Materiały źródłowe

• #1 Epidemiology of chemical burns: An 11‐year retrospective study of 126 patients at a referral burn centre in the north of Iran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10410324/

  The etiology and outcomes of chemical burns vary worldwide, influenced by the local population structure, industry distribution, and geographical and social environments. The aim of this study was to evaluate the epidemiology of chemical burns among patients referred to a burn centre in the north of Iran. […] Of the 10133 burn patients treated in a burn centre in the north of Iran between 2011 and 2021, 1.2% had chemical burns. […] Chemical burns occurred most frequently in patients aged 20 to 49 years (69.8%, n = 107), and most of the burns were accidental (84.9%, n = 107). […] Acid (74.6%, n = 94) was the most common cause of chemical burns. […] Community education on household safety, restricting nonspecialists’ access to chemical substances, and the promotion of early consultation could reduce chemical burn prevalence and improve outcomes.

• #2

  https://journals.lww.com/ijob/fulltext/2020/28010/epidemiological_analysis_of_chemical_burns__does.4.aspx

  Chemical burns constitute small proportion of cases among the total admissions due to burn injuries. The spectrum of severity of illness can vary from mild injuries to life-threatening trauma. In the Indian scenario, the incidence of chemical burns has been reported to be 2.25%2.4% of total burn admissions. […] During the study period of 6 calendar years from 2013 to 2018, a total of 142 patients of chemical burns attended the hospital, with 47 of them requiring admission. The chemical burns accounted for 0.45% of the total burn patient’s attendance. […] It was observed that acid burns have decreased in comparison to the initial 3 years. […] Downward trend in the incidence of overall chemical burns was noted. Acid burns decreased with simultaneous increase in alkali burns. […] The analysis of chemical burn exclusively done at the burn unit of Aligarh Medical college had revealed majority of the chemical burns were due to domestic accidental burns (58%), followed by homicidal accounting to 29% of cases.

• #3 CHEMICAL BURNS – EPIDEMIOLOGY

  http://www.medbc.com/annals/review/vol_10/num_1/text/vol10n1p16.htm

  SUMMARY. This survey considers the 5-year period 1991-1995, during which the total number of burn patients admitted to our clinic was 1548. Forty-nine (3.2%) presented chemical burns (38 male/11 female; mean age, 41.4 yr; age range, 14 to 80 yr). The commonest cause of chemical burns was some form of acid. The home was the most frequent site of chemical burn incidents (73.5% of all such cases), the main reasons being criminal acts or negligence. […] Considering Bulgaria’s limited surface area, chemical industries are well represented. However, our research indicates that chemical burns are quite rare, constituting only 3.2% of all burns treated in our centre in the 5-year period 1991-1995. […] With regard to the cause of the burns, acids played a primary role (42.8% of cases). Sulphuric and nitric acids were most frequently involved.

• #4 A Review of Management Methods and Modern Treatments for Chemical Wounds

  https://brieflands.com/articles/jamm-112029

  Chemical burns are very important because of their irreversible and unpredictable physical and mental effects, both at work and at home, even intentionally. Approximately 2 to 11% of burns are chemical burns. […] Chemical burns have been reported to account for 1.4 to 8.5% of burn-related hospitalizations. […] The American Burn Association reported that more than 4,500,000 victims of burn injuries are treated annually. Approximately 40,000 victims of acute burn injuries are admitted to hospitals each year, with 4% of cases leading to death. […] According to the World Health Organization, more than 11 million people around the world, including 100,000 to 500,000 victims of chemical injuries, must be hospitalized, with 30% eventually dying. […] About 70% of accidental acid burns occurred in dyeing workshops, fertilizer factories, and pharmaceutical companies.

• #5 Cutaneous chemical burns: assessment and early management

  https://www.racgp.org.au/afp/2015/march/cutaneous-chemical-burns-assessment-and-early-mana

  Burns are a common trauma that affects up to 1% of the Australian population and may be associated with significant physical, psychological, social and economic burden. Chemical burns represents 35% of all burns-associated admissions. Despite the small proportion, chemical burns account for 30% of burns-associated death, most commonly occurring as a result of chemical ingestion. Given the nature of injury, hospitalisation tends to be prolonged and healing is delayed. […] Many substances that are freely available in the community, either occupational or domestic items, have the potential to cause chemical burns. The immediate availability and poor labelling of these substances has accounted for an increase in unintentional chemical burns. […] The affected population is generally evenly distributed but an increase in paediatric chemical burns has been previously documented. Areas affected tend to include the face, eyes and extremities.

