Background Hot water scalds continue to pose a serious threat in the home, causing over 1500 hospital admissions and 100 deaths each year in the United States. We aimed to determine whether households who participated in an enhanced home safety visit demonstrated improved safety behaviours about hot water compared to homes receiving a standard home visit as part of a community intervention trial.

Methods The temperature of the hot water and self-reported prevention behaviours were recorded at a baseline visit, and retested 6–9 months later in a follow-up visit. Residents whose hot water temperatures remained at an unsafe temperature were asked why they did not adjust the temperatures. Demographic data were also recorded.

Results A total of 708 households participated. There was no significant difference emerged between the two study groups in the proportion of households observed to have adjusted their hot water temperature to safe levels between the baseline and follow-up visits (t = 1.24; P = 0.22). Residents who received the enhanced education were more likely to report testing their hot water temperature (27% vs 11%; P < 0.01) and turning their hot water temperature below 120°F (43% vs 32%; P =0 .08). Among those who had unsafe temperature levels and did not reduce the water temperature, the most common reason (26%) offered was that they “liked it hot.”

Conclusions These results suggest that water temperatures remain unsafe in many urban homes. The effect of educational interventions may be mitigated by personal preferences of hot water temperature. Passive intervention such the installation of scald prevention devices may be necessary to reduce risk from hot water.