Has the energy poverty crisis fuelled a rise in hot water bottle burn injuries within the United Kingdom?

INTRODUCTION: There are an estimated 10 million hot water bottles (HWB) currently in use within the United Kingdom (UK), and HWB related burn injuries represent a significant resource burden to UK Burns Services. These injuries can be caused through a variety of mechanisms including scalds sustained when filling the bottle or scalds from leaking or rupture. The fuel poverty crisis started in February 2022 leading to an estimated six-fold increase in alternative sources of heating, in particular hot water bottles. In this study, we wish to understand the impact that this may have had upon burn injuries sustained by these products. METHODS: All hot water bottle (HWB)-related injuries sustained January 2014 - February 2023 were retrieved from the UK International Burn Injury Database (IBID). Data were collected on patient demographics, injury mechanism, anatomical location, and clinical outcomes. The data were collated and analysed; statistical analysis was performed using R StudioTM. Patient levelling costs were also incorporated to enable translation of these data into healthcare costs. RESULTS: A total of 5944 HWB-related burn injuries were recorded in the IBID database in England and Wales, from 2014 to 2023, with a mean of 594 (SD 146.2) burn injuries annually, costing an estimated £ 12.7 million. There were 423 burn injuries sustained from HWB in winter 2022 compared to 295 in winter 2021, representing a 43.4 % increase over one year, with a corresponding increase of 43.1 % in the number of patients managed in an outpatient setting. The largest increase in burn incidence between winter 2021 and winter 2022 was seen in children (0-16 years old) and older adults (greater than 65 years old) with a rise of 60.3 % (n = 41) and 68.5 % (n = 37) respectively. CONCLUSION: Our epidemiological study on hot water bottle (HWB)-related burn injuries within the United Kingdom has shown that the dramatic rise in fuel prices, which sparked the fuel poverty crises, has coincided with a 43.4 % increase in HWB burns incidence on the health service in that year alone. This alarming rise in HWB-related injuries highlights the continued need for targeted public awareness campaigns to ensure a safe and proper use of these devices.

[CONTACT BURNS WITH A HOT WATER BOTTLE FOLLOWING AN ABDOMINOPLASTY. CASE REPORTS AND LITERATURE REVIEW]. / BRÛLURES PAR CONTACT AVEC UNE BOUILLOTE DANS LES SUITES D'UNE ABDOMINOPLASTIE. CAS CLINIQUES ET REVUE DE LA LITTÉRATURE.

Loss of sensitivity in the operated area is common after some plastic surgery procedures and promotes accidental trauma on a daily basis. Several studies showed that a loss of sensitivity is constant after an abdominoplasty. We report here the cases of three 3rd degree burns by contact, at the subumbilical level, with a hot water bottle soon after an abdominoplasty, responsible for significant aesthetic sequelae.

Assessing the effect of the cost-of-living crisis on hot water bottle-related burns in the United Kingdom, a single-centre retrospective observational study.

Background: The cost-of-living crisis (CoLC) is an economic climate that the United Kingdom (UK) has been experiencing since late 2021, characterized by an increase in the price of essential goods faster than real-term incomes. Food and fuel poverty has ensued. This study aimed to assess whether the CoLC is associated with an increase in hot water bottle (HWB)-related burns as patients seek alternative heating sources to keep warm. Methods: Records of patients treated for HWB burns between December 2019 and March 2023 were reviewed for patient demographics, burn depth and surface area, patient comorbidities, and patient index of multiple deprivation (IMD). The incidence of admissions, IMD, and severity of injury were compared prior to and during the CoLC using either independent t-test or Kruskal-Wallis H test. Results: Between December 2019 and March 2023, 177 patients were treated for HWB burns, 79 prior to the CoLC, and 98 during. Of the patients, 55 patients were male and 122 females. An independent t-test comparing average monthly admissions prior and during the CoLC identified a significant difference (p = 0.042), with a mean increase of 1.85 cases (95% CI: 0.71-3.63). Additionally, a Kruskal-Wallis H test showed statistically significant difference in the number of patients treated for HWB burns between the seasons (p = 0.001). An independent t-test comparing average patient IMD prior and during the CoLC identified no difference (p = 0.33). Conclusion: The increase in HWB burns coincides with the increase in energy costs and general cost of living that has occurred in the UK since October 2021.