• #6 Emergency Management of Chemical Burns

  https://www.heraldopenaccess.us/openaccess/emergency-management-of-chemical-burns

  Chemical burns can be caused by acids, bases, organic and inorganic solutions. More than 25 000 products which can cause chemical burns are available for use in agriculture, household, industry and military forces. Chemical burn accounts for 2.4%-10.7% of the overall percentage of burns with a mortality rate of 30% of all burn deaths. The recognition of the causes, types and mechanisms of tissue destruction of the chemical agents can help in the management of this type of burns. […] The increased use of chemical peeling in the last few years created a new category of chemical burn cases who can have serious complications. […] Although chemical burns constitute a small percentage of the overall burn affecting the human body, their morbidity and mortality rates are high. Proper history taking, clinical examination and early management of such cases can greatly reduce the morbidity and mortality rates of these patients.

• #7 The Epidemiology of Chemical Burns Among the Patients Referred to Burn Centers in Shiraz, Southern Iran, 2008–2018

  https://journals.sums.ac.ir/article_47668.html

  The prevalence of chemical burns was 1% during 2008-2018. Acid and alkali burns were accounted for 93.5% and 6.5% of burns, respectively. […] The study’s findings revealed that chemical burns were more common in men than women, and the majority of chemical burns occurred at home. […] There is a great deal of disagreement regarding the epidemiology of chemical burns in different countries. […] Due to the American Burn Association (ABA), chemical burn patients accounted for 3% of burn patients admitted to hospitals and burn centers during 2005-2014. […] This study showed that men are more likely to work in at-risk environments. […] The caustic chemicals were the main cause of chemical burns. […] The highest burn percentage was observed in the 21-30-years age group and then children under 10 years of age.

• #8

  https://www.who.int/news-room/fact-sheets/detail/burns

  Burns are a global public health problem, accounting for an estimated 180 000 deaths annually. The majority of these occur in low- and middle-income countries and almost two thirds occur in the WHO African and South-East Asia Regions. […] Non-fatal burns are a leading cause of morbidity, including prolonged hospitalization, disfigurement and disability, often with resulting stigma and rejection. […] The incidence of burn injuries requiring medical care is nearly 20 times higher in the WHO Western Pacific Region than in the WHO Region of the Americas. […] People living in low- and middle-income countries are at higher risk for burns than people living in high-income countries. Within all countries however, burn risk correlates with socioeconomic status. […] Burns occur mainly in the home and workplace. Community surveys in Bangladesh and Ethiopia show that 80-90% of burns occur at home.

• #9 Epidemiology of Work-Related Hydrofluoric Acid Exposure in Wester

  https://www.longdom.org/open-access/epidemiology-of-workrelated-hydrofluoric-acid-exposure-in-western-zhejiang-province-china-52459.html

  Hydrofluoric acid (HF) burns are one of the most frequent chemical burns in western Zhejiang province of China, and most of them are work-related. This study documents the epidemiology of HF burns in the region using burn data from a local specialized hospital. Results from this survey will assist in the planning of prevention strategies for high-risk occupations and groups. […] A total of 316 patients (294 males, 22 females; average age: 39.5 10.31 y) were admitted for work-related HF burns. The incidence of HF burn injury has increased gradually over the last 13 y period, although several slight fluctuations were observed in several years. […] Work-related HF burns are preventable. The high morbidity of HF burns in western Zhejiang Province is related to the industrial structure of the area.

