American College of Surgeons of the Joseph M. Still Burn Center at Doctors Hospital in Augusta, Georgia,
were collected and analysed. Results. During the time period studied, 2510 adult patients with acute burns were admitted; 384 cases
(15%) were work-related. The average age of the patients was 37 yr (range, 15-72 yr). Males constituted the majority (90%) of workrelated burn injury admissions. The racial distribution was in accordance with the Centre’s admission census. Industrial plant explosions accounted for the highest number of work-related burns and, relatively, a significant number of patients had chemical burns.
The average length of hospital stay was 5.54 days. Only three patients did not have health insurance and four patients (1%) died.
Conclusion. Burn injuries at the workplace predominantly occur among young male workers, and the study has shown that chemical
burns are relatively frequent. This study functions as the basis for the evaluation of work-related burns and identification of the causes of these injuries to formulate adequate safety measures, especially for young, male employees working with chemicals.
Keywords: workplace, burns, epidemiology, aetiological factors, industrial plant explosion
Introduction
Burns in the workplace are a substantial social and
economic threat to individuals and families, as also to the
community. Despite numerous safety measures and guidelines, burns in the workplace continue to account for a a
considerable proportion of all burns.1 The key element of
a safe workplace for employees is to ensure fire safety.
Statistics presented by the Occupational Safety and Health
Administration show that in the US work-related fires and
explosions account for more than 5,000 burn injuries each
year. There are studies showing a substantially high number of burn injuries occurring in the workplace, ranging
from 10 to 45% of all burns.1-6 One study observed that
40% of all burn deaths were related to workplace fires and
explosions and that 20% of all cases of thermal burns in
admitted patients occurred at work.3 Another study reported
that 42% of all work-related injuries were burns.7 The National Census of Fatal Occupational Injuries reported that
in 2007 there were 617 work-related deaths in the US, of
which about 10% were fire- or burn-related. Death due to
electric burns was the most frequent cause (6%) of these
burns.8
A hospital-based study showed that with regard to the
causes of the accidents suffered by burn victims treated as
hospital in-patients, the majority of the accidents were
work-related.5 The study also showed that young workers
and African American workers experienced the highest
burns rate, which was respectively two and four times higher than that of their older and Caucasian counterparts.5 A
population-based national survey among the working-age
population (aged 18-64 yr) revealed that annually (19971999) work-related burns (3.3%) were almost twice as frequent as non work-related burns (1.8%).7
Within the working age population, employed men and
women sustained more work-related injuries than non
work-related injuries.7 Some of the common types of workrelated burn injuries include chemical, thermal, electrical,
contact, and scald burns.1,5 Reviewing the literature we noted that there was no comprehensive national surveillance
* Corresponding author: Mian M.A.H., MBBS, PhD, MPH, Joseph M. Still Research Foundation, Inc., 3675 J Dewey Gray Circle, Suite 200B, Augusta, GA 30909,
USA. Tel.: 01 706 3642966; fax: 01 706 3642878; e-mail: [email protected]
89
Annals of Burns and Fire Disasters – vol. XXIV – n. 2 – June 2011
system for occupational injuries and illnesses. Two studies mentioned that owing to the lack of a national comprehensive surveillance system for occupational injuries
and illness, the major source of US occupational health
data relied on the Bureau of Labor Statistics (BLS) annual survey of occupational injuries and illnesses, workers’
compensation records, and physician reporting systems.9,10
Our study is part of a continued epidemiological observation of work-related burns from the health care providers’
perspective in a regional burn centre.
Methods and materials
To complete this study, data from January 2005 until
December 2006 were obtained and reviewed from the Trauma Registry of the American College of Surgeons of the
Joseph M. Still Burn Center at Doctors Hospital in Augusta, Georgia. The working age population was considered to be patients aged 18 to 64 yr.7 The data retrospectively collected and analysed included information about
the age, sex, race, occupation, type of burn injury sustained, aetiology, percentage of total body surface area
(TBSA) affected, length of hospital stay (LOS), place of
occurrence, and insurance status of the various patients.
results
JMS Burn Center’s Census Caucasian
African American
Hispanic
Others
63%
33%
3%
1%
Fig. 2 – Racial distribution of the patients.
31% African American, 7% Hispanic, and 1% other (Fig.
2). The average percentage of TBSA burned was 6.5%
(SD = 9.67); 16 patients (4%) had injuries that involved
more than 25% TBSA, while 23% had injuries involving
1% TBSA or less. Industrial plants accounted for 111 cases (29%) of the burn injuries, followed by activities related to food preparation (restaurant / fast food / pizzeria):
58 cases (15%); working in electrical companies and stores:
56 (15%); and working in automotive servicing shops or
due to motor-vehicle accidents: 51 (13%) (Fig. 3).
During the time period studied, 3896 patients with
acute burns were admitted, of whom 2510 were between
18 and 64 years of age. Among these cohorts, 384 patients
(15%) sustained their burns at work.
