Scald risk in social housing can be reduced through thermostatic control system without increasing Legionella risk: a cluster randomised trial

Edwards, Phil; Durand, Mary Alison; Hollister, M.; Green, John; Lutchmun, Suzanne; Kessel, Andreas; Roberts, Ian

doi:10.1136/archdischild-2011-300606

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…While some parents describe safety equipment as an aid to their injury prevention practices, as also found in other studies the perceived limitations of safety equipment can be a further barrier to its installation, maintenance and use [ 12 , 13 ] as can the financial cost of such equipment [ 12 , 13 ]. Social housing providers may be willing to engage with safety interventions as recently demonstrated for scald prevention [ 37 , 38 ], but enforcement through legislation, regulations or standards may also be required to address these barriers. Home safety interventions providing and fitting safety equipment may address some financial barriers and barriers relating to a lack of tools or skills to install and some equipment.…”

Section: Discussionmentioning

confidence: 99%

Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study

et al. 2015

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BackgroundChildhood unintentional injury represents an important global health problem. Most of these injuries occur at home, and many are preventable. The main aim of this study was to identify key facilitators and barriers for parents in keeping their children safe from unintentional injury within their homes. A further aim was to develop an understanding of parents’ perceptions of what might help them to implement injury prevention activities.MethodsSemi-structured interviews were conducted with sixty-four parents with a child aged less than five years at parent’s homes. Interview data was transcribed verbatim, and thematic analysis was undertaken. This was a Multi-centre qualitative study conducted in four study centres in England (Nottingham, Bristol, Norwich and Newcastle).ResultsBarriers to injury prevention included parents’ not anticipating injury risks nor the consequences of some risk-taking behaviours, a perception that some injuries were an inevitable part of child development, interrupted supervision due to distractions, maternal fatigue and the presence of older siblings, difficulties in adapting homes, unreliability and cost of safety equipment and provision of safety information later than needed in relation to child age and development. Facilitators for injury prevention included parental supervision and teaching children about injury risks. This included parents’ allowing children to learn about injury risks through controlled risk taking, using “safety rules” and supervising children to ensure that safety rules were adhered to. Adapting the home by installing safety equipment or removing hazards were also key facilitators. Some parents felt that learning about injury events through other parents’ experiences may help parents anticipate injury risks.ConclusionsThere are a range of barriers to, and facilitators for parents undertaking injury prevention that would be addressable during the design of home safety interventions. Addressing these in future studies may increase the effectiveness of interventions.

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Section: Discussionmentioning

confidence: 99%

Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study

et al. 2015

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“…To answer these questions a cluster randomised trial in 22 social housing estates was conducted, which showed that scalds were indeed reduced but there was no effect on heating bills. 18 The argument for a concept of social equipoise was made by the evaluation guru Donald Campbell (though he does not refer to it as equipoise) in his seminal paper "Reforms as Experiments" in 1969. 19 In it he discusses the difficulty of evaluating the effects of US policy reforms (box).…”

Section: Legitimising Uncertaintymentioning

confidence: 99%

In search of social equipoise

Petticrew

Lock

Green

et al. 2013

BMJ

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“…4 Edwards et al quantified the effects of a thermostatic control system on the prevalence of dangerous water temperatures in a cluster randomized controlled trial in London. 27 Results showed that the prevalence of dangerous hot water temperatures was significantly reduced and gas consumption was not significantly affected. 27 The cost of installing thermostatic mixing valves has been estimated at $250 per room ($100 for the valve and $150 for installation).…”

Section: Discussionmentioning

confidence: 98%

“…27 Results showed that the prevalence of dangerous hot water temperatures was significantly reduced and gas consumption was not significantly affected. 27 The cost of installing thermostatic mixing valves has been estimated at $250 per room ($100 for the valve and $150 for installation). 28 A cost analysis of mass installation in government managed housing in England estimated installation costs at £13.68 (~$22), which included parts, maintenance, and educational material but not labor.…”

Section: Discussionmentioning

confidence: 98%

Still Too Hot

Shields

McDonald

Frattaroli

et al. 2013

Journal of Burn Care & Research

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Objective Although water heater manufacturers adopted a voluntary standard in the 1980’s to pre-set thermostats on new water heaters to 120°F, tap water scald burns cause an estimated 1,500 hospital admissions and 100 deaths per year in the United States. This study reports on water temperatures in 976 urban homes and identifies water heater and household characteristics associated with having safe temperatures. Methods The temperature of the hot water, type and size of water heater, date of manufacture and the setting of the temperature gauge were recorded. Demographic data including number of people living in the home and home ownership were also recorded. Results Hot water temperature was unsafe in 41% of homes. Homeowners were more likely to have safer hot water temperature (≤ 120°F) than renters (63% vs. 54%; p<0.01). For 11% of gas water heaters, the water temperature was ≥ 130°F, although the gauge was set at less than 75% of its maximum setting. In a multivariate logistic regression, electric water heaters were more likely to have safe hot water temperatures than gas water heaters (OR=4.99; p<0.01). Water heaters with more gallons per person in the household were more likely to be at or below the recommended 120°F. Conclusions Our results suggest that hot water temperatures remain dangerously high for a substantial proportion of urban homes despite the adoption of voluntary standards to preset temperature settings by manufacturers. This research highlights the need for improved prevention strategies such as installing thermostatic mixing valves to ensure a safer temperature.

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Scald risk in social housing can be reduced through thermostatic control system without increasing Legionella risk: a cluster randomised trial

Cited by 7 publications

References 9 publications

Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study

Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study

In search of social equipoise

Still Too Hot

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