Investigating the factors related to burns in children aged 1-6 years who referred to the training and treatment center for burn accidents in Rasht city in 2019.

Shahid Beheshti Rasht Nursing and Midwifery

Summary

Introduction: Burns are one of the most important accidents that threaten the health of children, among the most common injuries and the third cause of death in this age group. Considering the cultural, social and climatic differences in different societies, it is very important to investigate the factors related to burns in each region.

The purpose of this research is to determine the factors related to burns in children aged 1-6 years who refer to the burn accident training center of Rasht province.

Materials and methods: The current research is a cross-sectional comparative study. The research samples are 350 children aged 12 months to 6 years, who were admitted to education and treatment centers of Velayat and 17 Shahrivar, Rasul Akram, Gil and Aria hospitals. Of these, 175 people were examined as the group of children with burns and 175 people as the group of children without burns. The sampling method in both groups was gradual. In order to collect data, a questionnaire including three parts of personal, family and environmental characteristics was used. After collecting information, data were analyzed by SPSS 16 software with Mann-Whitney U, Kaido, Fisher's exact test, and multiple logistic regression.

Results: The results of the research showed that among the individual factors, the child's age, the place where the child spends most of his time, and among the family factors, the mother's age, the father's education level, the monthly income level, and among the environmental factors, the substructure of the house, the number of rooms Sleep, type of kitchen, away from the availability of fuel and flammable materials and detergents, there was a statistically significant difference between the two groups.

Final conclusion: according to the findings of this research, the possibility of burns in young children who spend most of their time in the bedroom, who have young mothers and fathers with a low level of education and low-income families, is also more likely to burn in children who live in houses with an open kitchen, under a high building and They live in fewer rooms and have more access to flammable and detergent substances.

Keywords: burns, risk factors, children

Field of research

Injuries are the most common cause of death during childhood and adolescence after the first few months of life and represent one of the most important preventable causes of death and disabilities in pediatrics. (1). Accidents are always an important and at the same time complex challenge for children's health system. According to statistics, between 20-30% of the victims of accidents in general hospitals and emergency rooms are children under 16 years of age (2). Due to their growing tissues, children are completely vulnerable to environmental hazards and diseases, and in adulthood they suffer from complications caused by childhood injuries. Two-thirds of adult diseases are related to people's lives in childhood and adolescence in environments that endanger health (3). Although unintentional accidents in developing countries include a smaller part than in developed countries, the existence of disability and unhappiness caused by it has basically provided a depressing situation for children in order to flourish and become healthy, creative and cheerful adults (1). A child's developmental stage can predict the types of injuries that are most likely to occur. So that a curious toddler may experience falling and bumping into objects, and as soon as he enters the next stage of development, he is exposed to environmental injuries such as traffic accidents and burns due to playing (4). According to the definition of the World Health Organization (WHO) [1], burn injuries are intentional and unintentional injuries caused by exposure to heat, electricity, and chemicals (7) Burn injuries are one of the causes of death in developed and developing countries and cause significant financial and life losses to patients and their families in different societies (10,9,8).

        Normally 5% of the admission of patients in hospitals is due to burn injuries (8). According to the latest report of the World Health Organization and UNICEF [2] (2009), burns caused by fire are the cause of death of about 96,000 children per year (11), of which 11% of deaths are reported in children under 5 years of age (1). The death rate due to burns in low and middle income countries is 11 times that of high income countries (11), which is 4.3 per 100,000 people compared to 0.4 per 100,000 people. Also, in developed countries, the hospitalization rate of burn cases is higher in children under 5 years old (12). Every year in the United States, 1.2 million people require medical care due to burns. Approximately 30-40% of these patients are under the age of 15, whose average age is 32 months. (13,14,1) Of these, 3000 children die every year due to burns. Also, every year, 3.5 billion dollars are spent on the treatment of burn patients (14,13,8). In Iran, burn injuries are one of the most important causes of death (15). According to the statistics announced by the Ministry of Health and Medical Education in 2016, more than 100,000 burn cases are treated annually in Iran, of which the share of children is more than (50%). They also stated that the incidence of burns is more than this number, but due to self-treatment at home, accurate statistics are not available. The head of the accident and accident prevention department of the Ministry of Health also stated: According to the latest national statistics, the most common accident among children under 10 years of age is burn accidents with a prevalence of 6.48% of all accidents, and burn accidents have the highest death rate (16). According to the statistics available in Gilan Burn Accident Hospital in 2017, out of 7341 people admitted to the hospital, 334 were children under six years of age (17). Meanwhile, the population of children aged 1-6 in Gilan province is 176,145 (18). A study by Hadian Jezi et al. (2011) in Tehran showed that the highest incidence of burns was in children aged 5 and under and they reported the mortality rate of children as 4.8% (19). The prevalence of burns is also different in boys and girls. According to the statistics reported by UNICEF, burns in girls are 4.9 per 100,000 people compared to 3 per 100,000 boys (12).

         Mukarogwiza [3] writes in 2009 that many factors play a role in the occurrence of children's burns, and in recent studies more attention has been paid to individual, family and home environment factors (20). Parbhu et al.[4] (2009) in their study stated that paying attention to individual and family characteristics, community and health policies and laws of the country are very important to reduce burn risk factors (21).

(24,23,22,12). These children reach here and there, run, climb, put their fingers in any hole, spill and splash, take objects out of their places and take almost everything they see into their mouths (25), this natural learning process causes them to come into contact with objects that can cause them to burn (12). In this way, children experience the first accident inside the home (28,27,26) and among the various accidents that occur at home, burns are the most common accident at home for children and infants (29,28,26). In the studies conducted, among the set of factors affecting children's burns at home, the absence of a clear boundary for the kitchen and the presence of a large number of rooms are among the reasons for the increase in the incidence of burns in children (30). Approximately 75% of burns in young children are caused by hot water and steam (12), which often occur during daily activities such as bathing and cooking (32, 31). Berman [5] (2018) also writes: more than 90% of children's burns occur due to parental negligence (1). Nutter [6] (2009) and Chester [7] (2006) also emphasized in their study on informing parents about the dangers in the home environment and preventing burns (33,32). The risk of burns is higher in children who live in crisis and stressful families (34). So that approximately 18% of burns are due to misbehaving with children, such as making them hot (1).