• #10 Epidemiology of Work-Related Hydrofluoric Acid Exposure in Wester

  https://www.longdom.org/open-access/epidemiology-of-workrelated-hydrofluoric-acid-exposure-in-western-zhejiang-province-china-52459.html

  This study was conducted to analyse the occupational distribution and clinical features of work-related HF exposure in patients admitted to Zhejiang Quhua Hospital between January 2004 and December 2016 to provide evidence in support of upgrading safety measures and for the formulation of preventive strategies. […] The majority of chemical burns are work-related, and working-age individuals are affected most frequently. In this study, most HF burns (316 patients, 99.1%) were occupational, and more than half (53.8%) came from the fluoride industries, with 46.2% from nonfluoride industries. […] This epidemiological survey showed that the morbidity of HF burns in western Zhejiang Province reached up to 33.1% of all chemical burns, which is much higher than the rates reported by other investigators. The frequency of HF burns has increased over the past several decades. […] The results described above emphasise the importance of safety management and protective equipment for workers in both fluoride and non-fluoride industries. Most cases of work-related HF injury can be prevented.

• #11 Ophthalmologic Approach to Chemical Burns: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1215950-overview

  Chemical injuries are responsible for approximately 7% of work-related eye injuries treated at US hospital emergency departments. More than 60% of chemical injuries occur in workplace accidents, 30% occur at home, and 10% are the result of an assault. Thus, 90% result from accidental exposures. Safety glasses can help prevent injuries, but industrial accidents often involve chemicals under high pressure. Safety glasses are not of much defense in this setting. […] As many as 20% of chemical injuries result in significant visual and cosmetic disability; only 15% of patients with severe chemical injuries achieve functional visual rehabilitation. […] Males are three times more likely to experience chemical injuries than females. […] Chemical injuries can strike any population; however, most injuries occur in patients aged 16-45 years.

• #12

  https://journals.lww.com/jfmpc/fulltext/2015/04010/epidemiology_and_outcome_of_chemical_burn_patients.21.aspx

  The objectives of this study were to evaluate the epidemiology, clinical variable of chemical burns, and their outcomes to prevent or reduce the frequency and morbidity of such injuries. […] A total of 96 patients (2.4% of total burn admissions) (42 males and 54 females) were admitted to our hospital with chemical burn injuries. […] Acid was found to be the most common cause of injury. […] It was found that chemical burns, though not very common, are deeper burns and can be accidental or non-accidental, and the high-risk age group is 1625 years. […] Chemical burns are largely preventable and if properly managed have a good outcome. […] The incidence of chemical burn was found to be 2.4% in our study, which corresponds to other studies showing an incidence between 1.4% and 4.8%. […] Common substances that may cause chemical burns are acids, alkalis, and various organic and neutral substances.

• #13 Rare chemical burns: first response, early hospitalization and first t | CWCMR

  https://www.dovepress.com/rare-chemical-burns-first-response-early-hospitalization-and-first-tre-peer-reviewed-fulltext-article-CWCMR

  Chemical burns are common enough not to be underestimated and may cause significant physical, psychological and economic burdens in poor and rural areas. […] The objective of this study was to evaluate the outcomes of chemical burns and clinical variables of chemical burns. […] Chemical burns constitute 3% of all burns, and 30% of chemical burns result in death. […] The most common causes of chemical burns are acids such as sulfuric, hydrofluoric, hydrochloric and acetic acid, bases such as sodium and potassium hydroxide and calcium hydroxide, oxidants used in the home such as chlorides and peroxides, and various other substances such as hair dyes and airbag injuries. […] The prognosis of a chemical burn depends on the type of chemical and the degree of injury. […] The aim of this study was to present the demographic data of patients with common and rarely seen chemical burns treated in our clinic, the type of chemical substance that caused the burn, the burn area and depth, the location of the accident, the first intervention made, the time to first admittance to hospital and to discuss these data in the light of information in literature.

• #14 Chemical (Alkali and Acid) Injury of the Conjunctiva and Cornea – EyeWiki

  https://eyewiki.org/Chemical_(Alkali_and_Acid)_Injury_of_the_Conjunctiva_and_Cornea

  Chemical injuries to the eye represent 11.5%-22.1% of ocular traumas. About two-thirds of these injuries occur in young men, and children ages 1-2 years are particularly at risk. The vast majority of the injuries occur in the workplace as a result of industrial accidents. A minority of injuries occur in the home or secondary to assault. Alkali materials are found more commonly in building materials and cleaning agents, and alkali injuries occur more frequently than acid injuries. […] Chemical injuries occur as a result of acid, alkali, or neutral agents, with alkalis being responsible for 60%. Common causes of alkali and acid injuries are listed below.

