Clouatre Elsa, Pinto Ruxandra, Banfield Joanne, Jeschke Marc G
University of Toronto, Ontario, Canada.
J Burn Care Res. 2013 Mar-Apr;34(2):243-8. doi: 10.1097/BCR.0b013e3182789057.
Hot water scalds can be quite debilitating for a prolonged period of time. It has been previously determined that the severity of hot water scalds increases in a logarithmic trend with water temperature, which has led to legislations requiring changes to the physical environment to reduce the temperature of hot water. In September 2004, Ontario changed its Building Code, requiring all new or renovated residential buildings to lower the maximum setting of their hot water heaters to 49°C (120°F). The aim of the present study was to evaluate the effectiveness of the legislation at reducing both the overall incidence and hospitalizations caused by hot tap water scalds. Hot tap water scald cases were identified from the National Ambulatory Care Reporting System and Discharge Abstract Database databases provided by Canadian Institute for Health Information for April 2002 to March 2010. Annual incidences, hospitalizations, and outcomes were recorded. There were a total of 6952 hot tap water scald cases in Ontario, including 408 hospitalizations in the 8-year period. The average annual incidence rate for hot tap water scalds for the study period was 6.93 cases per 100,000 population and the average hospitalization rate was 0.4 cases per 100,000 population. The high-risk population group of children and elderly comprised the majority of hospitalization cases (60%); however, adults are responsible for the majority of the ambulatory cases (67%). There was a significant decrease in the age-standardized monthly ambulatory scald cases per 100,000 population after the intervention of 0.01055 (95% confidence interval [CI] [0.004, 0.017]; P = .0018) with a rate of change of 0.9455 (95% CI [0.90, 0.98]; P < .0001) and a long-term decrease of 0.19 per 100,000. There was no significant difference in length of stay of hospitalized cases after the intervention (rate ratio = 0.91; 95% CI (0.70, 1.18); P = .4624). Overall, the regulation of limiting the maximum hot water temperature in residential homes has had a positive impact on reducing the overall number of hot tap water scalds; however, they still cause a considerable amount of morbidity because the number of hospitalized cases did not change significantly. In addition to implementing regulations, active prevention and educational campaigns are still necessary to eliminate this preventable injury.
长时间的热水烫伤可能会使人相当虚弱。此前已经确定，热水烫伤的严重程度随水温呈对数趋势增加，这导致了相关法规要求改变物理环境以降低热水温度。2004年9月，安大略省修改了其建筑规范，要求所有新建或翻新的住宅建筑将热水器的最高设置温度降至49°C（120°F）。本研究的目的是评估该法规在降低由自来水烫伤导致的总体发病率和住院率方面的有效性。从加拿大卫生信息研究所提供的2002年4月至2010年3月的国家门诊护理报告系统和出院摘要数据库中识别出自来水烫伤病例。记录年度发病率、住院率和治疗结果。安大略省共有6952例自来水烫伤病例，其中8年期间有408例住院治疗。研究期间自来水烫伤的平均年发病率为每10万人6.93例，平均住院率为每10万人0.4例。儿童和老年人这一高危人群占住院病例的大多数（60%）；然而，成年人占门诊病例的大多数（67%）。干预后，每10万人口中按年龄标准化的每月门诊烫伤病例显著减少0.01055（95%置信区间[CI][0.004, 0.017]；P = 0.0018），变化率为0.9455（95%CI[0.90, 0.98]；P < 0.0001），每10万人长期减少0.19例。干预后住院病例的住院时间没有显著差异（率比 = 0.91；95%CI(0.70, 1.18)；P = 0.4624）。总体而言，限制住宅热水最高温度的规定对减少自来水烫伤的总数产生了积极影响；然而，由于住院病例数量没有显著变化，它们仍然导致了相当数量的发病情况。除了实施法规外，积极的预防和教育活动对于消除这种可预防的伤害仍然是必要的。
