Abstract
Introduction—Many countries still have unacceptably high hospitalizations and deaths from scalds from hot tap water. Prevention strategies implemented in some countries may not work in others. Legislation aimed at changing environments that are conducive to hot tap water scalds may not be effective in many situations for a number of reasons, including lack of acceptability and practicality.
Method—A qualitative study of a purposefully selected group of craftsman plumbers across New Zealand was conducted using a structured format with open ended questions. The questionnaire was administered by telephone. Information was sought on the opinions, knowledge, and practice of these plumbers regarding hot tap water safety in homes.
Results—Several barriers to hot tap water safety in homes were identified by the plumbers. These included common characteristics of homes with unsafe hot tap water, such as hot water systems heated by solid fuel, and public ignorance of hot tap water safety. Other factors that emerged from the analysis included a lack of knowledge by plumbers of the hazards of hot tap water, as well as a lack of importance given to hot tap water safety in their plumbing practice. Shower performance and the threat to health posed by legionella were prioritized over the prevention of hot tap water scalds.
Conclusion—The findings of this study allow an understanding of the practical barriers to safe hot tap water and the context in which interventions have been applied, often unsuccessfully. This study suggests that plumbers can represent a barrier if they lack knowledge, skills, or commitment to hot tap water safety. Conversely, they represent a potential source of advocacy and practical expertise if well informed, skilled, and committed to hot tap water safety.
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Selected References
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- Adams L. E., Purdue G. F., Hunt J. L. Tap-water scald burns. Awareness is not the problem. J Burn Care Rehabil. 1991 Jan-Feb;12(1):91–95. doi: 10.1097/00004630-199101000-00022. [DOI] [PubMed] [Google Scholar]
- Andersen R. D., Lauer B. A., Fraser D. W., Hayes P. S., McIntosh K. Infections with Legionella pneumophila in children. J Infect Dis. 1981 Mar;143(3):386–390. doi: 10.1093/infdis/143.3.386. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Baux S., Mimoun M., Saade H., Lioret N., Esteve M., Nolland X. B., Bertiere M. N. Burns in the elderly. Burns. 1989 Aug;15(4):239–240. doi: 10.1016/0305-4179(89)90039-9. [DOI] [PubMed] [Google Scholar]
- Borland B. L. Prevention of childhood burns: conclusions drawn from an epidemiologic study. Clin Pediatr (Phila) 1967 Dec;6(12):693–695. doi: 10.1177/000992286700601210. [DOI] [PubMed] [Google Scholar]
- Darko D. F., Wachtel T. L., Ward H. W., Frank H. A. Analysis of 585 burn patients hospitalized over a 6-year period. Part III: Psychosocial data. Burns Incl Therm Inj. 1986 Aug;12(6):395–401. doi: 10.1016/0305-4179(86)90034-3. [DOI] [PubMed] [Google Scholar]
- Dickson N., Martin M., Waller A. E. Hot water temperature in Dunedin homes with preschool children. N Z Med J. 1990 Sep 26;103(898):452–454. [PubMed] [Google Scholar]
- Erdmann T. C., Feldman K. W., Rivara F. P., Heimbach D. M., Wall H. A. Tap water burn prevention: the effect of legislation. Pediatrics. 1991 Sep;88(3):572–577. [PubMed] [Google Scholar]
- Feldman K. W., Clarren S. K., McLaughlin J. F. Tap water burns in handicapped children. Pediatrics. 1981 Apr;67(4):560–562. [PubMed] [Google Scholar]
- Feldman K. W. Help needed on hot water burns. Pediatrics. 1983 Jan;71(1):145–146. [PubMed] [Google Scholar]
- Feldman K. W., Schaller R. T., Feldman J. A., McMillon M. Tap water scald burns in children. Pediatrics. 1978 Jul;62(1):1–7. [PubMed] [Google Scholar]
- Gordon P. G., Ramsay G. C. A survey of thermal injuries to children in Australia. Part one. Aust Fam Physician. 1986 Sep;15(9):1222-3, 1226-9. [PubMed] [Google Scholar]
- Hammond J., Ward C. G. Burns in octogenarians. South Med J. 1991 Nov;84(11):1316–1319. doi: 10.1097/00007611-199111000-00006. [DOI] [PubMed] [Google Scholar]
- Heaton P. A. The pattern of burn injuries in childhood. N Z Med J. 1989 Nov 8;102(879):584–586. [PubMed] [Google Scholar]
- Herd A. N., Widdowson P., Tanner N. S. Scalds in the very young: prevention or cure? Burns Incl Therm Inj. 1986 Apr;12(4):246–249. doi: 10.1016/0305-4179(86)90124-5. [DOI] [PubMed] [Google Scholar]
- Herd B. M., Herd A. N., Tanner N. S. Burns to the elderly: a reappraisal. Br J Plast Surg. 1987 May;40(3):278–282. doi: 10.1016/0007-1226(87)90123-8. [DOI] [PubMed] [Google Scholar]
- Katcher M. L. Scald burns from hot tap water. JAMA. 1981 Sep 11;246(11):1219–1222. [PubMed] [Google Scholar]
