of the M.B.C. - vol. 1° - n° 1 - September 1987
THE PREVENTION OF BURNS IN PEDIATRICS:
10 YEARS'ACTIVITY IN THE CESENA AREA
Landi G., Arcangeli F.
Divisione Dermatologica - Centro Ustion Ospedale Sufalini - U.S.L. N. 39 -
SUMMARY. In 1987 and 1978 a
domestic burns prevention campaign was organised in the area of Cesena and 10 years later
the epidemiological data were compared and reported.
A substantial reduction of bum morbidity was observed in the resident population, but not
in the non-resident population.
The morbidity reduction was very important in resident children, in accordance with the
Much has been written about the high
frequency of bum accidents in children and the seriousness of the clinical and
psychological consequences which burning can cause in subjects at a critical stage of
investigations in Italy and abroad have shown that among children burn accidents occur
most frequently at home, and mainly involve contact with hot liquids. This finding is
confirmed by a statistical analysis of the cases observed at the Divisione Dermatologica
of Cesena Hospital.
Between October 1969 and
December 1986 a total of 2,417 cases were admitted here, 961 being children under age 14
years, equal to 39% of all the cases (Tables I and 11).
Bums at work constituted no
more than 21% of the total, most cases (71%) occurring at home, with a particulary high
rate among pre-school infants and schoolchildren (95%). In this age-range burns were
caused by hot liquids in 73% of cases and by flame in 19%. In the latter category, the
most frequent cause was the use of surgical spirit by the children in imitation of adults
in order to light or revive e fire.
In such an important field of
collective pathology, the epidemiological investigation underlines the absolute need for
preventive measures, since bum accidents - as indeed all accidents in general - are
strongly conditioned by human behaviour patterns. The high frequency of bums in children
is also attributable to behaviour patterns typical of the age, such as the wish to
explore, inexperience, overestimation of personal capabilities, thoughtlessness and the
tendency to imitate adults, who themselves with regard to children are responsible for
acts of carelessness and unawareness of environmental risks.
As a follow-up to our first
epidemiological analyses and on the basis of the above considerations we organized in 1977
and 1978 a campaign for the prevention of burns in the home, with particular regard to
pre-school and school age. This campaign was carried out -in the area covered by the
U.S.L. N. 39,
Cesena, with a population of about 175,000 inhabitants.
Cases 1969 - 1986
2417 Burn patients
|Place of accidents
961 Burn Patients aged up to 14 years (39% of total number)
|Place of accident and cause
Flame (61% from surgical
In collaboration with
assistants of the School Medical Service we gave a series of informative lessons at
nursery, primary and junior secondary schools, using specially prepared audiovisual aids.
In order to stimulate the interest of the parents we also used local information media
(newspapers, radio and TV stations).
Our illustrative material was
deliberately clear and straight forward so that it should be immediately understood by the
children. There were pictures of risk situations due either to personal behaviour or to
environmental factors. The accidents themselves and their dramatic consequences were
however never stressed (Figs. 1 and 2).We checked the actual utility of our campaign, with
a view to extending and renewing it, by comparing the epidemiological data of the years
1980, 1983 and 1986 with those of 1976, the year immediately before the campaign began.
The statistical data
of the last 10 years and a comparison of the sample years show (Fig. 3) that the burn
morbidity rate in our territory, on the whole, gradually dropped: there were 95 cases in
1976, 38 in 1980, 25 in 1983 and 18 in 1986 (- 81% compared to 1976). In contrast the
number of bum patients not residing in our territory who came to our attention increased
in the same period as follows: 93 in 1976, 109 in 1980, 110 in 1983 and 100 in 1986 (+ 8%
compared to 1976).
The number of bum patients
aged 0-14 years resident in our territory (Fig. 4) dropped sharply by 77% in 1980 and 90%
in 1983 and 1986. Non-resident patients in the same age range, taken as a reference
control group, showed an increase of 48% in 1980 and only a small decrease in 1983 and
1986 (- 15%).
These results clearly
indicate a reduction in the bum morbidity rate in residents in the Cesena area in the
years subsequent to the prevention campaign. This reduction is present among adults but it
is particulary clear and marked among residents of pediatric age.
This is in agreement, at
least apparently, with the angle we gave to our compaign, which was particularly aimed at
infants and children of compulsory school age.
Morbidity in general is
affected by numerous variables that are only partially known and always difficult to
quantify. Thus, with particular reference to bum pathology, it is difficult to assess to
what extent the reduction in the number of cases in our territory can be attributed to the
success of our prevention compaign.
However, the statistical
findings that we collected, even in the limited geographical area that comes under our
Centre, do seem to confirm and reinforce in their homogeneity over a 10 - year period the
widespread conviction of the usefulness of basic prevention campaigns with regard to burn
morbidity, as also of every appropriate initiative of public information.
RÉSUMÉ. Pendant 1977 et
1978 on a organisé dans la zone de Césène une campagne pour la prevention des brûlures
domestiques, et à
distance de 10 ans les données épidémiologiques out été confrontées et décrites.
On note une importante diminution de la morbidité des brûlures chez la population
résidante, mais non pas chez la population non-résidante.
La diminution de la morbidité était très importante chez les enfants résidants,
d'accord avec les buts de la campagne,
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