Injuries associated with... TAP WATER

CHIRPP database, summary data for 1994-1998, ages 0-6 years

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LIMITATIONS

This report is based on information from the database of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). It is important to note that the injuries described do not represent all injuries in Canada, but only those seen at the emergency departments of the 15 hospitals in the CHIRPP network. Since the bulk of CHIRPP data comes from the pediatric hospitals, which are in major cities, injuries suffered by the following people are under-represented in the CHIRPP database: older teenagers and adults, who are seen at general hospitals; native people; and people who live in rural areas. Fatal injuries are also under-represented in the CHIRPP database because the emergency department data do not capture people who died before they could be taken to hospital or those who died after being admitted.

SUMMARY (114 records)

Overall, children less than two years of age represented 67.5% of all tap water injuries amongst those aged 0-6 years. Of the 114 injured patients, 48.3% were males. Over half (52.9%) of the injuries occurred between 4:00 pm and 11:59 pm. Over a third (37.8%) of the injuries were experienced on the weekend (Saturday and Sunday). Injuries were fairly evenly distributed over all seasons of the year. The majority (84.2%) of the incidents happened in the patients own home; of these, 52.1% occurred in the bathroom. Over half (53.5%) of the injuries occurred when i) the hot water was turned on (or the cold turned off) when the patient was in the bathtub, sink or shower (32.4%) or ii) when hot tap water was spilled on the patient (21.1%). Half of the burns or scalds were to the lower extremity; of these, 51% were to the foot or toe(s). Of all the patients, 59.6% were treated with follow-up required and 27.2% were admitted to hospital. Of the admitted patients, 41.9% were male and 71% were less than two years of age.

SPECIFICATIONS OF THE SEARCH

In February 2000, a search of the CHIRPP database for the years 1994 -1998 (594,103 records total; 212,437 records for children aged 0-6 years) was conducted. Age was restricted to less than 84 months (0-6 years). Records were selected if i) the mechanism of injury was contact with hot liquids or steam (code 53) and ii) the nature of the injury was burn or corrosion (code 20) and iii) they contained the factor code for hot tap water (code 1382). The total number of records captured was 114.

MISSING (UNKNOWN) VALUES

In the following sections, at the bottom of each table or in the description, the number of missing values is indicated (if necessary). Missing values are those numbers for which the value of the variable in question is unknown (i.e. the information was not provided on the CHIRPP reporting form). In these cases the percentages are calculated on the total after the missing values are removed.

AGE AND SEX DISTRIBUTION OF INJURED

Age (Years)	Frequency	Percent of Injuries	Number /100,000 *	Percent male**
< 1 year	33	28.9	162.0	48.5
1	44	38.6	101.9	45.5
2	15	13.2	36.6	53.3
3	10	8.8	31.1	60
4	6	5.3	22.0	33.3
5	5	4.4	20.3	40
6	1	0.9	4.2	100
Total	114	100	53.7	48.3
* The number of injuries per 100,000 CHIRPP injuries of all types within the age group indicated. Using number per 100,000 within an age group (instead of overall percent by age group) adjusts for different age group distributions. ** Of children aged 0-6 years in the CHIRPP database for 1994 - 1998, the percentage of males was 57.2 %.

OVERALL PATTERN OF OCCURRENCE

Between 1994 and 1998 (inclusive), children aged 0-6 years accounted for 77% of all tap water scalds. Tap water related injuries represented 0.05% of all injuries to 0-6 year olds in the CHIRPP database and of all burns experienced by 0-6 year olds in this time period, 2.1% were associated with tap water.

Time at which the injury occurred

Time of day	Frequency	Percent of Injuries
Midnight to < 8:00 am	1	1.4
8:00 am to < Noon	18	25.7
Noon to < 4:00 pm	14	20
4:00 pm to < 8:00 pm	16	22.9
8:00 pm to < Midnight	21	30
Total	70	100
# of missing values = 44

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Day during which the injury occurred

Day	Frequency	Percent of Injuries
Sunday	19	16.7
Monday	15	13.1
Tuesday	19	16.7
Wednesday	12	10.5
Thursday	15	13.2
Friday	10	8.8
Saturday	24	21.1
Total	114	100

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Season during which the injury occurred

Season	Frequency	Percent of Injuries
Spring (March-May)	32	28.1
Summer (June-August)	22	19.3
Fall (September-November)	29	25.4
Winter (December-February)	31	27.2
Total	114	100

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CIRCUMSTANCES OF THE INJURY

Where the injury occurred

Location/Area	Frequency	Percent of Injuries
Own home bathroom kitchen bedroom living room yard other room/area unknown	96 50 19 7 2 1 2 15	84.2
Other home bathroom kitchen unknown	6 4 1 1	5.3
Trade or service area	3	2.6
Unknown	9	7.9
Total	114	100

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Circumstances surrounding the injury*

Circumstances	Frequency	Percent of Injuries
Patient in bathtub, sink or taking a shower when the patient, sibling or parent turned on the hot water or turned off the cold	37	32.4
Hot water spilled or splashed on the patient by the patient by another person	24 14 10	21.1
Patient burned or scalded while stepping or being put into bathtub filled with water or while bathing	14	12.3
Burned or scalded by hot tap water, not further specified	12	10.5
Patient climbed into or fell into a bathtub or sink already filled with water or turned hot water on	11	9.6
Playing or washing hands, turned hot water on	9	7.9
Patient put hands in container of hot tap water	4	3.5
Contents of vaporizer/humidifier spilled on patient	2	1.7
Plumbing malfunction	1	0.9
Total	114	100
*Each patient was assigned to a single category and percentages were based on the 114 persons injured. Category assignment was based on the level of detail available in the description of the injury.