- Katcher M. L. Tap water scald prevention: it's time for a worldwide effort. Inj Prev. 1998 Sep;4(3):167–168. doi: 10.1136/ip.4.3.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Langley J., Dodge J., Silva P. A. Scalds to preschool children. N Z Med J. 1981 Feb 11;93(677):84–87. [PubMed] [Google Scholar]
- Langley J., Tobin P. Childhood burns. N Z Med J. 1983 Sep 14;96(739):681–684. [PubMed] [Google Scholar]
- Le H. Q., Zamboni W., Eriksson E., Baldwin J. Burns in patients under 2 and over 70 years of age. Ann Plast Surg. 1986 Jul;17(1):39–44. doi: 10.1097/00000637-198607000-00008. [DOI] [PubMed] [Google Scholar]
- MacKay A. M., Rothman K. J. The incidence and severity of burn injuries following Project Burn Prevention. Am J Public Health. 1982 Mar;72(3):248–252. doi: 10.2105/ajph.72.3.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McLoughlin E., Crawford J. D. Burns. Pediatr Clin North Am. 1985 Feb;32(1):61–75. doi: 10.1016/s0031-3955(16)34756-3. [DOI] [PubMed] [Google Scholar]
- McLoughlin E., Vince C. J., Lee A. M., Crawford J. D. Project Burn Prevention: outcome and implications. Am J Public Health. 1982 Mar;72(3):241–247. doi: 10.2105/ajph.72.3.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Molinaro J. R. The social fate of children disfigured by burns. Am J Psychiatry. 1978 Aug;135(8):979–980. doi: 10.1176/ajp.135.8.979. [DOI] [PubMed] [Google Scholar]
- Murray J. P. A study of the prevention of hot tapwater burns. Burns Incl Therm Inj. 1988 Jun;14(3):185–193. doi: 10.1016/0305-4179(88)90036-8. [DOI] [PubMed] [Google Scholar]
- Ostrow L. B., Bongard F. S., Sacks S. T., McGuire A., Trunkey D. D. Burns in the elderly. Am Fam Physician. 1987 Jan;35(1):149–154. [PubMed] [Google Scholar]
- Pegg S. P., Gregory J. J., Hogan P. G., Mottarelly I. W., Walker L. F. Burns in childhood: an epidemiological survey. Aust N Z J Surg. 1978 Aug;48(4):365–373. doi: 10.1111/j.1445-2197.1978.tb04878.x. [DOI] [PubMed] [Google Scholar]
- Petro J. A., Belger D., Salzberg C. A., Salisbury R. E. Burn accidents and the elderly: what is happening and how to prevent it. Geriatrics. 1989 Mar;44(3):26-7, 32-6, 48. [PubMed] [Google Scholar]
- Roberts N. J., Jr, Baum J., Douglas R. G., Jr The absence of differences in cellular immunity in elderly individuals with and without delayed local cutaneous reactions to influenza vaccine. J Med Virol. 1979;3(3):195–201. doi: 10.1002/jmv.1890030305. [DOI] [PubMed] [Google Scholar]
- Rossignol A. M., Locke J. A., Burke J. F. Paediatric burn injuries in New England, USA. Burns. 1990 Feb;16(1):41–48. doi: 10.1016/0305-4179(90)90204-a. [DOI] [PubMed] [Google Scholar]
- Schwarz D. F., Grisso J. A., Miles C., Holmes J. H., Sutton R. L. An injury prevention program in an urban African-American community. Am J Public Health. 1993 May;83(5):675–680. doi: 10.2105/ajph.83.5.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Slater H., Gaisford J. C. Burns in older patients. J Am Geriatr Soc. 1981 Feb;29(2):74–76. doi: 10.1111/j.1532-5415.1981.tb01231.x. [DOI] [PubMed] [Google Scholar]
- Tejerina C., Reig A., Codina J., Safont J., Mirabet V. Burns in patients over 60 years old: epidemiology and mortality. Burns. 1992 Apr;18(2):149–152. doi: 10.1016/0305-4179(92)90015-m. [DOI] [PubMed] [Google Scholar]
- Thomson H. G., Shore B. The bathtub burn--a pediatric disaster. Can J Surg. 1971 Nov;14(6):399–401. [PubMed] [Google Scholar]
- Walker A. R. Fatal tapwater scald burns in the USA, 1979-86. Burns. 1990 Feb;16(1):49–52. doi: 10.1016/0305-4179(90)90205-b. [DOI] [PubMed] [Google Scholar]
- Waller A. E., Clarke J. A., Langley J. D. An evaluation of a program to reduce home hot tap water temperatures. Aust J Public Health. 1993 Jun;17(2):116–123. [PubMed] [Google Scholar]
- Waller A. E., Marshall S. W. Childhood thermal injuries in New Zealand resulting in death and hospitalization. Burns. 1993 Oct;19(5):371–376. doi: 10.1016/0305-4179(93)90056-e. [DOI] [PubMed] [Google Scholar]
- Waller A. E., Marshall S. W., Langley J. D. Adult thermal injuries in New Zealand resulting in death and hospitalization. Burns. 1998 May;24(3):245–251. doi: 10.1016/s0305-4179(98)00018-7. [DOI] [PubMed] [Google Scholar]
- Webne S. L., Kaplan B. J. Preventing tap water scalds: do consumers change their preset thermostats. Am J Public Health. 1993 Oct;83(10):1469–1470. doi: 10.2105/ajph.83.10.1469. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams E. E., Griffiths T. A. Psychological consequences of burn injury. Burns. 1991 Dec;17(6):478–480. doi: 10.1016/0305-4179(91)90075-r. [DOI] [PubMed] [Google Scholar]
- Yeoh C., Nixon J. W., Dickson W., Kemp A., Sibert J. R. Patterns of scald injuries. Arch Dis Child. 1994 Aug;71(2):156–158. doi: 10.1136/adc.71.2.156. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zamboni W. A., Cassidy M., Eriksson E. Hand burns in children under 5 years of age. Burns Incl Therm Inj. 1987 Dec;13(6):476–483. doi: 10.1016/0305-4179(87)90227-0. [DOI] [PubMed] [Google Scholar]