• #15 Chemical burns acid or alkali, what’s the difference? | Eye

  https://www.nature.com/articles/s41433-019-0735-1

  Acid and alkali injuries have traditionally been assigned clearly defined pathophysiological pathways by which injury and tissue damage occurs but in severe cases the outcome is equally devastating. […] Chemical injury represents up to 22% of ocular trauma. […] Alkali burns that represent two third of chemical burns worldwide, cause hydrophilic and lipophilic degeneration. […] It is almost customary to check the pH of the eye as soon as a patient with ocular chemical injury attends the eye emergency department, to ascertain whether the injurious agent was an acid or an alkali. […] The overall acute stage management of chemical burns involves (a) Prevention of further damage by elimination as much of the injurious agent as possible, (b) complete and thorough assessment, (c) control for the acute inflammatory reaction, (d) facilitation of the healing process and (e) prevention and management of complications. […] Two prognostic classifications are in vogue, the Roper-Hall and the Duas classification. […] Surgical intervention in the form of tenoplasty and autologous conjunctival grafts from the other eye are important in cases of limbal ischemia.

• #16 Chemical Burns | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/18716

  Chemical burns occur commonly in children who explore at their „cruiser” level. Many households keep toxic chemicals under the sink or in other low-lying locations where a child may access them. Additionally, in the workplace or home environment, an individual may contact one or more chemicals that have the potential to cause external or internal injury, either because of unawareness of exposure or casual contact. […] In the last few years in the United Kingdom, there have been many caustic chemical assaults on women. […] Children tend to suffer chemical injuries in the home; whereas, adults suffer chemical injuries in the workplace.

• #17 Clinical-epidemiological profile of chemical burns in a Burn Therapy Unit in Brazil

  https://repositorio.unesp.br/items/24e7bc1d-e96c-40ff-b3e7-e9470982aaa7

  Introduction: Chemicals have a relatively low prevalence among the causes of burns. However, they are important because most accidents occur in the scope of work and in an economically active population. […] In total, 40 (1.7%) patients were hospitalized due to chemical burn. […] The main site of trauma was in the workplace, in 20 cases (50%). […] The sample and results presented in this article are similar to the world literature on the subject. We evidenced the importance of this burn in the work environment and the involvement of individuals of active age, as well as the greater severity of accidents with chemical substance.

• #18

  https://journals.lww.com/jfmpc/fulltext/2015/04010/epidemiology_and_outcome_of_chemical_burn_patients.21.aspx

  We found similar results as 65% of patients sustained injury due to acids in our study. […] Various factors were found to be responsible for chemical burns, including mishandling of chemicals, lack of awareness regarding action and side effects of specific chemicals, lack of employee’s knowledge, and not using appropriate protective measures. […] A total of 28 patients (29%) in this series were cases of vitriolage (acid attacks); 21 (75%) of them were females. […] The Supreme Court’s judgment on regulation of sale of acids came on July 16, 2013 following an incident in which four sisters sustained burns after being attacked with acid. […] It was found that chemical burns, though not very common, are deeper burns, can be accidental or non-accidental, and the high-risk age group is 1630 years.

• #19 Factors associated with chemical burns in Zhejiang province, China: An epidemiological study | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-746

  Work-related burns are common among occupational injuries. Zhejiang Province is an industrial area with a high incidence of chemical burns. We aimed to survey epidemiological features of chemical burns in Zhejiang province to determine associated factors and acquire data for developing a strategy to prevent and treat chemical burns. […] Most chemical burns are preventable occupational injuries that can be attributed to inappropriate operation of equipment or handling of chemicals, lack of employee awareness about appropriate action and lack of effective protective equipment and training. Emphasis on safety education and protection for workers may help protect workers and prevent chemical burns. […] The chemical industry has a strong presence in Zhejiang Province, which is the 10th largest province in China. In recent years, large chemical corporations have expanded their plants and increased production. In the wake of new joint ventures, private enterprises and sole proprietorships, chemical burn casualties are on the rise, with occasional mass-injury chemical burn accidents.