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BODY PART BURNED OR SCALDED *

Body part	Frequency	Percent of Injuries
Lower extremity foot or toe thigh leg hip knee	57 29 13 10 3 2	50
Upper extremity hand, fingers or wrist forearm upper arm shoulder	32 16 12 3 1	28.1
Trunk thorax back abdomen pelvis, perineum, external genitalia	18 10 5 2 1	15.8
Face	7	6.1
Total	114	100
* up to three injuries and body parts can be entered per record; only the most severe injury is indicated in the above table; 71.9% of the injured sustained only one injury; 18.4% experienced two injuries and 9.6% suffered three injuries.

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TREATMENT PROVIDED IN THE EMERGENCY DEPARTMENT

Disposition	Frequency	Percent of Injuries
Left without being seen	1	0.9
Advice only	2	1.8
Treated, follow-up if necessary	11	9.6
Treated, medical follow-up required	68	59.6
Short stay, observation in emergency	1	0.9
Admitted to hospital*	31	27.2
Fatal injury**	0	0
Total	114	100
* The percentage of admitted cases for all injuries amongst 0-6 year olds for 1994 to 1998 (inclusive) was 5.64% * *Fatalities counted by CHIRPP include only those patients who were dead on arrival at the emergency department or who died in the emergency department. They do not include people who died before they could be taken to hospital or those who died after hospital admission.

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SUMMARY OF PERSONS ADMITTED TO HOSPITAL

Age and sex distribution of injured (admitted cases)

Age (Years)	Frequency	Percent of Injuries	Percent male*
< 1 year	10	32.2	60
1	12	38.7	25
2	6	19.4	50
3	1	3.2	0
4	1	3.2	0
5	1	3.2	100
Total	31	100	41.9
* The percentage of males amongst admitted children aged 0-6 years in the entire CHIRPP database for 1994 - 1998 is 58.5%.

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Where the injury occurred (admitted cases)

Location/Area	Frequency	Percent of Injuries
Own home bathroom kitchen bedroom other room/area unknown	28 14 4 2 1 7	90.3
Other home bathroom unknown	2 1 1	6.5
Unknown	1	3.2
Total	31	100

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Circumstances surrounding the injury* (admitted cases)

Circumstances	Frequency	Percent of Injuries
Patient in bathtub, sink or taking a shower when the patient, sibling or parent turned on the hot water or turned off the cold	10	32.3
Hot water spilled or splashed on the patient by the patient by another person	6 4 2	19.4
Patient climbed into or fell into a bathtub or sink already filled with water or turned hot water on	6	19.4
Patient burned or scalded while stepping or being put into bathtub filled with water or while bathing	4	12.9
Burned or scalded by hot tap water, not further specified	2	6.4
Patient put hands in container of hot tap water	2	6.4
Contents of vaporizer/humidifier spilled on patient	1	3.2
Total	31	100
*Each patient was assigned to a single category and percentages were based on the 31persons injured. Category assignment was based on the level of detail available in the description of the injury.

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Body part burned or scalded * (admitted cases)

Body part	Frequency	Percent of admitted Injuries	Percent of all injuries**
Lower extremity foot or toe leg thigh hip	18 7 5 4 2	58.1	31.6
Trunk thorax back pelvis, perineum, external genitalia	7 4 2 1	22.6	38.9
Upper extremity hand, fingers or wrist forearm	5 3 2	16.1	15.6
Face	1	3.2	14.3
Total	31	100	27.2
* up to three injuries and body parts can be entered per record; only the most severe injury is indicated in the above table; 48.4% of the injured sustained only one injury; 29 % experienced two injuries and 22.6% suffered three injuries. ** Percentage of all injuries (over all dispositions) for that body part.

SUGGESTED REFERENCE AND REPORTING INFORMATION

This report and data from it may be copied and circulated freely provided that the source is acknowledged. The following citation is recommended:

Injury data were obtained from the database of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), Public Health Agency of Canada.

If data from this report are included in any other document or publication, it should be noted, where appropriate, that the information comes from 15 hospitals (10 pediatric and 5 general) across Canada.

For additional information on the CHIRPP program, please contact the Child Injury Section, Public Health Agency of Canada by phone at (613) 941-9918, by FAX at (613) 941-9927 or visit our website at <www.phac-aspc.gc.ca/injury-bles/index-eng.php>.