Effect of Hot Water Bottles on Body Temperature during Magnetic Resonance Imaging in Dogs under General Anesthesia: A Retrospective Study.

Prevention of hypothermia induced by anesthesia and enhanced by low environmental temperatures is difficult in magnetic resonance imaging (MRI) examinations in dogs as forced warming devices, including magnetic materials, are not acceptable for use in the MRI room. A hot water bottle (HWB) can be carried into an MRI examination room and can contribute to the prevention or attenuation of hypothermia. Here, we retrospectively investigated the effects of HWB on body temperature during MRI examinations in dogs under general anesthesia (GA). From anesthesia records of the Veterinary Medical Teaching Hospital, Okayama University of Science, validated data of 100 dogs that underwent an MRI examination under GA were obtained and divided into the following two groups: one group received HWB, while the other did not. Decrease in rectal temperature 15 min after intubation was significantly smaller in the group using HWB than in the group without HWB. In conclusion, the use of hot water bottles might be one of the methods to attenuate hypothermia in the early period but should not be expected for complete prevention of hypothermia, and it was not recommendable necessarily for body temperature management during MRI examinations in dogs under general anesthesia.

In hot water: The impact of burn injuries from hot water bottles - Experience of a UK burns unit and review of the literature.

INTRODUCTION: Hot water bottles (HWBs) are a common domestic item in the UK. Their use is associated with burns injuries, either by contact for prolonged periods with the skin, or through the HWB leaking or bursting. METHODS: We used electronic health records to retrospectively review HWB related burns treated by the Burns Service at Chelsea and Westminster Hospital between January 2017-March 2018. We analysed the mechanism of injury, size and depth of burn, method of treatment and costs associated with HWB burns in our centre. RESULTS: 80 patients sustained HWB burns during this period, with a similar incidence of contact burns (41/80, 51.3%) and scalds (38/80, 47.5%), with one steam burn. The commonest area burnt was the lower limb (40/80, 50%). Most burns had a TBSA of 1% or smaller (50/80, 62.5%). 30 patients had full thickness burns, with 37 in total received operative management. We estimate that the total cost for managing this cohort of patients was over £68,634. CONCLUSIONS: There are a significant proportion of patients presenting with HWB burns that could be prevented, with significant impact on patient morbidity and resource burden on the NHS. Targeted public awareness campaigns are needed to ameliorate these injuries.

Quemaduras en niños provocadas por rotura de bolsa para agua caliente / Children's scalds from tearing of hot water bottle

INTRODUCCIÓN: La quemadura en niños por rotura de bolsa de agua caliente, presentó un incremento brusco y significativo alrededor del año 2000 en Chile. Ante ello, la Corporación de Ayuda al Niño Quemado (COANIQUEM) difundió conceptos de prevención en su uso y alerta a autoridades. Posteriormente el Instituto de Normalización Nacional introdujo normativas de certificación de calidad de los productos comercializados en el país. OBJETIVO: Determinar el impacto de medidas preventivas y de certificación de calidad de las bolsas de agua caliente en las quemaduras por rotura del producto en niños. PACIENTES Y MÉTODO: Revisión de ingresos de 795 pacientes menores de 15 años, con quemaduras por rotura de bolsa de agua caliente, entre 2000-2014, en COANIQUEM-Santiago. Se determinó evolución de las frecuencias de quemaduras por el agente etiológico y se comparó el perfil epidemiológico en los períodos quinquenales inicial y final. RESULTADOS: Entre 2000-2004, se registró un incremento de 272,7% en los ingresos y un descenso de 81,3% entre 2005-2014. Las características demográficas, mes de ocurrencia de las quemaduras y necesidad de algún tipo de cirugía, fueron similares en los períodos comparados. El número de localizaciones disminuyó concentrándose en una quemadura (77,8%). En el segundo período incluyó además de extremidad inferior, abdomen y pelvis como ubicaciones frecuentes. CONCLUSIONES: Se verifica un importante descenso de las quemaduras por bolsa de agua caliente en niños, y un cambio significativo en sus características epidemiológicas, coincidiendo con medidas de prevención y normativa de certificación de calidad de los implementos.