Males accounted for the majority of work-related burns
(346, 90%) and their average age was 37.33 yr (SD =
11.22). Age and sex distribution are illustrated in Fig. 1.
The racial distribution was found to be 60% Caucasian,
Fig. 3 – Distribution of burns by workplace and sex.
Fig. 1 – Age and sex distribution of the patients.
90
Table I shows that burns sustained in a restaurant/fast
food/pizzeria were smaller in size (average, <5% TBSA) than burns that occurred in other workplaces, while patients who sustained burns while working in manufacturing or paper industries suffered extensive burns (average >60% TBSA). Categorizing by burn aetiology, hot water and grease
Annals of Burns and Fire Disasters – vol. XXIV – n. 2 – June 2011
Table I – Average percentage total body surface area burned by
workplace
Automobile
Chemical plant
Construction company
Electric appliance company
Restaurant/fast food/pizza
Manufacturing industries
Paper mills
Others
Mean
6.90
5.12
5.11
6.81
3.70
7.59
10.38
6.69
Minimum
0.00
1.00
1.00
0.00
1.00
0.00
2.00
1.00
Maximum
40.00
17.00
25.00
35.00
40.00
85.00
60.00
20.00
ed inhalation injuries were 7.16 times more likely LOS adjusted for age and pre-existing medical condition of the patients (Table II). The data showed that all but three of the
patients admitted were insured, 30 (7.8%) suffered respiratory injuries, and four patients (1%) died. Of the four
who died, one sustained 85% TBSA thermal burns due to
an explosion with inhalation, one had 56% thermal burns
from a flash fire with inhalation, one had a 4% scald with
inhalation, and the last one had a 4% electric burn. Only
six patients were admitted with less than 1% burns – these
had either inhalation injuries or electrical or chemical burns.
Discussion
Fig. 4 – Type of burns.
scalds accounted for 37% of all work-related burns, thermal burns 26%, chemical burns 16%, and electric burns
11% (Fig. 4). Chemical, electric, and friction burns accounted for 60% of all smaller burns (≤1% TBSA). The
total length of hospital stay (LOS) for the survivors was
2104 hospital days, which ranged from 1 to 183 days, with
an average of 5.54 days per patient. A multi-variable regression model showed that, for every 1% increase in TBSA, there was a 1.12-day increase in LOS, while associat-
Since the majority of previously published studies were
specifically industry- or occupational health-based, while
our study was performed using healthcare provider data,
an appropriate comparison could not be drawn. Our study
showed a lower proportion of work-related burn admissions (15%) than various previous studies, which reported
20-40% work-related burn admissions.5,7,11-13 The lower percentage in our study could be due to underreporting of
work-related burns to the health care providers. It is not
uncommon for hospital data to underreport work-related
burns, especially when the injuries involve domestic help
or undocumented immigrant workers.7,9,10 In previous studies, African Americans were found to have more work-related burns than their Caucasian counterparts.5,11,14 In our
study the racial distribution of workplace burns was consistent with the demography of the Centre’s patients (Caucasians to African Americans = 2 to 1) and no particular
race suffered an increased number of burns. Some of the
findings of this review are consistent with those of past
studies, such as the fact that young males were at greatest risk of burns at the workplace,1,5,15 and also that, in general, most of the patients admitted to our centre with chemical burns and scalds sustained their injuries at the workplace.1,5 Unlike some previous studies, ours considered
chemical burns separately, since we received a large number of patients with chemical burns. Sixteen per cent of
workplace-related burns were due to chemicals, compared
to an average of 3.92% over the last 10 years reported in
the burn centre chemical burns census.
Table II – Multiple variable linear regression of hospital length of stay
Variable
Age
Pre-existing medical conditioned (Yes/No)
Inhalation (Yes/No)
Percentage TBSA burned
Constant
Correlation Coefficient: r2 = 0.57
Coefficient
0.005
0.209
7.157
1.118
-2.447
SE
0.048
0.175
2.203
0.060
1.862
F-test
0.0108
1.4280
10.5558
343.0859
1.7263
p
0.917299
0.232864
0.001256
0.000000
0.189701
91
Annals of Burns and Fire Disasters – vol. XXIV – n. 2 – June 2011
The average TBSA of 6.5% in our study was low compared to many previous studies.2,16,17 This may be because
a large number of patients had chemical and electric burns,
and inhalation injuries. The average LOS in our patient
population was 5.54 days, which was lower than the 8.5
to 11.1 days reported in previous studies.1,5,16 The percentage TBSA burned was found to be higher in certain workplaces and with certain types of burns. Burns in manufacturing industries and in paper mills are relatively larger in size, most of them being due to explosions and flash
fire. Although there is a higher incidence of burns in workplaces like restaurants / fast foods / pizzerias, burns sustained in these places are relatively smaller in size and
depth.
