Adapting adult scald safety standards to children

Scald burns by domestic tap water constitute a painful, potentially debilitating, and sometimes-fatal form of thermal injury. In this setting, the very young and older members of the population are particularly susceptible, owing in part to having thinner skin, which renders them more susceptible to thermal insult. Various codes have set forth a safety standard for maximum delivery temperature of domestic tap water at 120 degrees F (48.9 degrees C), based on adult susceptibility to burns. This work addresses the issue of how the current safety standard for tap water temperature could be adjusted to provide a level of protection to children equivalent to that for an adult at 120 degrees F. A well-accepted mathematical model for predicting burn injury as a function of applied surface temperature and time is used to identify these equivalent conditions. Data from the literature of sonographic measurements indicate a representative ratio of child to adult skin thickness of 0.72. The mathematical model shows that the equivalent surface temperature for a threshold scald injury in children is dependent on the depth into the skin at which the injury is identified. For example, the injury produced by a 120 degrees F, 10-second exposure at a depth of 600 microm in an adult is matched in a child at 72% of the depth (432 microm) by an insult of 115.9 degrees F for the same duration. The recommendation is that existing hot water standards be reduced by 3 to 4 degrees F to provide an equivalent level of scald protection to children.