Journal of Academia and Industrial Research (JAIR)
Volume 2, Issue 10 March 2014
552
ISSN: 2278-5213
RESEARCH ARTICLE
Epidemiological Study of Fatal Burn Cases in SVN Government Medical College
Sachin Janbaji Gadge*, Raviprakash Dinanath Meshram, Manish Baburao Shrigiriwar
and Sharad Vasantrao Kuchewar
Dept. of Forensic Medicine, Shri V.N. Govt. Medical College, Yavatmal, Maharashtra, India
sachinjgadge@yahoo.co.in, sachinjgadge2004@gmail.com*; +91 9422559373
______________________________________________________________________________________________
Abstract
A two year prospective study of fatal burn cases in SVNGMC, Yavatmal, Maharashtra was carried out in the
present investigation. A standardized performa specially designed was used and filled in each case after
detailed interviews with the investigating officials, their relatives/friends and hospital records to gather
information. About 68% cases were from 21 to 40 years of age. From the findings it is clear that the deceased
who were less educated was mostly affected. About 282 cases (90.7%) were educated below matriculation
level. About 179 housewives (57.6%) were among the victims followed by the 55 labourers (17.7%) and
38 were unemployed (12.2%). No seasonal variation was seen among the victims. The study showed that the
cause of fire was ‘Fall of lamp’ in 150(48.2%) followed by kerosene stove in 92(29.6%) and pouring of
kerosene in 44(14.1%) cases. Most cases i.e. 176(56.6%) died after 4 d of burn whereas, 135(43.4%) died
within 4 d. Most cases 160(51.4%) had body surface involvement from 80 to 100%. Majority of cases about
210(67.5%) were accidental whereas, 78(25.1%) suicidal and 23(7.4%) were homicidal in manner.
Most victims i.e. 174(55.9%) died of septicemia due to burns followed by 110(35.4%) oligemic shock and
18(5.8%) neurogenic shock.
Keywords: Fatal burn, interviews, deceased, housewives, labourers, kerosene stove, septicemia.
Introduction
Fire was perhaps, man's first double-edged sword, for
throughout history, it has served as well as destroyed
mankind. Burns have tremendous medico-legal
importance as they may be considered to be the
commonest cause of unnatural death in India (Mazumder
and Patowary, 2013). Fire-related incidents are behind
maximum deaths among young women in India.
It was estimated that 68,000 urban and 95,000 rural
fire-related deaths took place in India in 2001. These
numbers added to a national estimate of 1.63 lakh
deaths caused by fire, of which 1.06 lakh (65%) were
females (Gupta, 2014). Fifty seven percent of these
deaths happened in women between 15 and 34 years of
age; the ratio as compared to young men being 3:1
(Gupta and Srivastava, 1988; Gupta et al., 2012).
Man has invented fire since times immortal. The use of
fire in various aspects has not only added to his
comforts, but it also added to his miseries by increasing
the risk of burns. Since ages, man has paid the price for
his comforts in terms of thermal injuries. Since long, fatal
burns have continued to be a major public health
problem in India. In India, about 60,000 people suffer
from burns annually, more than 50,000 are treated in
hospitals and about 10,000 succumb to thermal injuries.
Microbial infection after burns, where a large portion of
the skin is damaged, is a very serious complication that
often results in the death of the patients.
©Youth Education and Research Trust (YERT)
About 45% of the mortality in burn patients is caused by
septicemia (Gupta and Srivastava, 1988). In cases of
burning, the usual explanation given for such death is
that the woman caught a fire accidentally while cooking a
meal or preparing tea or snacks. Sometimes a woman's
death is attributed to other accidents such as a lighted
lamp falling on her during night or stove catching fire or
an oil explosion in a stove. Rarely such a death is
attributed to suicide or homicide (Memchoubi and
Nabachandra, 2007). The married women in their
matrimonial home are increasingly harassed, taunted,
humiliated and subjected to worst cruelty, mental and
physical for their failure to satisfy the men’s lust for
dowry, married women are murdered with no qualms and
by most inhuman modes or incited, prompted, instigated
to commit suicide (Mazumder and Patowary, 2013).
Self-immolation, suicide by pouring kerosene over
oneself, is also seen frequently among the females.
