Clinical evaluation of chemical assault burns and occupational injuries: A 20-year study at a single burn center

Occupational and chemical assault injuries were the two most common factors associated with chemical burns. These two types of injuries were identified and analyzed covering a 20-year period. Methods. Patients with second- to third-degree chemical burns admitted to the Linkou Burn Center, Chang Gung Memorial Hospital from May 1986 to May 2005 were included in the analysis. Injuries other than occupational and chemical assaults were excluded from this study. Results. A total of 46,283 burns were admitted during the study period while 327 patients were included in the study with 250 (77.5%) cases classified to occupational injury (OI) and 77 (23.5%) in the chemical assault (CA) group. The mean age in the OI group was 33.2 years and 36.2 years for the CA group. The mean burn size was 10.9% for the OI group and 14.1% in the CA group. The mean length of hospitalization was 15.8 days in the OI group and 32.3 days in the CA group. The main causative agents were acids, which accounted for 57.2% of injuries in the OI group and 98.7% in the CA group. Sulfuric acid was the primary acidic agent and the main alkali was sodium hydroxide. The face was the most frequently injured area (59.6%) followed by the extremities (upper limb [52.2%], lower limb [44.2%]). The hand injury rate was significantly higher in the OI group (P ≤ 0.009). The injury rates to the face, neck, and chest (P < 0.05) were significantly higher in the CA group. Conclusion. Chemical assault burns might cause more damage and suffering than occupational burn injuries. The promotion of occupational injury protection, public empowerment, and public security in recent years has markedly decreased the occurrence and severity of occupational and chemical-related burns. Modern advances in burn care and surgical procedures contribute greatly to decreasing the length of hospital stays for patients who have sustained an occupational or chemical assault injury.