INTRODUCTION: Children scalded by the tearing of hot-water bottles presented a sudden and significa tive increase around 2000 in Chile. For this reason the Aid to Burned Children Corporation (COA-NIQUEM) publicized prevention concepts concerning the careful use of this device and raised a voice of alarm to authorities. Later, the National Normalization Institute introduced quality certification standards for hot water bottles sold in the country. OBJECTIVES: Determine the impact of preventive measures and quality certification for hot water bottles in burns caused by tearing of the device on children. PATIENTS AND METHOD: Review of 795 patients under 15 admitted with injuries caused by hot-water bottle rupture between 2000 and 2014 at COANIQUEM Santiago. The frecuency of burns by the ethiological agent is determined and the epidemiological profile are compared in the initial and final quinquenial period. RESULTS: Between 2000-2004, an increase of 272.7% was recorded and then a decrease of 81.3 % was found between 2005-2014. Demographic characteristics, month of occurrence and need of some kind of surgery were similar in both periods. The number of locations and injuries diminished, and are concentrated in one burn (77.8%). In the first period the main anatomical region affected was lower limbs and in the second period abdominal and pelvis are also frequent. CONCLUSIONS: An important decrease of burns by hot-water bottle rupture with significant changes in their epidemiological characteristic is verified. This coincides with preventive measures and manufacturing standards regulations and quality control.

Too hot to handle? Hot water bottle injuries in Sydney, Australia.

OBJECTIVE: Hot water bottles are frequently used in the community as a source of warmth, and to alleviate a number of medical symptoms. In Australia it is believed that over 500,000 water bottles are sold annually (Whittam et al., 2010). This simple treatment is known to result in significant burns and has led to mandatory labeling requirements on hot water bottles in Australia. Despite this, few published studies have documented the incidence and nature of burns sustained through their use. This study aimed to assess the incidence, causation and outcome of hot water bottle burns presenting to a major burn trauma unit in Sydney (Australia). METHODS: The New South Wales Agency for Clinical Innovation Statewide Burn Injury database and admission data to the Concord Hospital Burns Injury Unit (major treatment unit) provided information on hot water bottle burns occurring between 2005 and 2013. Demographic details, cause of burn, burn depth, total burn surface area (%TBSA), and outcome of burn were ascertained. In order to assess the burn potential of hot water bottles, a separate study examined the thermic properties of hot water bottles in 'real life' scenarios. FINDINGS: There were 155 hot water bottle burn presentations resulting in 41 admissions and 24 grafts. The majority of patients were female, and most burns resulted from appliance rupture when used for local pain relief. Patients had an average TBSA of 2.4%. Burns patients were slightly more likely to reside in areas with greater socio-economic disadvantage. In real life scenarios, hot water bottles were shown to retain heat over 50°C for at least 3 hours (h). CONCLUSIONS: Hot water bottles are a source of common and preventable burns in the community, with women being more at risk than men. Hot water bottles may retain harmful levels of heat over an extended period of time. Additional labeling requirements pertaining to the longevity of hot water bottles and their use among people especially at risk of burns (i.e. children, the elderly, patients who have undergone recent surgery and/or those with conditions associated with sensory impairment) may further reduce the incidence and severity of hot water bottle burns in the community.