PubMed · 3968849
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P Drinka, A Bryan. 1985-03-01. Curb those tubes.. https://doi.org/10.1001/jama.1985.03350330053007
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An 8-year retrospective review of patients admitted to Stoke Mandeville Hospital (Aylesbury, UK) because of burns sustained by hot bath and shower water was undertaken. Fifty-seven patients of all ages were identified and stratified into paediatric (< 16 years) and adult groups. Nine patients died. The main characteristics of the burns, causes and outcomes of treatment were analysed for each group. Children were predominantly under three years of age (83%), sustaining most frequently only superficial burns (41%) with areas of less than 10% total body surface area (72%). Parents' supervision was inadequate in 85% of cases. Eighty-three percent of the adults were over the age of 60. Two thirds had some form of psycho-motor disorder that predisposed to an accident which should have been anticipated. In comparison to children, adults suffered more extensive and deeper burns that resulted in a mortality of 44% (8/18). In both groups, the lower parts of the body were most frequently involved. The observed decline in the number of admissions for the period of investigation is encouraging. It supports an ultimate need for further development and actual implementation of preventative measures for hot water burns in the homes of people who are at greatest risk.
Elderly people are particularly at risk of accidents in the home and with an ageing population, they constitute a large proportion of scald victims. We have seen several elderly patients every year in our own unit who had sustained domestic hot water burns. We decided to ascertain the temperature of water in the private homes of elderly people and in residential care homes in our community. Twenty-five private homes and 14 residential care homes were visited and peak water temperatures were measured in the kitchens and bathrooms. Only one private home and one residential home had water below 45 degrees C. It is recommended that water should be delivered at less than 43 degrees C. We conclude that water is dangerously hot. However, if water is stored at a temperature of less than 60 degrees C there is a risk of infection with Legionella pneumophila. Existing regulations governing the use of 'fail safe' thermostatic mixing devices must be enforced and extended to cover domestic hot water systems.