Burns are reported to be a persisting public health problem in South Africa. The current study describes the epidemiology of burn mortality across the lifespan in Cape Town (2.9 million inhabitants in 2001), one of the six South African metropolitan centres. The distribution of burn mortality across socio-demographic groups and also their circumstances of occurrence were investigated using 4 year (2001–2004) surveillance data from the National Injury Mortality Surveillance System (n=1024 cases). Burn mortality occurred at a rate of 7.9 per 100 000 person-years (95% CI 7.3 to 8.3), most often among males, with the highest rates in the 25 to 38 year age group (19 per 100 000). The greatest difference between male and female deaths was observed in that age group, when almost three male deaths occurred for every female one. The vast majority of fatal burns were registered as accidental and occurred in the home, either over the cold and wet months or during recreational periods over weekends and across the year. Alcohol intoxication was reported for the majority of those adults whose alcohol blood levels were tested. The high prevalence and circumstances of occurrence of burns among middle age men are a source of concern. There are reasons to believe that this over-representation is a reflection of detrimental living conditions, life-style and poor socio-economic status. It is recommended that prevention activities involve the management of kerosene appliances, alternatives to flammable housing materials, and the implementation of strategies to reduce harmful drinking practices.
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