Home heating, hot water and hot appliance injury in children (0 to 15 years)

July 2008

Over the three-year period from July 2003 to June 2006, there were at least 1,463 cases of children aged fifteen or younger presenting to an emergency department in Victoria for injuries related to hot water systems, heaters, stoves and hot electrical appliances (such as irons, toasters and hair dryers). These injuries included burns, scalds, cuts and falls.

In addition, hospital admissions data from the most recently available three-year period (July 2002 to June 2005) indicate a further 92 cases of burns and scalds only, that required admission to a ward over a similar timeframe. Together these data show an average of at least 488 child emergency department presentations and 31 child hospitalisations per year related to injuries associated with heating or heated home appliances.

Gender: Males were over-represented in both emergency department presentations and hospital admissions: 55% of presentations were boys, while boys were twice as common as girls among hospital admissions (66% male vs. 34% female).

Age: Infants and preschoolers were more likely to be injured than older school-aged children. Among emergency department presentations, 1029 cases were aged five years or younger (70%), while less than half that number were aged six to fifteen years (434 or 30%). The age pattern among hospital admissions was even more pronounced, 83 cases (90%) were aged five or younger compared to just 9 (10%) aged six to fifteen.

Cause: Contact burns (47%) and scalds (26%) accounted for the majority of emergency department presentations, followed by falls up to one metre (9%) and collisions with an object (7%). Being cut or pierced by an object (2%) and contact with fire, flames or smoke (1%) were less common (see Figure 1 over page). Hospital admissions were selected using a different data set and search criteria that identified burn or scald cases only.

Source of injury: Among emergency department presentations of 0-5 year olds for burns or scalds only, approximately half were due to contact with hot water or pipes (48%) with the remainder (52%) due to contact with heaters, stoves or other hot appliances. For older children aged 6-15 there was a less even division: over two thirds of cases were related to hot water systems (69%) and less than one third (31%) to contact with heaters or household appliances. Hospital admissions data were recorded under different injury-source categories. Burns or scalds due to contact with hot household appliances were the cause of 57% of admissions, while the remaining 43% were burns or scalds due to contact with 'heating appliances, radiators or hot pipes'.

Source: VEMD, Jul 2003 to Jun 2006
Figure 1: Cause of child heating, hot water and hot appliance injury, ED presentations (n=92)

Body region: For emergency department presentations, the most commonly injured region was the upper extremity (44%), followed by the head, face and neck (17%), lower extremity (16%) and trunk (12%). Multiple regions were injured in 4% of cases, while 11% did not specify the affected area. For admissions, the body region most commonly affected was also the upper extremity (80% of cases). A further 9% or injuries were to the trunk, 8% to the head, face or neck and the remaining 3% to the lower extremity.

Place of occurrence: Among hospitalisations where the place of occurrence was specified (78% of total, n=72), 97% happened in the home. Only 3% occurred in schools, public buildings or other specified places.

Injury prevention (safety tips): Heater and stove guards should be used to prevent small children touching hot surfaces or pulling hot objects onto themselves. Use irons and other hot appliances out of the reach of children making sure cords or attachments do not dangle within their grasp. Ideally, isolate children out of the room when cooking or using hot appliances.

When buying heaters or other appliances, select items that are stable, solidly constructed and free from sharp edges or other protrusions. Choose products with inbuilt guards and 'cool touch' surfaces that do not become dangerously hot when in use.

To reduce scald risk the maximum tap water temperature should be 50° C. New hot water installations should be set to deliver this temperature of water at bathroom outlets. For existing hot water the two most effective strategies are to either turn down the thermostat to lower the storage temperature or to install a thermostatic mixing valve as the hot water leaves the heating unit.

Further information: For further data and prevention tips related to burns and scalds among young children, access 'Hazard' edition 57 [2.4MB]

Data source: Victorian Emergency Minimum Dataset (VEMD) Jul 2003 to Jun 2006 (3 years) and Victorian Admitted Episodes Dataset (VAED) Jul 2002 to Jun 2005 (3 years)

Search Strategy: [Presentations]: A search was conducted for the text terms 'hot water', 'stove', 'oven', 'hot plate', 'heater', 'radiator', 'iron', 'electrical good', 'hairdryer', 'toaster', 'urn', 'kettle' etc. in the 250 character 'Description of Injury Event' field of the VEMD. Narratives were manually checked and irrelevant cases excluded. Cases subsequently admitted to hospital were excluded as they are covered under the VAED. [Admissions]: Cases in the VAED were selected if the activity code was 'X15: Contact with hot household appliances' or 'X16: Contact with hot heating appliances, radiators or pipes'. Re-admissions within 30 days are excluded.