• #20 Factors associated with chemical burns in Zhejiang province, China: An epidemiological study | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-746

  Among all substances contributing to chemical burns, hydrofluoric acid caused the largest share of casualties, likely due to the high concentration of the fluorochemical industry in Zhejiang. […] Our results strongly suggest that preventing occupational burn injuries due to inappropriate operation of equipment or handling of chemicals lies in increasing employee awareness about appropriate action and ensuring the provision of effective protective equipment and training. Emphasizing safety education, physical protection for workers and adequate information about emergency measures may directly benefit workers and reduce the occurrence of chemical burns.

• #21 Hydrofluoric acid burns in the western Zhejiang Province of China: a 10-year epidemiological study | Journal of Occupational Medicine and Toxicology | Full Text

  https://occup-med.biomedcentral.com/articles/10.1186/s12995-016-0144-3

  Chemical burns caused by hydrofluoric acid (HF) frequently occur in the Western Zhejiang Province. This study aimed to investigate the epidemiological characteristics of HF burns within this region. A total of 201 patients (189 males, 12 females; average age: 38.3310.57 years) were admitted due to HF burns. Over the 10-year period, the morbidity of HF burns in the past 10 years showed a gradual increase, which paralleled the development of local fluoride industries. Most HF injuries were work related and distributed in working-age patients. Aqueous HF solutions, especially highly concentrated ones, were the most common chemical cause of HF burns. Moreover, inappropriate operation, machine problems, and inadequate protection were identified as the leading causes of HF burns in the workplace. Based on the epidemiological results for HF burns in this region, the related enterprises and local authorities should be encouraged to upgrade management policies and to provide necessary occupational hazard education and safety training for high-risk occupations within high-risk working populations. Furthermore, the enhancement of hazardous chemicals management is also needed.

• #22 Pool Chemical Injuries in Public and Residential Settings — United States, 2008–2017, and New York, 2018 | MMWR

  https://www.cdc.gov/mmwr/volumes/68/wr/mm6819a2.htm

  Pool chemical injuries led to an estimated 13,508 U.S. emergency department visits during 2015-2017, approximately one third of which occurred in persons aged 18 years. […] Most injuries occurred at a residence, and two thirds occurred during the summer swimming season (Memorial Day weekend through Labor Day). […] Pool chemical injuries are preventable. […] During 2008-2017, the median estimated annual number of U.S. ED visits for pool chemical injuries was 4,535. […] An estimated 2,588 injuries were diagnosed as chemical burn. […] At least 56.3% of injuries occurred at a residence. […] Approximately two thirds of all ED visits occurred during the summer swim season. […] State and local jurisdiction over residential treated recreational water venues is limited compared with jurisdiction over public venues. […] To help prevent pool chemical injuries in the residential setting, state and local environmental health practitioners can be a resource for residential pool or hot tub/spa owners by offering them pool chemical safety training.

• #23 Chemical Burns: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/769336-overview

  Burns are a common problem seen in the emergency department. There has been a decrease in the number of burns in the United States through 2000, but this appears to have stabilized since. Most burns are only partial thickness and occur on the extremities. Approximately 5% of individuals with burns presenting to the ED require admission. […] The 2019 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS) reported the numbers of single exposures for the following: Chemicals: 40,816. […] Worldwide, corrosive substances are commonly used for chemical assault. The most common substances used are lye and sulfuric acid. […] Assaults with caustic chemicals worldwide are more likely to occur against women. […] Adults and children are nearly equally exposed to caustic chemicals. Adults exposed to industrial strength chemicals often suffer more severe burns.

• #24 Epidemiology of chemical burns: An 11‐year retrospective study of 126 patients at a referral burn centre in the north of Iran

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10410324/

  The present study confirmed previous findings that acidic substances are the most common aetiology for chemical burns. […] The ratio of hospitalised chemical burn patients from urban areas was higher than in rural areas. […] Most of the chemical burns occurred at home. […] In the present study, in terms of jobs, most of the chemical burns occurred among workers. […] The mortality prevalence in chemical burns was 4.8% (n = 6). […] To prevent chemical burns and adopt effective laws to protect at-risk populations, epidemiological studies on the prevalence and characteristics of this type of injury are essential.

