Burns and Scald Injuries Factsheet

In this fact sheet, we use the phrase “burns and scalds” to include all thermal injuries from contact with smoke, fire and flames, and other heat sources, such as hot food and drinks and household appliances. (AIHW: Injury in Australia, 2021)

While burns and scalds are not the most common types of injury in Australia, they can be among the most serious, traumatic and life altering, often requiring ongoing healthcare. Injuries from burns and scalds can be both unintentional and intentional. The data and information presented in this fact sheet refer to unintentional burn and scald injury.

These injuries are among the most preventable through product standards including hot water standards, flame-resistant child sleepwear and housing codes requiring firewalls and smoke detectors (WHO, 2018), and through the use and awareness of emergency plans in the event of building, house and bush fires. The severity of injuries due to burns and scalds can be minimised through application of effective first aid such as cold running water for twenty minutes.

What is the incidence and burden of burn and scald injury in the Australian population?

In 2017-2018, there were:

98 deaths, accounting for 0.8% of all injury deaths
(AIHW: Injury in Australia, 2021)
5,853 hospitalisations, accounting for 1.1% of all injury hospitalisations
(AIHW: Injury in Australia, 2021)
Age standardized rate of 23.7 per 100,000 people
(AIHW: Injury in Australia, 2021)

Burn and scald injury has the longest average length of stay in hospital of all the injury types with 4.9 days in hospital. (AIHW: Injury in Australia, 2021)

Burns and scalds rank 10th in terms of injury burden across the Australian population[1]. (AIHW, 2019)

For children (0-14 years) burns and scalds are the 8th leading cause of DALYs1 with children under five years of age being most vulnerable. (AIHW, 2019)

Aboriginal and Torres Strait Islander peoples accounted for:

9% of hospitalised burn cases for the 12-month period 2016-17 (AIHW: Pointer, 2019); and
the age-standardised rate of burn and scald injury in 2017-2018 for Aboriginal and Torres Strait Islander people was 61.3 per 100,000. (AIHW: Injury in Australia, 2021)

About 42% of all Aboriginal and Torres Strait Islander people hospitalized for burn and scald injury are children aged up to 14 years. (AIHW: Injury in Australia, 2021)

[1] Burden, described in terms of disability adjusted life years (DALY), combines the years of the life lost through premature death from an injury (YLL) with the total years of life living with disability following injury (YLD)

The cost from burn injury in Australia was over $112 million for the 2015-2016 period. (AIHW, 2020)

Common Risk Factors

Burn and scald injury rates are highest among:

Men

About two-thirds of people in hospital with a burn or scald injury were men (in 2017-2018; 3,732 men and 2,121 women).

Alcohol users

Alcohol users experience more severe burn and scald injury and poorer outcomes following a burn or scald injury than those with no alcohol at the time of injury.

Young children

One in five of people hospitalised for burns and scalds were children aged 0–4 (in 2017-2018, of the 5,853 people hospitalized with a burn injury, 1,064 were children aged 0-4)

Exposure to unsafe products

Unsafe products or chemicals such as friction burns from treadmills, button batteries causing oesophageal burns in children, or laser pointers leading to retinal burns.

People experiencing disadvantage

The highest proportions of burn and scald injury were from people living in areas of the lowest socio-economic classification.

People with sensory deficits or disability

Those with sensory deficits and/or disabilities have an increased risk of burn and scald injury.

Effective interventions

Is there any evidence of effective interventions?

Effectiveness of interventions to prevent burns and scalds, outlined in the table below, is based on the findings of the review of reviews that informed the National Injury Prevention Strategy 2021-2030. The table needs to be read recognising the limitations of current evidence, including a lack of investment in well-designed research studies.

While systematic reviews are regarded as the ‘strongest level of evidence’, there are limitations. Research evidence may be biased towards western science, lack consideration of Indigenous or other knowledges and may not accurately capture the experiences and priorities of particular population groups.

Some ‘rigorous’ research designs may not be acceptable, feasible or sufficiently adaptable to make them viable or appropriate to use within a particular setting, or with particular population groups.

Prioritising self-determination, a strengths-based approach and culturally responsiveness should be guiding principles in program planning and evaluations.

Data and research gaps – What don’t we know?

