Water Scald Research Articles

Scalding in Turkish children: Comparison of burns caused by hot water and hot milk

Introduction Our aim in this study was to compare the clinical differences and etiologic risk factors for hot water and hot milk scald burns in Turkish children. Methods The retrospective study examined the cases of 140 children aged 0.1–7 years who had scald burns treated in three burn units of a Turkish hospital network between March 2000 and December 2004. The patients were categorized in two groups: hot water burns or hot milk burns. Results Ninety-five (67.9%) patients had hot water burns and 45 (47.1%) had hot milk burns. The proportion of patients with hot milk burns who lived in rural areas was significantly higher than the corresponding proportion for the hot water cases (75.6% versus 52.6%, respectively; p < 0.01). In 20 (44%) of the hot milk cases, the burn was caused by milk being boiled in large pots outdoors for cheese production. The other 25 hot milk cases were caused by milk being boiled in the kitchen. The mean (±S.D.) percentage total body surface area burned in the hot milk cases was higher than that in the hot water cases (33.6 ± 2.24% versus 21.42 ± 1.43%, respectively; p < 0.001), and the corresponding mean percentages of TBSA with full-thickness burns were 9.2 ± 2.52% versus 3.13 ± 0.83%, respectively; ( p = 0.083). The mean percentages of TBSA with second-degree burns showed the same trend (29.0 ± 12.39% versus 18.8 ± 1.47%, respectively; p < 0.001) higher percentage of the children with hot milk burns required antibiotics (78% versus 52.8%, respectively; p < 0.006). Seven (7.4%) of the hot water burn patients and 15 (33.3%) of the hot milk burn patients died during the study period ( p = 0.025; overall mortality rate 15.7%). Conclusion Children scalded with hot milk tend to have more extensive burns, and thus have higher mortality, than those scalded with hot water. To create effective programs for preventing scald injuries in Turkey and elsewhere, it is essential to consider ethnic and cultural issues based on these characteristics. Simple precautions should be explained and methods of using liquids such as hot milk should be researched in different geographic locations in order to formulate good prevention strategies.

Postharvest handling and storage of cured vanilla beans

The vanilla bean, the fruit of the climbing orchid Vanilla planifolia, is used for the commercial production of vanilla flavour, consisting of vanillin and other numerous flavour compounds. Development of the prized vanilla flavour in harvested green beans is dependent, however, on a curing process. Studies on the botany of vanilla beans revealed that flavour precursors are found in the bean interior, where they are secreted onto the placental region around the seeds. Hydrolytic or other degradative enzymes, which catalyse the release of the flavour precursors to flavour compounds, are localised mostly in the outer fruit wall region. This insight suggests that the objective of killing, the first curing stage carried out by hot water scalding, freezing or by other methods, is to disorganise the bean tissue such that contact is created between substrates and their respective enzymes. Sweating, a subsequent step in curing entailing high temperatures (usually around 45-65o C) and high humidity, provides conditions for enzyme-catalysed production of flavour com- pounds and also for non-enzymatic oxidative reactions. The objective of the final curing steps, including drying and conditioning are designed to preserve the formed flavour compounds. The postharvest handling of cured vanilla beans is a continuation of the curing process, aimed at preserving quality attributes achieved in the production and curing of vanilla beans. Temperature, humidity, gas com- position and type of packaging are some important factors that determine bean quality in storage. Further understanding on the botany, curing and postharvest handling of the vanilla bean may render a full flavour complex and, subsequently, significant economic gains.

Overlapping agendas or serendipitous synergism

Overlapping agendas or serendipitous synergism

INTERRELATION OF CURING AND BOTANY IN VANILLA (VANILLA PLANIFOLIA) BEAN

INTERRELATION OF CURING AND BOTANY IN VANILLA (VANILLA PLANIFOLIA) BEAN

Cost Effectiveness Analysis of a Proposed Public Health Policy to Reduce Tap Water Scald Injuries in Children

Cost Effectiveness Analysis of a Proposed Public Health Policy to Reduce Tap Water Scald Injuries in Children

A Public Policy Approach to Addressing Tap Water Scald Burn Prevention

A Public Policy Approach to Addressing Tap Water Scald Burn Prevention

Child injury morbidity in New Zealand, 1987-1996.

New Zealand is one of a small number of countries that has a national hospital discharge database. The aim of this study was to use these data to provide an epidemiological description of child injury morbidity and to discuss options for prevention. Using national data, all public hospital admissions for the fiscal year 1995/6 were identified and grouped according to cause. This allowed identification of all children (0-14 years) hospitalized for injury in the period 1987-1996. Causes of injury, diagnoses and injury severity were examined in four age groups. Injury was the second leading cause of public hospital admissions. Children were hospitalized with injury at the rate of 1333 per 100 000 person-years. The victims were predominantly male (61%). In all age groups, falls were the leading cause of morbidity. 'Striking events', motor vehicle traffic crashes and poisoning were also major contributors to the child injury toll. The commonest injury diagnosis was a fracture of the upper limb (25%), followed by intracranial injury (18%). The leading causes of injury morbidity were noted to differ from previously reported leading causes of injury mortality. Review of the data in light of research literature suggests the need for policy changes to make alternatives to motor vehicle transportation safer and to encourage increased use of child restraints in order to reduce road traffic trauma. Legislation requiring child-resistant packaging for all toxic medications and household products is necessary to reduce rates of child poisoning. Further research is required on policies concerning playground equipment heights and surfacing requirements, and on interventions for hot water scalds.

