Tap water scalds among seniors and the elderly: socio-economics and implications for prevention.

INTRODUCTION: Tap water scalds among those >or=60 years old are often attributed to physical impairments with aging. This study assesses socio-economics associated with tap water scalds among seniors and the elderly. METHODS: Charts of patients admitted to an urban Burn Center between 7/00 and 6/04 for treatment of tap water scalds were reviewed. Demographics, injury details, co-morbidities, surgical interventions/critical care requirements, length of stay (LOS), disposition and related economics were reviewed. RESULTS: During the study period, 68 patients >or=60 years were hospitalized for treatment of these scalds. Mean age and burn size were 78+/-1 years and 7+/-0.9% TBSA. Over 98% of patients were admitted with pre-existing co-morbidities; 60% required ICU care for 40+/-5 days; 22% required mechanical ventilation and 71% required surgery. LOS was 34+/-4 days. Most patients received government assistance income. Pre-injury, 32% resided alone. Post-injury, 10% of patients returned home alone; mortality was 22%. Per patient hospital costs approximated $113,000. CONCLUSION: These findings report that tap water scalds result in significant morbidity, mortality and health care costs for local seniors and the elderly. Socio-economic factors play a significant role in these injuries and must be assessed when planning prevention efforts.

The impact of a legislative intervention to reduce tap water scald burns in an urban community.

To review the efficacy municipal legislation in the reduction of tap water scald burns among an urban population. A retrospective chart and database review of patients hospitalized at this burn center between July 1999 and June 2004 for treatment of tap water scalds were performed. Demographic information and injury details, including extent of injury and age, type and location of the dwelling in which the injury occurred, were reviewed. Citywide incidence of these injuries for periods before and after a local prevention law was enacted was also calculated. Hospital costs for acute care treatment of these injuries were estimated. Tap water scalds increased from 15 to 22 per million/yr after legislation enactment. This burn center treated 281 of these patients during 5 years of the study period. Patients experienced significant morbidity and mortality. All cases (100%) occurred in structures exempt from current legislation. Citywide treatment costs were estimated between $102 and $148,000,000. In New York City, tap water scald burns remain a significant public health risk and continue to occur within buildings exempt from current law. Future injuries may potentially be prevented by expanding the law to include all residential buildings, regardless of building age or minimum occupancy.