Almost 9 million people globally are injured by fire, heat, or hot substances, according to an international analysis published today. Additionally, more than 120,000 individuals around the world will die as a result of their injuries.
The findings are part of the annual Global Burden of Disease (GBD), an international assessment that “quantifies health loss across places and over time” in 195 countries in 2017. Researchers at the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine write in BMJ Injury Prevention that it is the first to quantify how many injuries occur from heat-related accidents like fires, explosions, smoke exposure, or contact with hot substances in an attempt to address future accidents.
"Prevention should be the first priority in reducing the intolerable number of injuries and deaths," said Dr. Spencer James, senior author on the study and Lead Research Scientist at the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine, in a statement. "Especially as treatment for burns and related injuries remains relatively expensive and requires robust health care services not often available in low- and middle-income countries."
Eight countries in particular – including the US – accounted for half of all heat-related deaths. It is important to note that the study does not include deaths associated with heatwaves, climate change, self-immolation, or interpersonal violence such as an acid attack. Injuries and death disproportionately kill the very young very old with the biggest burden seen in low- and middle-income countries. Generally, the leading cause of injury across the board being burns that affect less than 20 percent of the body. Just a small proportion of injury was attributed to burns affecting more than that.
"It is imperative that health policymakers study these patterns to help inform safety efforts, prevention programs, and resource planning," said James. "But more research is still needed on smoking, types of cooking fuel, smoke alarm efficacy, synthetic clothing, and other factors leading to these injuries."
In order, the countries with the most injuries and death include India, China, Russia, US, Nigeria, Pakistan, the Democratic Republic of Congo, and Ethiopia. Seychelles saw the greatest risk with 1-in-15 injuries related to heat resulting in death, followed by Laos (1-in-17). Singapore saw the lowest risk of injuries resulting in death among all nations at just 1-in-1,000, followed by Indonesia and Malaysia.
In the US, the states experiencing the highest death rates per 1,000 people were Alabama (3.7), Mississippi (3.5), South Carolina (3.2), Kentucky (3.1), Arkansas and Tennessee (2.9), West Virginia (2.8), Louisiana and Maine (2.7), and Oklahoma (2.6).
Those with the lowest death rates and no more than two per 1,000 include California, Hawaii, Arizona, Nevada, Florida, Colorado, Utah, Washington, Wisconsin, and Idaho.
Overall, heat-related injuries decreased between 1990 and 2017 as global death and disability rates dropped by nearly half and a quarter, respectively. This was likely due to safety improvements, fire danger awareness, and increased access to quality health care, note the authors.
As the authors note, several limitations must be considered in the interpretation of their data. For starters, many countries with a high risk of injury have a limited amount of quality data. Furthermore, some individuals who are injured may not seek medical attention.
