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Characteristics of Scald Burns Caused by Child Abuse in the United States: A Systematic Review
Wendy C Shields1, Evelyn Shiang1, Marisa Koontz1
1Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.
Insights
Hot tap water scald injuries are common in children. This review examines indicators of intentional scald burns to improve identification and prevention strategies for these serious injuries.
Area of Science:
- Pediatric injury prevention
- Forensic medicine
- Public health
Background:
- Hot tap water is a leading cause of scald injuries, particularly in children and older adults.
- Limited public knowledge of burn risks contributes to the burden of pediatric scald injuries.
- Scald injuries can be classified as unintentional or intentional, with the latter prompting justice system involvement.
Purpose of the Study:
- To review the literature on intentional scald burns in children caused by hot tap water.
- To identify indicators of intentional scald burns in children.
- To assess potential biases in the evidence base for these indicators.
Main Methods:
- Systematic literature review.
- Analysis of existing research on intentional scald burns in children.
- Evaluation of traditional indicators used to assess criminal intent.
Main Results:
- The review synthesizes literature on intentional scald burns in children.
- Identifies key indicators used in assessing criminal intent for childhood scald burns.
- Highlights the need to critically evaluate the evidence base for these indicators.
Conclusions:
- Improved identification and prevention of intentional hot tap water scald burns in children are crucial.
- Understanding indicators and potential biases is essential for accurate assessment.
- Further research may be needed to refine diagnostic criteria and reduce injury rates.
Abstract:
Hot tap water is the most common source of scald injuries, representing a quarter of all scald injuries requiring hospitalization in the United States. Children and older adults are at increased risk of scald burns. Evidence suggests that poor knowledge of burn risks and treatment among parents and the public may contribute to the burden of scald injuries in children. Medical and injury surveillance categorizes most scald burns as unintentional injuries. However, scald burns can also lead to investigation by the justice system if the injury is suspected to result from abuse or neglect. The Department of Justice recommends assessing criminal intent in childhood scald burns based on traditional indicators derived from medical research: burn uniformity, areas of sparing, burn locations, family history, and speed of medical care. In this study, we present an overview of the existing literature on intentional scald burns in children caused by hot tap water in order to improve their identification and prevention. This systematic review aims to answer two questions: (1) What are the indicators of intentional scald burns in children according to the literature and (2) Is the body of evidence for common indicators of intentional scald burns subject to bias?
