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Child abuse and neglect in paediatric burns: The majority is caused by neglect and thus preventable
Marie-Louise H J Loos1, Annebeth Meij-de Vries2, Michelle Nagtegaal3
1Emma Children's Hospital, Paediatric Surgical Centre Amsterdam, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Paediatric Surgery, Amsterdam, The Netherlands.
Insights
Neglect is a primary cause of burns in young children, with hot beverages and home environments being significant factors. Most pediatric burns are preventable through targeted educational programs focused on household safety.
Area of Science:
- Pediatric burn research
- Childhood injury prevention
- Public health
Background:
- Distinguishing negligent burns from inflicted or non-intentional burns is challenging.
- Recognizing negligent burns is crucial for preventing future harm to vulnerable children.
- The incidence and characteristics of negligent burns in children require further investigation.
Purpose of the Study:
- To investigate the incidence of negligent burns in children treated at a burn center.
- To identify associated characteristics and risk factors for negligent burns in pediatric populations.
- To inform prevention strategies for childhood burns.
Main Methods:
- Retrospective review of medical files of children with acute burns (2013-2015).
- Classification of burns (inflicted, negligent, non-intentional) by a Child Abuse and Neglect team and an expert panel.
- Collection of demographic, social, and clinical burn data.
Main Results:
- Negligent burns constituted 56% of cases, non-intentional 42%, and inflicted 2%.
- Risk factors for negligent burns included hot beverages (OR 4.40), younger age, home occurrence (OR 4.87), and specific locations (anterior trunk, neck).
- A significant association was found between negligent burns and younger age (p < 0.001).
Conclusions:
- Neglect is a significant factor contributing to pediatric burns, highlighting their preventability.
- The majority of preventable burns occur in domestic settings, emphasizing the need for household-focused interventions.
- Awareness and educational programs targeting households are recommended for burn prevention in young children.
Introduction:
It is complex to distinguish negligent burns from inflicted and non-intentional burns, especially since no deliberate action caused the burn. Its recognition is important to create a safe life without (future) burns for our loved-ones who cannot take care of themselves (yet). Our aim was to investigate the incidence and associated characteristics of negligent burns are among children treated at a burn center.
Methods:
We retrospectively reviewed medical files of all children attending a Dutch burn center with an acute burn between January 2013-December 2015. The conclusion of the Child Abuse and Neglect team (CAN) was used to define inflicted, negligent or non-intentional burns. The remaining cases were reviewed by an expert panel using a standardized protocol. Demographic and social data as well as clinical information about the burn were collected.
Results:
In total 330 children were included. Negligent burns accounted for 56%, non-intentional for 42% and inflicted for 2% of the burns. Negligent burns were associated with: hot beverages (OR 4.40, 95%CI 2.75-7.05), a younger age (p < 0.001), occurrence at home (OR 4.87 95%CI 2.80-8.45) and were located at the anterior trunk (OR 2.75, 95%CI 1.73-4.35) and neck (OR 1.98, 95%CI 1.12-3.50).
Conclusion:
This study shows that neglect is a major factor in the occurrence of burns in young children, therefore we conclude that the majority of paediatric burns are preventable. Educational programs creating awareness and focussing on prevention of these burns should be aimed at households, since the majority of negligent as cause of preventable burns occur at home.
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