36 A Regional Analysis of Completely Preventable Injuries Sustained from Burning Garbage and Yard Waste

Abstract Introduction Burn injuries due to garbage and yard waste burning account for a high percentage of flame injuries in the south. Understanding the injury pattern and healthcare burden is important for effective prevention of these completely unnecessary burn injuries. Methods This five-year retrospective, single-center, review included patients admitted between 2016 and 2021. Patients included were at least 14 years of age and sustained an open flame burn injury due to burning brush and/or trash. Patients who experienced a burn injury due to gasoline, hazardous material, lighter, fireworks, accelerant/gel, aerosol can, and burning bedding/clothing, were excluded. Results Based primary residence of the 136 patients, 56% had access to free municipal waste disposal, 25% could have had access with additional payment (not included in taxes), and 18% did not have access to municipal waste disposal. The median age was 50 (32, 66.5) years. The majority were burning yard debris, while 32% were burning trash. The majority were male (85%) and Caucasian (71%). The median TBSA was 5 (2.5, 12) percent with 36% having some portion of full-thickness injury. One-third had some form of substance use with 29% tobacco, 5% alcohol, and 4% illicit drugs. There were 151 total operations with a median of 1 (0, 1.5) per patient. There were 1,620 unnecessary hospital days utilized (~6.6% of available bed-days per study period). The median length of stay was 3 (1, 10) days with the majority (85%) being discharged back to their home. Twenty-five percent were discharged with a paired functional status worse than pre-injury. Eighty-eight percent required no assistance prior to injury, while only 67% were discharged without requiring mobility or assistance with ADLs. Patients with some degree of pre-injury function limitations had a three-fold higher LOS (10 vs 3 days; p = 0.023) and associated costs. Although deaths were few in this sample, patients with lower pre-injury functionality had almost 5 times higher mortality (23.1% vs 5.3%; p = 0.083). Therapy data were available for 88 patients totaling 656 occupational and 462 physical therapy sessions, including acute care, inpatient rehabilitation unit, and outpatient. Unfortunately, there were 8 (6%) unnecessary deaths from their injuries with an average 77.3 ± 10.4 years of age and 42.4 ± 21.7% TBSA with 35.1 ± 23.7% being full-thickness. Total hospital charges exceeded $32.6 million with a median $32,952.26 ($8,790.48, $103,11