Toddler burns

One-year-olds sustain 10 times as many burns and scalds as older children, suggests a review of UK emergency department and burns units cases, undertaken by researchers at the School of Medicine.

The primary culprits are hot drinks, irons, hair straighteners and oven hobs, prompting the authors to conclude that more targeted prevention is needed.

They draw their conclusions, from across the UK and Ireland, on data from 1215 children under the age of 16 who were treated in five emergency care departments, one burns assessment unit, and three regional children's burns units across the UK.

Over half (58%, 709) of the children had been scalded; around a third (32%, 390) had sustained contact burns; and 116 had sustained burns from other causes.

Nearly one in five (17.5%, 214) had to be admitted to a specialist burns unit; the remainder were treated in the emergency department.

Nearly three quarters (72%, 878) of the children were under the age of five, with most burn/scald injuries occurring in one-year-olds. 78% of all scalds occurring in children under the age of five.

All scald injuries were sustained at home. Hot drinks accounted for most (55%, 305 out of 554) of the scald injuries among young children, and in half of cases (48%), this happened when the child reached up and pulled down the cup/mug of hot drink - mostly tea.

Among five to 16-year-olds, hot water was responsible for half of the total number of scalds (78 out of 155), mostly from spills during food preparation (76%, 118).

Nearly all scalds affected the front of the body, predominantly the face, arms and upper trunk in young children, and the lower trunk, legs, and hands in older children.

Contact burns in the under 5s were mostly (81%, 224 out of 277) caused by touching hot items in the home. The main culprits were hair straighteners or irons (42%) and oven hobs (27%).

Nearly half of older children sustained a contact burn outdoors. Two thirds of all contact burns were to the hands.

"Children make up half of all burns and scald cases seen in hospitals, with the potential for lifelong scarring/deformity and even death," said Professor Alison Mary Kemp from the School of Medicine's Institute of Primary Care and Public Health.

"Successful prevention is most likely to involve product design or environmental modification, and should be considered for hair straightener, iron, and oven related burns," she added.

But she acknowledges that universal product modification for mugs will be challenging. Heightened awareness and behaviour change among parents/carers will be essential to curb the number of such incidents.

"Public information messages, children's centres, health visitor or family nurse practitioners should address safety education as a matter of routine," she concluded.

This study highlights the potential benefits of detailed routine data collection and underpinned a successful bid to the Healing Foundation who have funded The Burns Collective: Children's Burns Research Centre. The five-year collaborative research programme, between Cardiff, Bristol and Bath Universities, and the University of West England, is addressing the prevention, treatment and rehabilitation of childhood burns.