Article Text

other Versions

Download PDFPDF
Preventing bath water scalds: a cost-effectiveness analysis of introducing bath thermostatic mixer valves in social housing
  1. Ceri J Phillips1,
  2. Ioan Humphreys1,
  3. Denise Kendrick2,
  4. Jane Stewart3,
  5. Mike Hayes4,
  6. Lesley Nish5,
  7. David Stone6,
  8. Carol Coupland2,
  9. Elizabeth Towner7
  1. 1Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, Wales, UK
  2. 2Division of Primary Care, University of Nottingham, Nottingham, England, UK
  3. 3Nottinghamshire County Teaching Primary Care Trust, Nottingham, England, UK
  4. 4Child Accident Prevention Trust, London, England, UK
  5. 5Public Health and Health Improvement Directorate, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
  6. 6School of Medicine, University of Glasgow, Glasgow, Scotland, UK
  7. 7Faculty of Health and Social Care, University West of England, Bristol, England, UK
  1. Correspondence to Ceri J Phillips, School of Human and Health Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK; c.j.phillips{at}


Aims To assess the cost-effectiveness of installing thermostatic mixer valves (TMVs) in reducing risks of bath water scalds and estimate the costs of avoiding bath water scalds.

Methods The evaluation was undertaken from the perspective of the UK public sector, and conducted in conjunction with a randomised control trial of TMVs installed in social housing in Glasgow. Installation costs were borne by the social housing organisation, while support materials were provided by the UK NHS. Effectiveness was represented by the number of families with at-risk bath water temperatures pre- and post-installation, and the number of bath scalds avoided as a result of installation. Differences in the number of families with at-risk temperatures between groups were derived from the RCT. Cost-effectiveness was assessed and a series of one-way sensitivity analyses were conducted.

Results Unit costs associated with installation were calculated to be £13.68, while costs associated with treating bath water scalds ranged from £25 226 to £71 902. The cost of an avoided bath water scald ranged from net savings to public purse of £1887 to £75 520 and at baseline produced a net saving of £3 229 008; that is, £1.41 saved for every £1 spent.

Conclusion It is very likely that installing TMVs as standard in social housing in new buildings and major refurbishments accompanied by educational information represents value for money.

Trial Registration Number ISRCTN:21179067.

  • Adolescent
  • burns
  • child
  • community
  • economics

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding National Institute for Health Research, Accidental Injury Prevention Research Initiative (001/0009). The final study design, data collection, analysis, interpretation of results, and paper writing was the sole responsibility of the authors. The views and opinions expressed in this paper do not necessarily reflect those of the funding body. This is an independent report commissioned and funded by the Policy Research Program in the Department of Health. The views expressed are not necessarily those of the Department.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The trial protocol was reviewed by Nottingham Research Ethics Committee. As the trial did not involve NHS staff or patients and hence did not fall within the remit for NHS ethics committee approval, the committee was able to provide a review, but not approval. The trial received NHS organisational approval from Nottinghamshire County Primary Care Trust (PCT) (formerly Broxtowe and Hucknall PCT) as some research staff working on the trial were employed by the PCT.

  • Provenance and peer review Not commissioned; externally peer reviewed.