Reduction in paediatric burn admissions over 25 years, 1970-94

Abstract

Objective–To describe trends in burn admissions to a large paediatric burn centre, between 1970 and 1994.

Methods–Hospital records of the Royal Children's Hospital burns unit were audited for the years 1970-94 (n=4992), statewide hospital admissions identified from the Victorian Inpatient Minimum Database for the period, 1987-94 (n=3353), and Victorian burn deaths ascertained from the Australian Bureau of Statistics (n=163), 1970-94.

Results–Between 1970 and 1994 there was a 66% reduction in the annual number of burn admissions to the Royal Children's Hospital, a similar reduction across the state, from 52.4 (95% confidence interval (CI): 48 to 57)/100 000 in 1987 to 34.5 (95% CI:31 to 38)/100 000 in 1994 (p<0.05), and over a 40% fall in the mortality rate. Reductions occurred for all types of burns: scalds 60%; flame burns 55%; and contact burns 70%, but at differing time periods corresponding to the introduction of product legislation, education programs, or changes in heating practices. There was no decline in beverage related scalds. The proportion of children admitted with severe burns increased over the 25 year period, probably reflecting changes in referral practice, while the average length of hospital stay steadily declined, independent of burn type or burn severity.

Conclusions–We believe these reductions reflect the effects of mandatory changes in sleepwear standards and regulations, modifications in heating practices, legislated improvements in the safety of household products, and to a lesser extent the effect of burn education prevention campaigns in the media, especially those directed towards hot water burn injuries among younger children.