Tap water scald burns in children

Tap water scald burns account for 7% to 17% of all childhood scald burns that require hospitalization. Often the burns are severe and disabling. Toddlers and preschool children are the...

Tap Water Scald Burns in Children, by K. W. Feldman, R. T. Schaller, J. A. Feldman, and M. McMillon,Pediatrics, 1978;62:1–7

Tap water scald burns account for 7% to 17% of all childhood scald burns that require hospitalization. Often the burns are severe and disabling. Toddlers and preschool children are the most frequent victims. In 45% of the injuries, the unsupervised victim or peer turned on the tap water; in 28% the cause was abuse. Eighty percent of the homes tested had unsafe bathtub water temperatures of 54°C (130°F) or higher, exposing the occupants to the risk of full-thickness scald with &amp;lt;30-second exposure to hot water. Such burns may be prevented passively by limiting household water temperatures to &amp;lt;52°C (125°F). New water heaters could be preset at this temperature, and families could be taught to turn down the temperature on existing units.

Acute airway obstruction following facial scalding: differential diagnosis between a thermal and infective cause

A 16-month-old boy received a 6 per cent hot water scald to his face and chest. The child had been suffering from an upper respiratory tract infection for 10 days prior to the injury. However, as the child rapidly developed respiratory tract obstruction, a differential diagnosis between acute infective epiglottitis and thermal injury to the hypopharynx was required. In fact, the hot water had reached the epiglottis and the aryepiglottic folds causing significant damage, whilst sparing the tongue and mouth. The child was admitted to the intensive care unit, intubated and ventilated for 4 1 2 days. The external burns eventually healed spontaneously. This case report demonstrates the rare occurrence of a minor scalding injury resulting in significant obstruction to the upper airway. Of additional interest is the presence of pre-existing symptoms of an upper respiratory tract infection and the total absence of any signs of intraoral burning. These additional factors demonstrate the necessity for absolute vigilance in the management of any scald in the region of a child's mouth. Intubation can be life saving and should be considered in any case of scalding associated with increasing respiratory distress.

Tap Water Scalds

Child Abuse ReviewVolume 5, Issue 3 p. 214-217 Forensic Notes Tap Water Scalds Chris Hobbs, Corresponding Author Chris Hobbs St James University Hospital Leeds UniversityCommunity Paediatrics, St James' University Hospital, Leeds LS9 7TF, UK.Search for more papers by this author Chris Hobbs, Corresponding Author Chris Hobbs St James University Hospital Leeds UniversityCommunity Paediatrics, St James' University Hospital, Leeds LS9 7TF, UK.Search for more papers by this author First published: August 1996 https://doi.org/10.1002/(SICI)1099-0852(199608)5:3<214::AID-CAR256>3.0.CO;2-0AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume5, Issue3August 1996Pages 214-217 RelatedInformation

Tap Water Scalds

Tap Water Scalds

Reducing the burn risk to elderly persons living in residential care

A 45-month retrospective analysis of 70 geriatric burn admissions to the Welsh Regional Burns and Plastics Unit highlighted 13 (18.6 per cent) injuries that occurred whilst the patient was in residential care (six residential care homes, seven nursing homes). The mean age overall was 83 years. The residential care patients had a TBSA of 12.5 per cent with a mortality of 46 per cent, whilst the group living in the community had a TBSA of 8.63 per cent with a mortality of 14 per cent. These results were not statistically comparable due to the unequal population grouping. The cause of injury in the residential group included five hot water scalds, six radiator contact burns, one flame burn and one flash burn. All 13 patients were found to have such severe dementia that they were unable to give a reliable history. In the majority of patients a lack of supervision was in part responsible. Some basic measures are presented that could reduce the incidence of accidental burn injury in this vulnerable group of the population.

Scalding Water Temperatures

Tap water scald burns are the most frequent cause of nonfatal burn injuries in United States children. Most of these burns occur in the home, and hot water heater thermostat settings below 60°C (140°F) significantly decrease the risk of such burns in young children. The American Academy of Pediatrics and other safety-promotion organizations recommend that thermostats be set at 49 to 53°C (120 to 130°F), and ordinances encouraging lower hot water temperatures exist in some localities. We advise our pediatric colleagues that consumer products manufacturers do not always follow these recommendations in their published guidelines for product use. Specifically, we have found that four of five major manufacturers of automatic dishwasher detergent recommend hot water thermostat settings of 60°C or higher. (See Table.)

Patterns of scald injuries.

