Annals
of the M.B.C. - vol. 1° - n° 1 - September 1987
THE PREVENTION OF ACCIDENTAL BURNS AT
HOME:
A PROPOSAL FOR A NEW PROTOCOL
Brienza E, Di Lonardo k Minervini C,
Portincasa -K
Università di Bari
Istituto di chirurgia d'urgenza e chirurgia plastica - Cattedra di Chirurgia plastica
Chief: Prof. Dioguardi D.
SUMMARY. A
statistical survey carried out by the authors in four Bum Centres in Southern Italy in the
years 1983-85 showed that:
+ the home was the most frequent site for accidental burns
+ the population groups most exposed to bums were children aged 0 to 14
years, and adult women.
Considering that prevention is possible in 90% of cases, the authors have prepared a
programme of social education aimed at reduc the frequency of accidental bums in the home.
On the basis of statistical findings two "TARGET POPULATIONS" were identified:
1) INFANTS AND CHILDREN (0-14 YRS)
2) ADULT WOMEN.
For Target 1 the programme provides for
+ CAMPAIGN IN KINDERGARTENS, NURSERY SCHOOLS, PRIMARY AND SECONDARY
SCHOOLS
+ CAMPAIGN ON TV DURING AFTERNOON PROGRAMMES
+ CAMPAIGN IN PUBLICATIONS FOR CHILDREN
For Target 2 the programme provides for
+ PREPARATION OF INFORMATIVE LEAFLETS, PAMPHLETS, POSTERS TO BE
DISTRIBUTED IN PLACES MOST FREQUENTLY VISITED BY THIS TARGET GROUP
I.E., BANKS, SUPERMARKETS, CHEMIST'S SHOPS, BABY GOODS SHOPS
+ CAMPAIGN ON TV AT PEAK VIEWING HOURS
+ CAMPAIGN IN MAGAZINES AND NEWSPAPERS
Considering the extreme usefulness of the programme both socially and from the
cost/benefit viewpoint, the authors believe that it can be
realized without great difficulty in all cuontries of similar social structure.
The prevention of
accidental burns at home: a proposal for a new protocol
For the victim a bum lesion represents an extremely
traumatizing illness, both physically and psychologically.
In the acute phase the patient is subjected to long and stressful periods of
hospitalization with repeated surgery, often followed by further operations to remove scar
tissue that has formed.
This causes the patient great suffering and interferes, sometimes irrevocably, with his
return to a normal social and working life.
The problem is all the more dramatic among children. At this age the bum lesion has
extremely serious after-effects that are both physical (disfiguring and disabling scars)
and psychological, with profound effects on the inner stability of the child and the other
members of his family.
Another important factor is the enormous social cost of the immediate and long-term
treatment that these patients require.
Faced with such a reality, many burn surgeons have become aware of the importance of a
programme of social prevention as a means for reducing the frequency of accidental bums.
It has indeed been shown that appropriate prevention could be successful in over 90% of
cases (2, 4, 5, 6, 8, 10, 11).
We thus think it may be useful to express our own opinion with regard to the creation of a
programme of prevention of accidental bums in the home.
For such a prevention programme to be fully effective, it is extremely important to
identify the situations at risk, the age ranges of the population most exposed, and the
ways of getting the prevention programme across (1, 5, 7, 9, 10). Obviously there can 'be
no single standard campaign of information - each country presents variable factors; even
regions within ne and the same country, such as
- social and economic conditions
- educational level
- impact of mass media
- customs and usages
- environmental factors.
A pilot research project carried out in four Burn Centres in Southern Italy in the
years 1983, '84 and '85 showed that the age range most atYected was be tween 0 and 14
years (44.9%), compared to 40.2% for adults (15-50 years) and 14.9% for the elderly (over
50 years) (Fig. 1).
Regarding the places where accidental bums most frequently occur, with respect to age, it
was found that among children - both boys and girls - the highest percentage of bums
occurred in the home.
The same finding was true also for adult women, while adult men had more accidental burns
at work.Also among the elderly, the home was the most frequent site of bum accidents (Fig.
2). We assessed the most frequent causes of acciden tal bums, with relation to age. Among
children the most frequent causes were boiling liquids, in particular water (Fig. 3).
The main reason for the high accident rate among &A children is the failure on the
part of the parents to observe the most elementary standards of safety and care in the
interest of the children (e. g. boiling liquids in containers within easy reach of the
child).
The second most frequent cause of bums is in-flammable substances (surgical spirit,
petrol, ether). These substances are frequently rashly used to revive barbecue fires and
open fires in the home.
With regard to bums by fire, a
very common cause in our region is burning coal, especially in the hinterland areas, due
to the use of open braziers to warm the house.
Chemical and electric bums constitute a significant percentage only among accidents at
work and, in view of the comparatively low degree of industrialization in southern areas,
they are rather infrequent (Fig. 4).
In the light of the above findings it is clear that:
a) the home is the most frequent site for the occurrence of accidental bums;
b) the age ranges most affected by bums are 0-14 years (both sexes) and adult women (15-50
years).