• #25

  https://www.who.int/news-room/fact-sheets/detail/burns

  Burns are preventable. High-income countries have made considerable progress in lowering rates of burn deaths, through a combination of prevention strategies and improvements in the care of people affected by burns. Most of these advances in prevention and care have been incompletely applied in low- and middle-income countries. Increased efforts to do so would likely lead to significant reductions in rates of burn-related death and disability. […] WHO is promoting interventions that have been shown to be successful in reducing the incidence of burns. The Organization is also supporting the development and use of a global burn registry for globally harmonized data collection on burns and increased collaboration between global and national networks to increase the number of effective programmes for burn prevention.

• #26 Context/Epidemiology – RCEMLearning

  https://www.rcemlearning.co.uk/modules/major-trauma-burns/lessons/contextepidemiology/

  Burns are a major public health problem globally. In addition to physical damage, they can leave a long lasting psychological and social impact. In the UK 130,000 people each year visit the Emergency Department with burn injuries. Approximately 8% (10,000) of these patients are admitted. […] Chemical: Acids and alkalis found in household chemical products can produce very deep burns through coagulative and liquefactive necrosis. They will continue to burn the skin until completely removed. It is therefore essential that the skin is thoroughly irrigated. Alkalis penetrate deeper than acids and those presenting with alkali burns (commonly due to cement) will require immediate attention.

• #27 DOAJ Logotype

  https://doaj.org/article/d5fece67f90b4bcba51e38adc802e968

  Chemical burns constitute small proportion of cases among the total admissions due to burn injuries. […] In the Indian scenario, the incidence of chemical burns has been reported to be 2.25%2.4% of total burn admissions. […] During the study period of 6 calendar years from 2013 to 2018, a total of 142 patients of chemical burns attended the hospital, with 47 of them requiring admission. The chemical burns accounted for 0.45% of the total burn patient’s attendance. […] It was observed that acid burns have decreased in comparison to the initial 3 years. […] Downward trend in the incidence of overall chemical burns was noted. Acid burns decreased with simultaneous increase in alkali burns. […] The study period coincided with the Supreme Court’s verdict with the formulation of guidelines on sale of acids in 2013 and this could be the major factor in declining trends of acid burns.

• #28

  https://journals.lww.com/ijob/fulltext/2020/28010/epidemiological_analysis_of_chemical_burns__does.4.aspx

  On year-to-year basis analysis of chemical burns at our institute, we found a downward trend in the chemical burns with more so specific to acid burns. […] In 2018, alkalis were the most common cause of chemical burns in this study. Although the number of acid burn injuries has reduced in this study, we did find that there were nine cases of vitriolage against women. […] There has been a downward trend in the incidence of acid burns in particular. Increase trend of the alkali burns is more due to the workplace related. The Supreme Court-induced stricter norms for sale of acids did have impact on reducing numbers.

• #29 CHEMICAL BURNS – EPIDEMIOLOGY

  http://www.medbc.com/annals/review/vol_10/num_1/text/vol10n1p16.htm

  The mortality rate in this group of chemical burn patients was 4.1% (two patients). One of these had 95% TBSA burns due to sulphuric acid. The other had only 6% TBSA burns, but he had also swallowed acid and the cause of death was severe ulcero-haemorrhagic and necrotic damage to the pharynx, oesophagus, and stomach.

• #30 NC DPH: Occupational and Environmental Epidemiology: Sulfuric Acid

  https://epi.dph.ncdhhs.gov/oee/a_z/sulfuric.html

  The very young, the very old, and people with health problems are at an increased risk from the health effects of sulfuric acid exposure. […] Erosion of the teeth, inflammation of mouth, narrowing of stomach or esophagus, chronic bronchial irritation with cough, and/or chronic shortness of breath may occur with repeated or long-term exposure to sulfuric acid.

