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Clothing-Related Burn Casualties: An Overlooked Problem?

An Erratum to this article was published on 27 April 2010

Abstract

Between 1997 and 2006, more than 4,300 serious burn injuries per year in the United States were associated with clothing. Ages 5–14 had the highest average annual burn injury rate, and ages 25–64 had the lowest rate. There were 120 deaths per year in the United States associated with clothing burns between 1999 and 2004. The death rate for those over 65 was six times the national average. The General Wearing Apparel Standard has regulated the flammability of clothing worn in the United States since 1953. Nearly all of the clothing-related injuries and deaths have occurred in fires involving apparel that complied with this Standard. Despite the size of this problem, there is no organized national activity under way to begin to address these casualties. Experience with the Children’s Sleepwear Flammability Standards, issued in the 1970s, suggests that safer garments can be manufactured that would prevent many clothing burn injuries and deaths. A more stringent up-to-date flammability standard, production of safer garments, use of warning labels, and educated consumers are needed.

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Notes

  1. 1.

    These death data show a substantial decline in deaths between 1998 and 1999. We believe that this decline, if it is real, would be reflected in a similar decline in the NEISS injury data between these years. However, no such decline was observed (see Table 1).

  2. 2.

    The Mann–Kendall equations are presented in Annex D.

  3. 3.

    Several times a year, ASTM International offers technical and professional training courses on Regulatory Compliance for the Flammability of Wearing Apparel and Children’s Sleepwear, in which CPSC representatives participate.

  4. 4.

    The other two criteria are “chronic illness and future injuries” and “additional criteria.”

  5. 5.

    Other factors (such as changes in raw material prices unrelated to standardization) can exert effects that exceed the effects of regulation. Standardization itself does not necessarily mean an increase in cost.

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Acknowledgement

The authors wish to acknowledge the efforts of Karen Suhr of the National Association of State Fire Marshals (www.firemarshals.org), who assisted in the editing and formatting of this article for submittal.

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Correspondence to James F. Hoebel.

Additional information

The authors all serve in a pro-bono capacity as science advisors to the National Association of State Fire Marshals in the United States.

An erratum to this article can be found at http://dx.doi.org/10.1007/s10694-010-0153-1

Appendices

Appendices

Annex A National Estimates of Clothing Thermal Burn Injuries Treated in Emergency Rooms, Breakdown by Year, Clothing Typea and Age, 1997–2006
Annex B US Population, 1997–2006, by Age Group, in Millionsa
Annex C National Estimate of Clothing Thermal Burn Emergency Room Injury Rate per Million Population, by Year, Clothing Typea and Age, 1997–2006

Annex D: The Mann–Kendall Statistic

Let:

  • x1,…,x n be a sequence of measurements over time. To test the null hypothesis,

  • H0: x1,…,x n come from a population where the random variables are independent and identically distributed,

  • H1: x1,…,x n follow a monotonic (e.g., increasing or decreasing) trend over time.

The Mann–Kendall test statistic is calculated as \( {\text{S}} = \sum\nolimits_{k = 1}^{n - 1} {\sum\nolimits_{j = k + 1}^{n} {{\text{sgn}}\left( {x_{j} - x_{k} } \right)} } \) where

$$ \text{sgn} (x_{j} - x_{k} ) = \left\{ {\begin{array}{*{20}c} 1 \hfill & {{\text{if}}\quad x_{j} - x_{k} > 0} \hfill \\ 0 \hfill & {{\text{if}}\quad x_{j} - x_{k} = 0} \hfill \\ { - 1} \hfill & {{\text{if}}\quad x_{j} - x_{k} < 0} \hfill \\ \end{array} } \right. $$

S is asymptotically normally distributed. The mean and variance of S are given by

$$ E\left( {\text{S}} \right) = 0 $$
$$ Var({\text{S}}) = \left\{ {\begin{array}{*{20}c} {{\frac{{\left\{ {n\left( {n - 1} \right)\left( {2n + 5} \right) - \sum\nolimits_{j = 1}^{p} {t_{j} \left( {t_{j} - 1} \right)\left( {2t_{j} + 5} \right)} } \right\}}}{18}}} \hfill & {{\text{if}}\;{\text{ties}}} \hfill \\ {{\frac{{\left\{ {n\left( {n - 1} \right)\left( {2n + 5} \right)} \right\}}}{18}}} \hfill & {{\text{no}}\;{\text{ties}}} \hfill \\ \end{array} } \right. $$

where p is the number of tied groups in the data set and is t j the number of data points in the jth tied group.

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Hoebel, J.F., Damant, G.H., Spivak, S.M. et al. Clothing-Related Burn Casualties: An Overlooked Problem?. Fire Technol 46, 629–649 (2010). https://doi.org/10.1007/s10694-009-0113-9

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Keywords

  • Burns
  • Injuries
  • Deaths
  • Clothing
  • Standards
  • Flammability