Motivations for this form of suicide are chiefly dowry,
family quarrel, marital disharmony, oedipal dominance of
mother in law, economic dependence of the husband’s
on the parents, near complete dependence of women on
their husband’s and in-laws, joint family, failure in love,
scolding by parents, chronic incurable diseases, lack of
social security amongst Hindu females were other
contributory factors affecting the incidence in some way.
Male burn deaths were few and accidental (Gupta and
Srivastava, 1988).
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Gadge et al., 2014
Journal of Academia and Industrial Research (JAIR)
Volume 2, Issue 10 March 2014
553
Often the circumstances of burns are enveloped in
mystery,
obscurity
and
unreliable
statements.
The reason behind this action may be personal,
domestic, occupational or social tragedy like dowry
deaths. Keeping the above facts in view, two year
prospective study of fatal burn cases in SVNGMC,
Yavatmal, Maharashtra was carried out in the present
investigation.
Materials and methods
Study duration and sample: The present study was
carried out from Jan 2010 to Dec 2013 in the Dept. of
Forensic Medicine and Toxicology at Govt. Medical
College and hospital, Yavatmal, Maharashtra. About
311 cases of fatal burns were included in this study.
Experimental design: A standardized performa specially
designed for this study was used and filled in each case
after detailed interviews with the investigating officials,
their relatives/friends, hospital records etc. to gather
information. The questioned were related to the Age,
Sex, Educational qualification, Occupation, Month of
Incidence, Cause of fire, Survival period, Body surface
area involved, Manner of burns and Cause of death. The
collected data were analyzed and presented in
percentage.
Table 1. Distribution of study cases according to
age and sex of the victims.
Age
Male (%)
Female (%)
Total (%)
(years)
0-10
2(0.6)
2(0.6)
4(1.2)
11-20
3(1.0)
50(16.1)
53(17.1)
21-30
36(11.6)
106(34.1)
142(45.7)
31-40
25(8.1)
44(14.2)
69(22.3)
41-50
16(5.1)
11(3.6)
27(8.7)
51-60
2(0.6)
5(1.6)
7(2.2)
61-70
2(0.6)
5(1.6)
7(2.2)
71-80
1(0.3)
1(0.3)
2(0.6)
Total (%)
87(27.9)
224(72.1)
311(100)
Table 2. Distribution of study cases according to
educational status of the victims.
Literacy
Cases
%
Illiterate
49
15.7
Primary
86
27.7
Middle
98
31.6
Secondary
49
15.7
High Secondary
27
8.7
Graduate
2
0.6
Total
311
100
Results and discussion
We found maximum cases i.e. 142(45.7%) in the 21-30
years age group. This age group was most vulnerable in
both Males [36(11.6%)] and Females [106(34%)].
The next was in the 31-40 years age group [69 (22.3%)]
(Table 1). The age group ranged from 1.5-76 years and
average age was 28±20.5 years. Similar findings were
reported by Batra (2003), Memchoubi and Nabachandra
(2007), Zanjad and Godbole (2007), Jaiswal et al.
(2007), Koulapur et al. (2011), Alam et al. (2010) and
Jain et al. (2011). This is the productive age and they are
generally active and exposed to hazardous situations
both at home and work. In the present study female i.e.
224(72.1%) predominated over male and male to female
ratio is 1:2.57 (Table 1). Results of our study are
consistent with Batra (2003), Zanjad and Godbole
(2007), Shanmugakrishnan et al. (2008), Akther et al.
(2010), Koulapur et al. (2011) and Jain et al. (2011).
The most probable reason is that females have ready
accesses to fire, accelerant and hot water. From Table 2
it is clear that the deceased who were less educated
mostly affected. Table shows 282 cases (90.7%) were
educated below matriculation level. The report is
consistent with the findings noted by Jayaraman et al.
(1993), Subrahmanyam (1996), Soltani et al. (1998) and
Akhter et al. (2010). The reason for this might be due to
low educational maturity. About 179 housewives (57.6%)
were among the victims followed by the 55 labourers
(17.7%) and 38 were unemployed (12.2%) (Table 3).
Akther et al. (2010), Taghavi et al. (2010) and
Subrahmanyam (1996) also reported similar findings in
their study.
©Youth Education and Research Trust (YERT)
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Table 3. Distribution of study cases according to
occupation of the victims.
Occupation
Cases
%
Housewife
179
57.6
Labourer
55
17.7
Student
10
3.2
Dependent
5
1.6
Business
4
1.3
Service
20
6.4
Unemployed
38
12.2
Total
325
100
Table 4. Distribution of study cases according to
month of incidence.
