Global burden of fire-, heat-, and hot substance-related injuries, 1990−2021: A systematic analysis for the Global Burden of Disease Study 2021

Fire-, heat-, and hot substance-related injuries represent a significant global health burden but are often understudied. Previous research has typically focused on macro-level trends, neglecting the underlying causes of these changes. Our study addresses this gap by using advanced methodologies, particularly focusing on regional disease trends during the 2019 to 2021 pandemic period, and proposes targeted interventions based on these insights. Using Global Burden of Disease (GBD) 2021 data, we analyzed age-standardized incidence (ASIR), prevalence, mortality, and Disability-Adjusted Life Years attributed to fire, heat, and hot substances. Trends were quantified via estimated annual percentage change, while risk factors, decomposition analysis, and health inequalities were assessed. Future burden from 2022 to 2050 was projected using a Bayesian age-period-cohort model. In 2021, fire, heat, and hot substances caused an estimated 9198,164 incident cases globally (95% uncertainty interval (UI): 7592, 028-10,784,350), with an ASIR of 118.82 per 100,000 population (95% UI: 97.49-139.41), showing a decline from 1990 levels. However, the rate of decline slowed significantly between 2019 and 2021. Southern Latin America had the highest regional ASIR (484.32; 95% UI: 401.38-560.57), while Lesotho saw the greatest ASIR increase (EAPC = 0.70%). Health inequities worsened between 2019 and 2021 (-155.2892-28.0021), with the disease burden shifting towards lower Socio-demographic Index regions. Epidemiological changes contributed 573.43% to the global decrease in incidence. Occupational injuries were the leading risk factor. Projections suggest that from 2021 to 2050, the ASIR will decrease by 41.77%, while prevalence cases will increase slightly by 12.53%. While the overall epidemiological trends of fire-, heat-, and hot substance-related injuries remain favorable, the observed plateau in nonfatal burden reduction during 2019 to 2021 underscores the need for more comprehensive and targeted healthcare policies. Moving forward, public health strategies must adopt an integrated "education-prevention-treatment" approach that specifically targets 3 high-risk groups: Children aged 0 to 14 years (developmental vulnerability); Older adults (age-related physiological risks); Populations in low-SDI regions (health system limitations). This demographic-specific framework will be essential for addressing the evolving epidemiology of thermal injuries in the coming decades.