To describe common patterns of bath water scald injuries in children, to examine differences between accidental and non-accidental bath water scalds in children, and to examine potential for prevention. A two year six month retrospective analysis of admissions to a specialist burns unit. The Burns Unit, St Lawrence Hospital, Chepstow serving children from south and west Wales. Sixty eight children attending the Burns Unit for treatment of bath related scald injuries. Bath scalds in children under 5 years of age was the cause of 14.7 per 100,000 children being admitted to the specialist burns unit in a year. The majority of the children were injured by falling in the bath but the tap was turned on by seven children themselves and by 10 siblings. Six children put hands in the hot water and two children were accidentally put into bath water that was too hot and were quickly withdrawn. Four children suffered probably non-accidental immersion scald injuries from hot water. They were characterised by a clear tide mark, a story that did not fit the injuries, associated injuries, and by symmetrical lesions. Accidental scalds were irregular geographical injuries and were asymmetrical. Bath scalds are a significant problem in children under 5 years. Their prevention should be part of an injury control programme on a local and national level. The best way to achieve this would be by reducing the temperature in domestic hot water tanks. The recognition of non-accidental bath scalds can be assisted by the pointers outlined and should be done in a multidisciplinary way with plastic surgeons, paediatricians, and social workers working together.

Burn-induced alterations in vasoactive function of the peripheral cutaneous microcirculation.

Alterations in the cutaneous vasomotion function caused by scald burns to a large area on the flank were observed and quantified in a dorsal skin flap window with a hamster model. Subsequent to chronic implantation of the window chamber to provide direct microscopic observation of blood flow for an entire thickness of skin, control measurements of vasoactivity in a defined network of arterioles were taken by means of a digital video image splitter over a period of several days. A 100 degrees C, 5-second water scald was then effected over 17% to 55% of the total body surface area, and the vasoactivity was remeasured in the targeted set of sites at serial time intervals for 2 to 4 days. Data were acquired directly into a computer and analyzed for both the magnitude and time pattern of diameter fluctuations during 3-minute observation periods. Average and standard deviations of diameters were computed, and the Prony power spectral analysis method was applied to identify the presence and strength of fluctuation frequencies. In general, vasomotion was suppressed for several hours subsequent to the burn, and the activity was dominated by much slower contractions than control. No direction of vessel diameter changes prevailed uniformly throughout the peripheral microcirculation. Large alternate constrictions and dilations were also observed for some arteriolar and venular components, but others exhibited no significant change at all. The incidence and magnitude of peripheral microvascular response was proportional to the size of the injured area.

Preventing tap water scalds: do consumers change their preset thermostats.

One goal of the regulatory approach to tap water scald prevention is the installation of hot water heaters at thermostat settings considered safe. In this strategy, it is assumed that consumers will not change preset thermostat settings, an assumption evaluated in a study of 62 families. It was found that 60% of the sample did not change their preset thermostats. Surprisingly, some of those families (27%) who did not increase their settings still had unsafe (> 54 degrees C) water temperatures.

Summary of Work to Control Pathogens in Poultry Processing

The National Broiler Council and Southeastern Poultry and Egg Association sponsored a study to determine whether various processing modifications would significantly alter the microflora of processed broilers. The results of this study were presented as part of the symposium and have been published in the Journal of Applied Poultry Research. Other current research covered include water recycling, scald and chill water treatments, and the effects of dietary manipulation on intestinal colonization and carcass contamination.

Liquid-Crystal Thermometer Use in Pediatric Office Counseling About Tap Water Burn Prevention

Tap water scald burns are an important topic of injury prevention in pediatricians' offices. Consecutive pediatric clinic clients, randomized to two groups, received an informational pamphlet, a one-minute discussion about tap water safety, and a baseline questionnaire. The first group also received a liquid-crystal thermometer for testing maximum hot tap water temperature. One month later in a follow-up telephone interview (n = 503), the impact of the added thermometer on knowledge regarding scalding, temperature testing, and thermostat lowering was assessed. Approximately 80% of each group read the pamphlet. Reading the pamphlet was associated with greater temperature testing in the thermometer (T) group but not in the pamphlet only (P) group. Temperatures were checked by 46.4% of the T group but by only 23.0% of the P group (P less than .001). In the households in which the reported water temperature exceeded 54.4 degrees C (130 degrees F) and the water heater was accessible, 77.3% reported lowering the setting, independent of receiving the thermometer. The reliability of self-reported water temperature was assessed after 1 year by home visits. The use of relevant facilitating devices, such as a liquid-crystal thermometer, in-office anticipatory guidance efforts may increase behavioral compliance.

Epidemiology of burns in Kuwait

A prospective study of 765 burns cases treated as inpatients at the Burns Unit, IBN Sina Hospital and the Plastic Surgery Unit, Mubarak Al Kabeer Hospital from January 1984 to December 1986 is presented. Hot water scalds were the commonest type of injury. Most of the burns occurred at home but coinciding with standard working hours. Children up to 5 years old were commonly affected, but most of the fatal burns were among adults. The overall mortality rate was 7·2 per cent with a male to female ratio of 1·1 : 1. Our survival rate from burn injuries is improving due to advances in treatment, but prevention remains the best cure. We consider our epidemiological survey to be important as the basis for a preventive programme in Kuwait's extremely heterogeneous society.