Work-Related Burn Injuries Treated in US Burn Centers: 2002-2011

Objectives: (1) Develop a work-related definition for the National Burn Repository (NBR); (2) Describe national work-related burn injury characteristics by occupations using the NBR research dataset; (3) Compare work-related with nonwork-related burn injuries. Methods: We developed a work-related definition based on four fields in the NBR research dataset, including injury-event narrative description, insurer, injury circumstance, and the original work-related variable. In total, 109,281 burn injury patients treated in US burn centers from 2002 to 2011 were included in this analysis, of which 22,969 were work-related. Results: We identified four times of work-related burn-injury patients compared to those identified by the NBR original work-related field. The occupations with highest in-hospital fatality rates from burn injuries were transportation and material-moving occupations (4.59%) and production occupations (2.3%). The occupations with longest length of hospitalization were arts, design, entertainment, sports, and media (Median: 4.5, Mean: 8.85); and transportation and material-moving occupations (Median: 4, Mean: 11.65).The three most common causes of burns in work settings were direct contact with fire/flame (32.3%), scald (22.8%), and electricity (14.1%). The proportion of burn injuries caused by fire/flame was highest among workers employed in protective services (72.9%), community and social-service workers (57.3%), and arts, design, entertainment, sports, and media workers (53.9%). In the comparison of work-related and non-work related burn injuries, work-related patients tended to have lower mean total burn surface area (TBSA) (8.14 versus 9.5), slightly shorter median hospital days (3 versus 4), lower in-hospital fatality rate (2.0% versus 3.5%), and higher proportion of third-degree burn injury (29.0% versus. 27.4%). In the multivariable logistic regression models, black patients and those suffering from electrical, inhalation, and fire/flame burns were at increased odds of dying during hospitalization. Female, black, Hispanic, and those who had third-degree burn, inhalation, and electrical burn were significantly associated with longer hospitalization. Conclusions: Simply relying on the NBR original work-related variable can only capture 20% of work-related burn-injury patients. Some occupations were associated with higher in-hospital burn-injury mortality and longer hospitalization. Black, third-degree burn, inhalation, and electrical burn were independent predictors of longer hospitalization and in-hospital mortality.