NICE advice on preventing scalds backed by study findings

Published on Friday, 04 March 2011 16:26
Posted by Scott Buckler

Installing a thermostatic mixing valve in the home is an effective way of controlling bath water temperature and could help to reduce the number of children who suffer bath water scalds, research suggests


Around 2,500 children are admitted to emergency departments following bath water scalds in the UK each year.

Scalds place a significant financial burden on the NHS and society. In 2009, the total cost of scald injuries and deaths from hot tap water was estimated to be £61 million.

Commonly scalds occur when children fall or climb unsupervised into bath water; when a child turns on the hot tap or when a parent puts a child into water that is too hot.

Home thermostats are typically set at a temperature of 60oC or above. Water at this temperature can cause a full thickness burn in adults in 5 seconds and even quicker in children.

Thermostatic mixing valves can reduce the risk of scalding by lowering the temperature of water coming out of the hot tap down to around 46oC.

NICE recommended the use of the mixing valves in guidance on preventing unintentional injuries in the home, published in November last year.

The guidance called for local authorities to develop local agreements with housing associations and landlords to ensure permanent home safety equipment, such as the mixing valves, is installed and maintained in all social and rental dwellings.

But little is known about the acceptability of fitting the valves in the home, particularly among a high-risk population in the UK.

Researchers at the University of Nottingham set out to examine this issue by conducting a study involving 124 families with children under 5 living in Glasgow Housing Association housing, one of the UK's biggest social housing providers.

The study found that families with a thermostatic mixing valve fitted to the hot and cold water pipes in their bathroom had bath water temperatures that were up to 11˚C cooler than those without and their baths were within the recommended temperature of 46˚C.

Writing in the journal Archives of Disease in Childhood, the researchers concluded that the use of the valves was effective in reducing bath hot tap water temperature, which should significantly lower the number of scalds.

As a result of the study, Glasgow Housing Association has fitted 24,000 new bathrooms with the valves and plans to fit another 12,000.

Lead researcher Professor Denise Kendrick, who was also involved in the development of the NICE guidance, said:

Most families were satisfied with the temperature and speed of flow of their hot water after fitting, and with the fitting process.

“Those with a valve were significantly less likely to check the bath temperature of every bath, but we did not find a negative effect on other safety practices. It is therefore important for plumbers fitting the valves to emphasise that people still need to check the temperature of the bath water before getting into, or putting a child into the bath.”

Heather Ward, Chair of the Programme Development Group (PDG) that developed the strategies guidance, said:

Installing a thermostatic mixing valve will help prevent very young children from being scalded when they are being bathed.

“It's already in the building regulations for new houses to be fitted with these valves but we would like to see them installed by landlords into existing properties where there are young children.

“Given that it can cost up to a quarter of a million pounds to treat a scalded child, not to mention the scarring for life that these children endure, then it's a very good measure to implement


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