Study highlights child burns dangers in the home

"Hair straighteners and mugs top child burns list," reports BBC News. The news follows an attempt by researchers to get a more accurate picture of what causes children's burns and scalds, and provide clues about how to prevent them happening in the first place. To do this, researchers analysed figures captured between 2008 and 2010 from several emergency departments and burns units.

The researchers found that:

children aged 12 to 24 months were particularly vulnerable, suffering 10 times as many burns and scalds as older kids
hot drinks were responsible for most scalds in infants and toddlers after they reached up and pulled drinks down on top of themselves
the most common cause of burns from touching things (contact burns) was from children touching irons, hair straighteners and oven hobs

While it is not clear how accurately this study represents the burns patterns across the British Isles or across time, the findings may be useful for helping parents better understand what the likely risks are.

If an infant or toddler can touch something, they will probably try to play with it. It is important to keep anything hot – including hair straighteners – well away from young children.

This includes storing items away safely after they have been used, as they can remain hot and harmful to children a long time after use.

Get advice about baby and toddler safety.

Where did the story come from?

The study was carried out by researchers from Cardiff University and was funded by the Wales Office of Research and Development for Health and Social Care and a Medical Research Council Healthcare partnership. No conflicts of interest were declared by the study authors.

It was published in the peer-reviewed medical journal, Archives of Disease in Childhood.

The media generally reported the story accurately, reflecting the key facts of the underlying study and providing some useful accident prevention advice.

What kind of research was this?

This was a cross-sectional study that aimed to identify priority areas for burns prevention in under-16s.

Previous research has focused on burns reported in inpatient burns units and looked at overall patterns in under-16s. Inpatient data detects only the most serious burns and scalds, which need at least one overnight stay in hospital.

To improve the existing knowledge on paediatric burns, this study set out to find age-related patterns in other settings. To do this, the researchers obtained information from "non-inpatient" settings – for example, when a child is treated at an A&E department but does not stay in hospital overnight.

A cross-sectional study is the ideal study design to take a snapshot of a particular situation at one point in time. A longitudinal study would have the added advantage of being able to place these findings in a historical context to see if patterns were changing or static over time.

What did the research involve?

The research gathered information on burns and scalds among under-16s from five emergency departments, a burns assessment unit and three regional children's burns units across England, Wales and the Republic of Ireland.

They analysed differences in the occurrence of burns and scalds across different age groups, and looked at the most common cause of these unintentional injuries.

Information gathered on burns and scalds from the health institutions included:

burn site
severity
distribution
age
motor development of the child
agent (what caused the burn – for instance, a hot iron)
how the injury happened

This information was obtained from doctors' assessments of the children's first attendance at hospital for the burn. Children injured in household fires were excluded.

The information was gathered in a two-and-a-half-year period between July 2008 and December 2010.

The researchers' main analysis compared the prevalence and cause of burns in children aged 5 to 16 with those under the age of five.

What were the basic results?

The key findings were:

of 1,215 children, 58% (709) had scalds, 32% (390) had contact burns, and 10% (116) had burns from other causes
17.6% (214 of the 1,215) were admitted to burns inpatient units, and the remaining majority were treated in emergency departments or burns assessment centres
72% (878) of burns and scalds were in children under five years, with peak prevalence in one-year-olds
in the under-fives, the most common scald agent (55%) was a cup or mug containing a hot drink, and the most common way this happened was a pull-down injury (48%), where a child reaches for something and pulls it down onto themselves
in 5 to 16-year-olds, scalds from hot water were 50% (78/155) and spill injuries were 76% (118/155)
scalds affected the front of the body in 96% of cases (680/709) – predominantly the face, arms and upper trunk in children below the age of five, while older children had scalds to the lower trunk, legs and hands
in under-fives, contact burns from touching hot items in the home were 81% (224/277) – most commonly, hair straighteners or irons at 42% (117/277) and oven hobs at 27% (76/277)
5 to 16 year-olds sustained more outdoor injuries at 46% (52/113)
67% (262/390) of all contact burns affected the hands

How did the researchers interpret the results?

The researchers concluded that, "Scalds to infants and toddlers who pull hot beverages over themselves or sustain burns from touching irons, hair straighteners or oven hobs are a high priority for targeted prevention."

Conclusion

This study provides a useful insight into the patterns of burns in parts of the British Isles, and identifies possible priorities for preventing burns.

However, such a study design can only ever provide a sub-sample of the total picture in the British Isles. It's not clear how the overall patterns of injury would match this sub-sample. It's plausible that regional and local variations may also emerge if the information was gathered more widely.

This study did not capture information about less serious burns that didn't result in a visit to either an emergency department or burns unit. It also excluded children harmed in house fires.

The study spanned an approximate two-and-a-half-year period between 2008 and 2010, so we need to be aware of the possibility that the top reasons for scalds and burns may change over time, and may have changed to some degree since this information was obtained.

However, common sense dictates that hot beverages, oven hobs and irons are very common household items that are unlikely to drop out of importance in terms of causing burns and scalds, at least in the short term.

The finding that one-year-olds sustain 10 times the burns and scalds of any year of school-age children is quite startling, and serves to highlight the vulnerability of this group in particular.

It is best to adopt a safety first approach – if a child can reach an object, they will try to touch it and play with it. Some commonsense safety advice you may want to consider includes:

keep matches and lighters out of young children's sight and reach
use a kettle with a short or curly flex to stop it hanging over the edge of the work surface, where it could be grabbed
use the rings at the back of the cooker and turn saucepan handles towards the back so they can't be grabbed by little fingers
it is best to keep your toddler out of the kitchen, well away from kettles, saucepans and hot oven doors – you could put a safety gate across the doorway to help
keep hot drinks well away from young children – a hot drink is still hot enough to scald 20 minutes after it was made
when you've finished using your iron or hair straighteners, put them out of reach while they cool down – this can take up to eight minutes after they are switched off
make sure your child can't grab the flex of your hair straighteners or iron while you're using them