For these reasons we therefore examined the possible strategies to reach what we defined
as the "TARGET POPULATIONS" i. e. infants, children and adult
women.
|
Liquids |
Inflammable |
Fire |
Chemical
Eletrical
others |
TOTAL |
Domestic |
52.2 |
10.7 |
12.3 |
1.6 |
76.6 |
Work |
1.9 |
6.2 |
6.0 |
2.1 |
16.2 |
Road |
0.1 |
2.5 |
1.0 |
0.5 |
4.1 |
Others |
0.7 |
0.8 |
0.9 |
0.5 |
2.9 |
|
CAUSES - SITE OF
INCIDENT (%) |
|
Such a campaign musthave
the greatest possible impact on these "TARGETS", bearing in mind the continual
physical and psychological variations between the age ranges.It is therefore necessary to
use appropriate language so as to stimulate the interest of the child without arousing in
him the curiosity to explore the forbidden.
However, it is the parents who, above all, must be made aware of the problem so that they
can train their own children.
However, it is the parents who, above all, must be made aware of the problem so tht they
can train their own children.
A proposal for a
Campaign of prevention of accidental burns in the home
The following
is a proposal for the creation of a campaign of prevention of accidental bums at home.
Objective
The prevention campaign is
aimed at what we define as "TARGET POPULATIONS":
CHILDREN AGED 0 TO 14 YEARS
ADULT WOMEN
Strategy
The realization of such a campaign
must take into account two fundamentally important problems if it is to be really
effecive:
a) the need to use language appropriate to the "population" of infants and
children,. considering the continual physical and psychological developments in this age
range;
b) the most advantageous possible cost/benefit ratio at the moment of actual realization
of the campaign.
The most effective means of reaching the "TARGET POPULATIONS" are, in our
opinion:
Target 1
+ CAMPAIGN IN KINDERGARTENS, NURSERY
SCHOOLS, PRIMARY AND JUNIOR SECONDARY SCHOOLS
+ CAMPAIGN ON TV DURING AFTERNOON PROGRAMMES
+ CAMPAIGN IN PUBLICATIONS FOR CHILDREN
Target 2
+ PREPARATION OF INFORMATIVE LEAFLETS, PAMPHLETS, POSTERS TO BE DISTRIBUTED IN PLACES MOST
FREQUENTLY VISITED BY THIS TARGET POPULATION I.E
BANKS
SUPERMARKETS
CHEMIST'S SHOPS
BABY GOODS SHOPS
+ CAMPAIGN ON TV AT PEAK VIEWING HOURS
+ CAMPAIGN IN MAGAZINES AND NEWSPAPERS
This programme will be
realized with the collaboration and financial backing of regional and provincial
institutions involved, and, if available, of private associations with humanitarian
objectives (Rotary Club, Lions etc.).
Programme
Target (1) children aged 0 to 14 years A) CAMPAIGN IN KINDERGARTENS
Information will be directed mainly at the mothers.
Periodic meetings will be held at which specialist physicians and Italian Red Cross
assistants will describe clearly and effectively all risks in the home, ways of preventing
the commonest accidents, and basic first aid.
Colour slides, leaflets and other illustrative material must be used to integrate this
campaign.
B) CAMPAIGN IN NURSERY AND
PRIMARY SCHOOLS
It is certainly more difficult nowadays to stimulate children's interest in a problem such
as domestic accidents and a totally new approach is required. This TARGET is exposed to
all sorts of new stimuli - electronic games, computerized cartoons etc. - in view of which
the school campaign will make use of
- puppet theatres for children up to 5/6 years
- mimes who will "tell" different stories for children
between 6 and 10 years.
All this will need the support of pedagogists, specialist physicians and Italian Red Cross
assistants.
C) CAMPAIGN IN JUNIOR
SECONDARY SCHOOLS
For the I I to 14 year age-range, educational programmes can be prepared in collaboration
with the teaching staff responsible for civic education, during school hours.
Simulations can be carried out with the aid of technical teachers, the local fire brigade
and specialist physicians.
The pupils themselves in this case can help to produce posters, folders and colour slides.
D) TV CAMPAIGN
Television is beyond any doubt the most effective way of stimulating the interest of this
target group.
Information can be put across through cartoons, films etc. on both national and regional
TV channels, as well as local networks. In this way the message can be made simple and
clear and thus more likely to achieve effective results.
E) PRESS CAMPAIGN
Our programme can also be promoted by the press. The attention of children can be drawn by
using the same characters as in cartoons and TV series and showing them in comic strips. A
competition can be organized on the theme, with prizes being awarded for the most
deserving and most meaningful drawings or paintings. These could then be used for the
preparation of a travelling exhibition in the schools.
Target (2), adult women.
A) INFORMATIVE LEAFLETS, PAMPHLETS AND
POSTERS
The information directed at this target group must be carefully prepared if it is to be
fully effective.
All aspects of a programme of information must be assessed, and it must be borne in mind
that means of communication prepared for children must at the same time involve also
mothers.
