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Running water while bathing is a risk factor for pediatric scald burns
William J Moser1, Kristen R Bilka2, Sebastian Q Vrouwe3
1Division of Child Abuse Pediatrics, Northwestern University, Chicago, IL, USA.
Insights
Running water is a significant risk factor in pediatric scald burns from bathing. Current guidelines should be updated to include avoiding running water to prevent these common childhood injuries.
Area of Science:
- Pediatric burn prevention
- Injury epidemiology
- Public health recommendations
Background:
- Scald burns are the most frequent burn injuries in children.
- Bathing scalds offer a key opportunity for injury prevention strategies.
- Existing infant bathing safety advice lacks specific guidance on running water risks.
Purpose of the Study:
- To determine the incidence of running water use in pediatric bathing scald burns.
- To assess the role of running water as a risk factor in these injuries.
- To inform updated injury prevention guidelines for infant bathing.
Main Methods:
- Retrospective review of pediatric patients under 3 years old admitted for bathing scalds (2010-2020).
- Analysis of risk factors including running water, water temperature checks, and caregiver presence.
- Exclusion of abuse or indeterminate injury cases.
Main Results:
- 95% of 101 bathing scald burn cases involved running water.
- Running water was present in 95% of cases with only one identified risk factor.
- The majority of scalds occurred in sinks (60%) or bathtubs (39%).
Conclusions:
- Running water is a critical, under-addressed factor in bathing scald burns.
- Recommendations to avoid running water during infant baths are needed.
- Updated guidelines can help reduce the incidence of pediatric scald injuries.
Introduction:
Scalds are the most common mechanism of burn injury in pediatric populations and scald burns sustained during bathing present a unique opportunity for injury prevention. Evidence-based infant bathing educational resources recommend checking water temperature and having a caregiver present for the duration of the bath, but do not explicitly recommend avoiding running water or explain the associated risks. This study seeks to determine the incidence and role of running water in bathing scald burns at our institution.
Methods:
This is a retrospective review of pediatric patients (<3 years) admitted to the University of Chicago Burn Center with scald injury from bathing between 2010 and 2020. Cases were reviewed to assess the following risk factors: whether there was running water, whether water temperature was checked before placing the child in water, and whether a caregiver was present for the entire bath. Injuries in which the manner of injury was abuse or indeterminate were excluded.
Results:
The study cohort included 101 cases of scalds due to bathing, with a mean age of 13 months and mean burn size of 7% TBSA. Of these 101 cases, 96 (95%) involved running water. Thirty-seven cases (37%) had only one of the three risk factors and 95% of those 37 cases involved running water. Twenty-nine cases (29%) involved all three risk factors while only two cases (2%) involved none of the three risk factors. Sixty-one cases (60%), thirty-nine cases (39%), and one case (1%) occurred in a sink, bathtub, or infant tub, respectively.
Conclusion:
We found that the vast majority of bathing scald burns involved running water, identifying a specific bathing recommendation that should be added to existing guidelines to reduce the incidence of bathing scald burns.
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