There are few studies that examine the effectiveness of interventions to prevent burns and scalds in children and almost none for other age groups, or targeting specific population groups most at risk of burn injury.

There is a need for further, and high quality, research that evaluates community based programs, together with examination of the cost effectiveness of programs that provide free, low cost or discounted safety equipment. While one review examined burn prevention programs in low and middle income countries, available studies provide limited focus on the effect of programs according to age, gender, social and cultural group.

Future studies should seek to expand this analysis, with a need to focus on the effectiveness of programs in preventing burns and scalds among Aboriginal and Torres Strait Islander children, people living in rural and remote areas and people in low socio-economic groups. In addition, there is no evidence that shows effectiveness of programs to ensure optimal outcomes following burn injury for Aboriginal and Torres Strait Islander people.

Given the potential for an increase in bushfires throughout Australia, there is also a need for research on the prevention of burns including death associated with these events.

Relevant national strategies

The following table presents an overview of national strategies that relate to prevention of burn and scald injury. There are currently no national specific burn prevention strategies.

Key partners and stakeholders

Key organisations with resources and programs for burn and scald prevention

Key additional organisations to consider partnering in program development and evaluation for burn and scald prevention

Aboriginal Community Controlled Health Organisations
Local government
Rural health services
State education departments
State and territory departments of health
State and territory departments of sport and recreation

Key resources and guidelines

Preventing hot water burns and scalds - Department and Health and Human services – Tasmania
Preventing burns and scalds - Kidsafe WA
Burns and scalds prevention- Kidsafe NSW, Inc.
Burns prevention - Australia and New Zealand Burn Prevention Association
Burns - WHO (fact sheet).
Adams S, Elkington J, MacKay JM, Zwi K, O’Sullivan M, Vincenten J, Brussoni M, Towner E, Brown J. Child Safety Good Practice Guide: Good investments in unintentional child injury prevention and safety promotion. Sydney: Sydney Children’s Hospitals Network, 2016.

References

Burden and incidence of burn and scald injury

Australian Institute of Health and Welfare (2021). Injury in Australia: burns and other thermal causes. Accessed from https://www.aihw.gov.au/reports/injury/burns-and-other-thermal-causes
Australian Institute of Health and Welfare (2019). Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease series no. 19. Cat. no. BOD 22. Canberra: AIHW
Australian Institute of Health and Welfare (2016). Australian Burden of Disease Study: impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2011. Canberra: AIHW Retrieved from Australian Burden of Disease Study: Impact and causes of illness and death in Aboriginal and Torres Strait Islander people 2011
Australian Institute of Health and Welfare (2020). Injury expenditure in Australia 2015–16. Cat. no. HWE 78. Canberra: AIHW. Data tables: Injury Expenditure in Australia 2015-16. Viewed 15 February 2021, https://www.aihw.gov.au/reports/health-welfare-expenditure/injury-expenditure-in-australia-2015-16
Australian Institute of Health and Welfare. (2021) Hospitalised injury in children and young people, 2017–18. Canberra: AIHW
Australian Institute of Health and Welfare. (2019). Injury mortality and socioeconomic influence in Australia 2015–16. Canberra: AIHW
Australian Institute of Health and Welfare: Pointer S. (2019) Trends in hospitalised injury, Australia 2007–08 to 2016–17. Cat. no. INJCAT 204. Canberra: AIHW
Tracy LM, Rosenblum S, & Gabbe BJ. (2020). Burns Registry of Australia and New Zealand (BRANZ) 2018/19 Annual Report. Department of Epidemiology and Preventive Medicine, Monash University. Melbourne, Australia
World Health Organisation. (2018). Burns. Accessed April 2018 https://www.who.int/news-room/fact-sheets/detail/burns

