title: Ten-year epidemiology of chemical burns in western Zhejiang Province, China.
abstract: BACKGROUND
  Chemical burns occur frequently in western Zhejiang Province. This study documents the epidemiology of chemical burns in the region using burn data from a local specialized hospital. Results from this analysis will assist in the planning of prevention strategies for high-risk occupations and groups.
  
  
  METHODS
  A 10-year retrospective analysis was conducted for all patients with chemical burns admitted to the Department of Burn and Plastic Surgery from January 2004 to December 2013. Information obtained for each patient included demographics (gender, age, occupation and education), location of the burn, cause of the burn, and categories of chemicals. Data regarding the season of admittance, prehospital treatment, wound site/size (area, region, and depth), accompanying injuries, operations, length of hospital stay and mortality were also assessed.
  
  
  RESULTS
  A total of 690 patients (619 males, 71 females; average age: 30.6±12.4 years) were admitted to the department for chemical burns. Over the 10-year period, the incidence of chemical burns showed an increasing tendency. Chemical burns occurred most frequently in patients aged 20-59 years (94.79%). Most of the chemical burns were work-related, primarily in private enterprises (47.97%) and state-owned enterprises (24.93%). Operations (68.99%) and machine problems (17.26%) were the main causes of chemical burns in the workplace. With regard to burns caused by chemicals, most were caused by acids (72.01%), with hydrofluoric acid and sulphuric acid causing 51.45%. Most chemical burns occurred in the summer and autumn seasons (61.02%). The burn size was <10% of the total body surface area (TBSA) for 445 patients (64.49%), while only 26 patients (3.76%) had burns covering >40% TBSA. The most common burn sites were the upper extremities (31.57%), lower extremities (19.86%), and head and neck (28.83%). Most patients (581 (84.20%)) received water washing treatment on site immediately after exposure. The most common accompanying injuries included inhalation injury, ocular burns and digestive tract injury. The average hospital stay was 17.0±23.1 days (range 1-333 days). Surgery was performed in 146 patients (21.16%), and the overall mortality rate was 0.58%.
  
  
  CONCLUSIONS
  Chemical burns are preventable. The high morbidity of chemical burns in western Zhejiang Province is related to the industrial structure of the area. Governmental management in the fields of production, transportation, and utilization of chemicals could be improved. Workplaces have the responsibility to provide safe work environments and equipment, as well as occupational education and safety training for high-risk work groups.
authors.affiliation: Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China.
authors.forename: Chunjiang
authors.initials: C
authors.lastname: Ye
authors.affiliation: Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China. Electronic address: wxg8157@gmail.com.
authors.forename: Xingang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China.
authors.forename: Yuanhai
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China.
authors.forename: Liangfang
authors.initials: L
authors.lastname: Ni
authors.affiliation: Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China.
authors.forename: Ruiming
authors.initials: R
authors.lastname: Jiang
authors.affiliation: Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China.
authors.forename: Chunmao
authors.initials: C
authors.lastname: Han
mesh_terms: D000143:Acids / Q000009:adverse effects; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000468:Alkalies / Q000009:adverse effects; D001830:Body Surface Area; D002057:Burns, Chemical / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D002648:Child; D002681:China / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006760:Hospitalization; D006801:Humans; D006858:Hydrofluoric Acid / Q000009:adverse effects; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D017678:Sex Distribution; D013464:Sulfuric Acids / Q000009:adverse effects; D055815:Young Adult
chemical_list: D000143:Acids; D000468:Alkalies; D013464:Sulfuric Acids; C033158:sulfuric acid; D006858:Hydrofluoric Acid
keywords: Chemical burns; Epidemiology; Occupational education; Prevention; Survey