Tap Water Burn Prevention: The Effect of Legislation

¹ The University of Washington School of Medicine
² The Children's Hospital and Medical Center and the University of Washington School of Medicine, Department of Pediatrics and The Injury Prevention Center
³ The Children's Hospital and Medical Center and the University of Washington School of Medicine, Department of Pediatrics and The Injury Prevention Center and Regional Burn Unit of the Harborview Medical Center
⁴ The University of Washington School of Medicine and Surgery and Regional Burn Unit of the Harborview Medical Center
⁵ The Seattle City Light Department, Energy Management Services, Seattle, Washington

Five years after a 1983 Washington State law required new water heaters to be preset at 49°C (120°F), 77% of homes (84% of homes with postlaw and 70% of homes with prelaw water heaters) had tap water temperatures of less than 54°C. In 1977, 80% of homes had tap water temperatures greater than 54°C. Mean temperature in 1988 was 50°C compared with 61°C in 1977. Both changes were significant compared with 1977 temperatures. Few people increased their heater temperature after installation. Eighteen burn victims were identified from July 1979 through May 1988, for an average admission rate of 2.4 per year, compared with 5.5 per year in the 1970s. Compared with the 1970s, total body surface area burned, mortality, grafting, scarring, and length of hospital stay were all reduced, while the likelihood that scald burns were the result of child abuse increased to 50%. Both education campaigns and legislation have resulted in significantly safer water temperatures. Further, this change seems to have resulted in a reduction in frequency, morbidity, and mortality of tap water burn injuries in children. Lower water heater settings proved acceptable to the consumer.

Key Words: burns • tap water burns • accidents • injury prevention • child abuse

Submitted on December 1, 1989
Accepted on August 23, 1990

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