Risk factors for burn and scald injury

Australian Institute of Health and Welfare: Henley G, Harrison JE. (2019) Trends in injury deaths, Australia: 1999–00 to 2016–17. Injury research and statistics series no. 127. Cat. no. INJCAT 207. Canberra: AIHW, AIHW/Division
Australian Institute of Health and Welfare: Pointer S & Tovell A (2016). Hospitalised burn injuries, Australia, 2013–14. Injury research and statistics series no. 102. Cat. no. INJCAT 178. Canberra: AIHW
Cairns R., Brown JA., Lachireddy K., Wylie C., Robinson J., Dawson AH., Buckley NA. (2019) Button battery exposures in Australian children: a prospective observational study highlighting the role of poisons information centres. Clinical Toxicology, 57(6), 404-410
Marchalik R., Rada E, Albino F., Sauerhammer T.M., Boyajian M., Rogers G., Oh A. (2018) Upper extremity friction burns in the pediatric patient: A 10-year review. Plastic and Reconstructive Surgery Global Open 6(12), e2408
McInnes JA, Cleland HJ, Cameron PA, Darton A, Tracy LM, Wood FM, Singer Y, Gabbe BJ. (2019) Epidemiology of burn-related fatalities in Australia and New Zealand, 2009–2015, Burns, 45(7), 1553-156
Raoof N., Chan T.K.J., Rogers N.K., Abdullah W., Haq I., Kelly S.P., Quhill FM.(2014) ‘Toy’ laser macular burns in children. Eye 28(2), 231-234. DOI: 10.1038/eye.2013.315
Chen, G., Smith, G., Ranbom, L., Sinclair, S., Xiang, H. 2007. Incidence and Pattern of Burn Injuries Among Children With Disabilities. The Journal of Trauma: Injury, Infection, and Critical Care. 62(3): 682-686 doi: 10.1097/01.ta.0000203760.47151.28

Burn and scald prevention

Hahn AP, Jochai D, Caufield-Noll CP, Hunt CA, Allen LE, Rios R, Cordts GA. (2014) Self-inflicted burns: a systematic review of the literature. J Burn Care Res. Jan-Feb;35(1):102-19. doi: 10.1097/BCR.0b013e31828b0a46. PMID: 24165664
Kendrick, D., Smith, S., Sutton, A. J., Mulvaney, C., Watson, M., Coupland, C., & Mason-Jones, A. (2009). The effect of education and home safety equipment on childhood thermal injury prevention: meta-analysis and meta-regression. Injury Prevention, 15(3), 197-204. doi:https://dx.doi.org/10.1136/ip.2008.020677
Kendrick, D., Young, B., Mason-Jones, A. J., Ilyas, N., Achana, F. A., Cooper, N. J., . . . Coupland, C. (2012). Home safety education and provision of safety equipment for injury prevention. Cochrane Database of Systematic Reviews(9), CD005014. doi:https://dx.doi.org/10.1002/14651858.CD005014.pub3
Rybarczyk, M. M., Schafer, J. M., Elm, C. M., Sarvepalli, S., Vaswani, P. A., Balhara, K. S., ... & Jacquet, G. A. (2016). Prevention of burn injuries in low-and middle-income countries: a systematic review. Burns, 42(6), 1183-1192
Senthilkumaran M, Nazari G, MacDermid JC, Roche K, Sopko K (2019) Effectiveness of home fire safety interventions. A systematic review and meta-analysis. PLoS ONE 14(5): e0215724. https://doi.org/10.1371/journal.pone.0215724
Shokouhi M, Nasiriani K, Cheraghi Z, Ardalan A, Khankeh H, Fallahzadeh H, Khorasani-Zavareh D (2019) Preventive measures for fire-related injuries and their risk factors in residential buildings: a systematic review. J Inj Violence Res, 11(1):1-14. doi: 10.5249/jivr.v11i1.1057. Epub
Turner BJ, Austin SB, Chapman AL. (2014) Treating Nonsuicidal Self-Injury: A Systematic Review of Psychological and Pharmacological Interventions. The Canadian Journal of Psychiatry, 59(11):576-585. doi:10.1177/070674371405901103
Turner, C., Spinks, A., McClure, R., & Nixon, J. (2004). Community‐based interventions for the prevention of burns and scalds in children. Cochrane Database of Systematic Reviews(2). doi:10.1002/14651858.CD004335.pub2
Zou K, Wynn PM, Miller P, Hindmarch P, Majsak-Newman G, Young B, Hayes M, Kendrick D (2015) Preventing childhood scalds within the home: Overview of systematic reviews and a systematic review of primary studies. Burns, 41(5):907-24. doi: 10.1016/j.burns.2014.11.002

Acknowledgements

This fact sheet was prepared by The George Institute for Global Health in partnership with the Australasian Injury Prevention Network (AIPN) and Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, University of Wollongong.
Date: September 2021