Hot water scalds – a horrific injury that can be prevented

Hot water scalds are horrific injuries, and heartbreakingly this is an injury that is commonly sustained by young children. This topic is particularly close to my heart, as many years ago my infant cousin was hospitalised after his older siblings knocked a saucepan of boiling water off the stove-top and it splashed all over his back. I will never be able to erase his endless, hysterical screams, my only memory of visiting him when I was just a child myself. The arrival of my own children meant the installation of two gates barricading off our kitchen area, and consumption of hot drinks and soups in the kitchen area only. It also meant a reduction of the maximum water temperature in our hot water system.

Two publications in the recent issue of Journal of Burn Care and Research caught my eye this week, flooding my senses with the childhood memory of my cousin’s injury. The first article examines the incidence of hot water scalds from tap water, after the introduction of Building Code regulations in Ontario in 2004. Pleasingly, mandating a maximum temperature of 49 degrees celsius (120 degrees F) resulted in a signficant reduction in the number of ambulatory scald cases. Disappointingly, there was no significant reduction in the duration of hospitalisation. Read more at http://www.ncbi.nlm.nih.gov/pubmed/23514985. These results suggest that not only is mandated maximum tap water temperatures vital, further efforts including education are required.

The second publication examines the water temperature and water heater characteristics of water heaters in 976 homes in the US, 24 years after water heater manufacturers voluntarily agreed to the 49 degrees celsius maximum temperature. Alarmingly the water exceed this limit in nearly half of the houses surveyed. Interestingly, gas heaters were more likely to have unsafe temperatures. Read more at  http://www.ncbi.nlm.nih.gov/pubmed/23514986.

Considering that young children living in low-income urban housing may be at greater risk, I was pleased to read in a December Pediatrics article that two-thirds of children aged 0-7 years (246 primary caregivers were recruited from a pediatric emergency department and a well-child clinic) were living in an environment with safe hot water temperatures. This does still leave one third at greater risk, however. Importantly a connection between housing quality and water temperature safety was observed, with better housing quality associated with less risk. Read more at http://www.ncbi.nlm.nih.gov/pubmed/23147973.

 

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