In 1991, Personick reported that in restaurants, burns
accounted for 12% of work-related injuries.18 In our study
we found that 15% of all work-related burns occurred in
restaurants, including fast foods and pizzerias.
This retrospective review identified workplaces and
some aetiological factors associated with burns. It also
identified workplaces that might cause more severe burns.
Burn injuries sustained in manufacturing industries and paper mills tended to be more severe. Restaurant workers
were more likely to sustain smaller burns. Most of the explosion burns were severe – contact or mechanical/friction
burns were less severe.
Health care provider-based data are considered to be
the most authentic source for work-related injuries.7 Hospital- or employer-based injury data potentially underestimate the incidence. For instance, burns sustained by selfemployed persons, informal workers (e.g. housekeepers, undocumented immigrant workers), farm workers, and workers in small businesses may fail to report workplace-related injuries.19 The data used in this review were obtained
from our hospital records and we acknowledge the fact that
as a result of inadequate information on patients’ charts regarding the place of injury, our study may not include many
workplace-related burns treated in our Burn Centre.
conclusion
Workplace burn injuries predominantly occur among
young male workers, and this study has shown that chemicals and scalds are the leading causes. Contributory factors include inexperience, failure to enforce safety regulations, inadequate training of employees with regard to handling bio-hazardous materials, and employee non-compliance. This study can serve as the basis for the evaluation
of work-related burns. Identification of the causes of such
injuries helps to formulate adequate safety measures, especially for young male employees who work where chemicals are widely used.
LES BrÛLUrES LIÉES AU LIEU DE TrAVAIL. rÉSUMÉ. Pour la population active, l’élément clé de la sécurité au lieu de
travail dépend de l’efficacité de la protection anti-incendie. Les brûlures thermiques, chimiques et électriques sont les brûlures les
plus typiques au lieu de travail. Sur la base d’une analyse des travailleurs traités dans un centre régional des brûlés, les Auteurs
ont évalué l’épidémiologie des brûlures qui se produisent au lieu de travail. Méthodes. Les Auteurs ont collecté et analysé deux
ans de données rétrospectives (2005-2006) qu’ils ont trouvées dans le Registre des Traumatismes du Collège Américain des Chirurgiens au Centre des Brûlés Joseph M. Still à l’Hôpital Doctors (Augusta) en Géorgie. Résultats. Au cours de la période étudiée,
2510 patients adultes atteints de brûlures graves ont été admis, dont 384 (15%) en relation à un accident au lieu de travail. L’âge
moyen des patients était de 37 ans (variation, 15-72 ans). La majorité (90%) des patients hospitalisés à cause de brûlures subies
au lieu de travail étaient du sexe masculin. La répartition raciale était conforme aux données du recensement du Centre. Les explosions des installations industrielles ont représenté la proportion la plus élevée des brûlures liées au travail et conséquemment un
nombre important de ces patients présentaient des brûlures chimiques. La durée moyenne de l’hospitalisation était de 5,54 jours.
Seulement trois patients n’avaient pas d’assurance maladie et quatre patients (1%) sont décédés. Conclusion. Les brûlures subies
au travail se produisent principalement chez les jeunes travailleurs du sexe masculin, et l’étude a montré que les brûlures chimiques
sont relativement fréquentes. Cette étude sert comme base pour l’évaluation des brûlures liées au monde du travail et pour l’identification de leurs causes dans le but de formuler des mesures de sécurité adéquates, en particulier pour le personnel du sexe masculin qui travaille avec les produits chimiques.
Mots-clés: lieu de travail, brûlures, épidémiologie, facteurs étiologiques, explosion dans les installations industrielles
BIBLIoGrAPHY
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This paper was accepted on 18 May 2011.
G. WHITAKEr INTErNATIoNAL BUrNS PrIZE-PALErMo (Italy)
Under the patronage of the Authorities of the Sicilian region for 2013
By law n.57 of June 14th 1983 the Sicilian Regional Assembly authorized the President of the Region
to grant the “Giuseppe Whitaker Foundation”, a non profit-making organisation under the patronage of
the Accademia dei Lincei with seat in Palermo, a contribution for the establishment of the annual G.
Whitaker International Burns Prize aimed at recognising the activity of the most qualified experts from
all countries in the field of burns pathology and treatment.
Law n° 23 of December 2002 establishes that the prize becomes biannual.
The next prize will be awarded in 2013 in Palermo at the seat of G. Whitaker Foundation.
The amount of the prize is fixed at Euro 20,660.
The Adjudicating Committee is composed of the President of the Foundation, the President of the Sicilian Region, the Representative of the National Lincei Academy within the G. Whitaker Foundation,
the Dean of the Faculty of Medicine and Surgery of Palermo University or his nominee, a Representative of the Italian Society of Plastic Surgery, three experts in the field of prevention, pathology, therapy
and functional recovery of burns, the winner of the prize awarded in the previous year and a legal expert nominated in agreement with the President of the …
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