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

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 (p < 0.05), and over a 40% fall in the mortality rate. Reductions occurred for all types ofburns: 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 ofmandatory changes in sleepwear standards and regulations, modifications in heating practices, legislated improvements in the safety ofhouse-hold 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. Burn injuries are an important cause of paediatric morbidity. In a study conducted by Nolan and Penny (1992), burns represented approximately 5% of emergency department injury presentations in children aged 0-14 years in Victoria. During the same period, the hospital admission rate for burns and scalds was 165/100 000 children aged 0-14 years.' Evidence from studies in North America and Asia indicate that the burn rates in children have fallen steadily over the past decade.2 3 Although the general epidemiologic patterns of burn injuries among children are known, large scale studies of burn trends have not been conducted. In Victoria, substantial lifestyle, environmental , and regulatory health care changes are factors that may have had an effect on childhood burns. These include changes in indoor heating devices, the introduction of clothing regulations and standards, and more recently the introduction of smoke detectors. These factors have not been evaluated, nor have the trends in Victorian hospital burn admissions been previously documented. The aim of this study was to provide …