Month
Cases
%
January
23
7.4
February
28
9.0
March
31
10.0
April
30
9.7
May
28
9.0
June
23
7.4
July
26
8.3
August
16
5.1
September
24
7.7
October
27
8.7
November
25
8.0
December
30
9.7
Total
311
100
Table 5. Distribution of study cases according
to cause of burn.
Cause of fire
Total(%)
Kerosene stove
92(29.6)
Fall of lamp
150(48.2)
Pouring of kerosene
44(14.1)
LPG gas
12(3.9)
Hot liquid
7(2.3)
Electricity
6(1.9)
Total
311(100)
Gadge et al., 2014
Journal of Academia and Industrial Research (JAIR)
Volume 2, Issue 10 March 2014
554
The most probable reason might be physical and
psychological stress due to harassment from parents in
law, inadequate precautions during cooking and wearing
of the loose Indian sari. Distribution of study cases
according to month of incidence is shown in Table 4.
In the present study no seasonal variation is seen among
the victims. Our study shows that the cause of fire was
‘Fall of lamp’ in 150(48.2%) followed by kerosene stove
in 92(29.6%) and pouring of kerosene in 44(14.1%)
cases (Table 5). Jaiswal et al. (2007), Zanjad and
Godbole (2007) and Alam et al. (2010) also published
similar findings. Kerosene oil is routinely used for
domestic purpose as it is cheap and easily available
especially for poor people living in rural part of India.
The casual handling of kerosene oil with minimal safety
measures to handle any mishap makes it more
vulnerable for causing fatal burns. Most cases i.e.
176(56.6%) died after 4 d of burn whereas 135(43.4%)
died within 4 d (Table 6). Findings of our study are
consistent with Zanjad and Godbole (2007) and Koulapur
et al. (2011). We found that most cases 160(51.4%) had
body surface involvement from 80-100% (Table 7).
In the present study, majority of cases 210(67.5%) were
accidental whereas, 78(25.1%) suicidal and 23(7.4%)
were homicidal according to manner of burns (Fig. 1).
Similar findings were reported by Batra (2003), Zanjad
and Godbole (2007), Akther et al. (2010), Alam et al.
(2010) and Koulapur et al. (2011). The cooking activity in
our region is involved with fire associated with wearing of
loose synthetic material leads to accidental burns.
Most victims i.e. 174(55.9%) died of septicemia due to
burns followed by 110(35.4%) oligemic shock and
18(5.8%) neurogenic shock (Table 8). Most victims i.e.
174(55.9%) died of septicemia which is at par with
Mago et al. (2004), Jaiswal et al. (2007) and Koulapur
et al. (2011). High rate of mortality due to septicemia is
probably due to the fact that burnt tissue acts as a nidus
for infection and the rampant use of higher antibiotics
which are resistant to the nosocomial microorganisms.
Table 6. Distribution of study cases according to
survival period of the victims.
Period of survival
Cases
%
Spot
8
2.6
Way to hospital
16
5.1
<24 h
70
22.5
1-3 d
41
13.2
4-7 d
93
29.9
>7 d
83
26.7
Total
311
100
Table 7. Distribution of study cases according
to percentage of burn.
Body surface area involved
Total(%)
<30%
3(1.0)
30–39%
5(1.6)
40–49%
21(6.8)
50–59%
35(11.3)
60–69%
45(14.4)
70–79%
42(13.5)
80–100%
160(51.4)
Total
311(100)
Table 8. Distribution of study cases according
to cause of death.
Cause of death
Cases
%
Neurogenic Shock
18
5.8
Oligemic shock
110
35.4
Septicemic shock
90
28.9
ATN + Septicemic complications
84
27.0
Other
9
2.9
Total
311
100
Fig. 1. Distribution of study cases according
to manner of burns.
Accident
Homicide
23
Conclusion
This study showed that females are the most vulnerable
in burns. The reproductive age group 21-40 years is
highly susceptible for burns. Maximum victims were less
educated. Hence, literacy should be increased in the
society. Unemployment is the major cause for the burns.
According to history, fall of lamp used by the rural people
is the root cause as per investigating authority. Mostly
the cases are accidental in nature but suicide and
homicide are also of great concern though less in our
case.
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