It is also clear that mor,:- detailed information will be required about ways of
prevt,.Jing accidents and about the need to train children.
Propaganda material will be distributed in places most frequently visited by women (banks,
chemist's shops, supermarkets, baby goods shops).
B) TV CAMPAIGN
Short mini-serials can be prepared on the subject of prevention and training to be shown
during peak viewing hours and/or after children's programmes.
C) PRESS CAMPAIGN
The same subjects and the same characters used in the TV campaign will appear in daily
newspapers and periodicals.
Realization of the campaign
TIME REQUIRED
The complete programme will take 6 to 8 months for realization and actual performance.
ORGANIZATION
A working commitee will have to be set up, consisting of:
+ a scientific and technical commitee including
the promoters of the programme and technical/ scientific experts;
+ an executive commitee to put the programme
into operation.
CONCLUSION
On the basis of our studies we are convinced of the necessity of an educational campaign
directed at "TARGET POPULATIONS" in order to achieve effective prevention of
accidental bums.
Our message is aimed at high risk categories identified on the basis of epidemiological
studies carried out in our region.
Considering-the high social value of such a programme, also in terms of cost/benefit
ratio, we believe that it can be realized without great difficulty in all countries and
areas that are socially similarly exposed to the same risks.
RÉSUMÉ. Une
enquête statistique réalisée par les auteurs dans 4 Centres pour les Brûlés dans
l'Italie Méridionelle pendant les années 1983-85 montre che
+ c'est la maison l'endroit plus fréquent pour les brûlures
accidentelles
+ les groupes de population plus exposés aux brûlures sont les
enfants âgés de 0 jusqu'à 14 ans, et les femmes adultes.
Vu che la prévention et possible en 90% des cas, les auteurs ont préparé un programme
d'éducation sociale avec le but de réduire la fréquence
des brûlures accidentelles dans la maison.
Sur la base des résultats statistiques on a identifié deux "POPULATIONS
CIBLE":
1) LES ENFANTS (0-14 ANS)
2) LES FEMMES ADULTES.
Pour le premier groupe le programme indique:
+ CAMPAGNE DANS LES ECOLES MATERNELLES, LES ECOLES ELEMENTAIRES ET
SECONDAIRES
+ CAMPAGNE EN TELEVISION PENDANT LES PROGRAMMES DE L'APRES-MIDI
+ CAMPAGNE DANS LES PUBLICATIONS POUR LES ENFANTS.
Pour le second groupe:
+ PREPARATION DE PROSPECTUS, BROCHURES ET AFFICHES D'INSTRUCTION POUR
DISTRIBUER DANS LES LIEUX PLUS FREQUEMMENT VISITES PAR CE GROUPE,
C'EST-A-DIRE:
BANQUES
SUPERMARCHES
FARMACIES
BOUTIQUES ET MAGASINS QUI VENDENT LES OBJETS
NECESSAIRES AUX BEBES
+ CAMPAGNE EN TELEVISION PENDANT LES HEURES DE GRAND PUBLIC
+ CAMPAGNES DANS LES REVUES ET LES JOURNAUX.
Vu l'extrême utilité du programme et socialement et du point de vue coût bénéfice,
les auteurs croient qu'il peut être réalisé sans grande difficulté dans tous les pays
ayant une structure sociale semblable.
BIBLIOGRAPHY
- Glasheen W.P., Attinger E.D., Anne
A. et al.: identification of high risk population for serious bum injuries. Burns, 9; 3
193/200, 1983.
- Gunay Medha: bums prevention in
Europe. A report of a study tour 1982. Burns, 9; 5 312/317, 1983.
- Bowger B.H., Aldwell F.T., Baker
J.A., Walls R.C.: Statistical methods to predict morbidity and mortality: self assessment
techniques for bums units. Burns, 9; 5 318/326, 1983.
- Scatafassi S.: Burn prevention.
Organization of information as a social service. Riv. Ital. Chir. Plast. 3, 253/258, 1981.
- Apesos L, Dawson BK, Law E.J.:
Comparative statistical methods in the analysis of bum victims. Burns, 6; 81, 1980.
- Tapp T., Abude E., Brindza E.,
Ferendzi K_ Kincs M_ Lincsel E.: The health education of in-patients on the prevention and
first aid of burns. Burns, 5, 92/93, 1978.
- Keswani M.H.: A decade in the field
of bum prevention. Burns, 5 5/7 1978.
- 'Ya H.O., Ohmori S.: Most bums are
preventable. Burns, 5, 8/11, 1978.
- 'Ya H.O.: The characteristics of
bums of the elderly and the preventive measures for burns. Med. Accident, 12, 610 1978.
- Gordon P.G., Pressley T.A.: The tire
hazard of children's night wear; the Australian experience in developing clothing fire
hazard standards. Bums, 5, 12, 1978.
- Gardner AW., Foster S.: Teaching
safety, accident prevention and first aid in school. Burns, 2, 204/206, 1976.
- Skoog T.: The surgical treatment of
bums. Stoccolma Al. e W. e; 1963.
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