• #31 Glaucoma Associated With Chemical Burns – Glaucoma Today

  https://glaucomatoday.com/articles/2012-may-june/glaucoma-associated-with-chemical-burns

  Chemically burned eyes often develop multiple ocular diseases, including opaque corneas, ocular surface derangements, cataract, and uveitis. The most important preventable complication is glaucoma, however, which occurs in up to 75% of eyes with severe chemical burns. Patients are typically male industrial workers, but chemical injuries also occur in the domestic and/or assault setting. Glaucoma is a serious complication due to its high prevalence and severity, the difficulty of diagnosis, and its general refractoriness to treatment. […] After chemical burns, physicians’ attention focuses on the cornea, and glaucoma is a secondary consideration. IOP spikes may be missed, and glaucoma is frequently overlooked entirely. This disease, however, is the single most important factor limiting patients’ visual outcomes.

• #32 Rare chemical burns: first response, early hospitalization and first t | CWCMR

  https://www.dovepress.com/rare-chemical-burns-first-response-early-hospitalization-and-first-tre-peer-reviewed-fulltext-article-CWCMR

  The first intervention requires irrigation with a large amount of water. […] The first intervention is very important in such burns. […] In this study, the importance of the first intervention, the importance of early presentation at hospital and the treatment applied have been discussed in light of the information in literature. […] Chemical burn injuries represent a small proportion of total burn injuries. However, they are a specific type of injury requiring immediate initial intervention and treatment management.

• #33 A Review of Management Methods and Modern Treatments for Chemical Wounds

  https://brieflands.com/articles/jamm-112029

  Acids and alkalis are the most common causes of chemical burns. […] The main difference between chemical and thermal burns is that tissue damage persists until the chemical is removed from the chemical burn. […] The priority of conventional medical treatments is to prevent further complications and reduce inflammation. […] Rapid treatments, such as washing the wound with water, should be done before visiting the medical centers. Also, given the very high cost of treatment for this type of burn, the importance of low-cost treatment methods has been highlighted.

• #34 Acid and chemical burns

  https://www.nhs.uk/conditions/acid-and-chemical-burns/

  Get medical advice as soon as possible if you think you have an acid or chemical burn. You’ll need to be treated as soon as possible. […] Acid and chemical burns need to be checked and treated in hospital.

• #35 Acid and chemical burns | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/injuries/skin-injuries/acid-and-chemical-burns/

  Burns caused by acid, alkaline or caustic chemicals can be very damaging and need immediate medical attention. […] Immediate treatment for chemical burns in hospital includes: continuing to wash off the corrosive substance with water until its completely removed. […] Specialist burns teams include occupational therapists, physiotherapists and mental health professionals who can support your recovery. […] For chemical burns affecting the eyes, you’re also likely to be urgently assessed by an eye specialist to help minimise the risk of lasting vision loss.

• #36 Sulfuric Acid Burns | SpringerLink

  https://link.springer.com/10.1007%2F978-3-642-02035-3_207

  Chemical burns (e.g., sulfuric acid) are more deleterious than thermal burns as the effect continues till the cauterizing agent is neutralized. […] Management of sulfuric acid burns needs further research in the areas outlined. […] DHHS (Department of Health and Human Services, North Carolina) (2010) Sulfuric acid facts. Hazardous substances emergency events surveillance program. […] Xie Y, Tan Y, Tang S (2004) Epidemiology of 377 patients with chemical burns in Guangdong province. Burns 30:569572.

• #37 Chemical Burns Management | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-642-59307-9_41

  Chemical burns are less frequent in routine practice, but can be very serious owing to the complexity and severity of their actions. […] According to epidemiological data, management during the acute stage is particularly intense and there are difficult-to-manage sequellae in some mucosal areas like eyes or mouth. […] Some chemical agents can create intense general disorders.

• #38 Glaucoma Associated With Chemical Burns – Glaucoma Today

  https://glaucomatoday.com/articles/2012-may-june/glaucoma-associated-with-chemical-burns

  Physicians continue to underestimate the danger of IOP spikes and the potential for long-term glaucomatous damage after an ocular chemical burn. Classification systems devised to indicate the prognosis of ocular chemical burns ignore IOP and glaucoma altogether. Data have suggested a 22% incidence of secondary glaucoma in patients with severe chemical burns, but disturbingly, 75% of the patients in a study by Cade et al had advanced glaucoma prior to vision rehabilitation surgery. Despite the heroic efforts of doctors and patients alike, visual rehabilitation surgery is futile if glaucoma goes unrecognized or undertreated.

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