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HealthNewsDigest.com

"Burn Awareness: Forty-Three Percent of All Burns Happen At Home"
February 7, 2007

American Burn Association – Journal of Burn Care and Rehabilitation

"Contact Palmar Burns in Toddlers from Glass Enclosed Fireplaces"

January/February 2004

"Gas Fireplace Contact Burns in Young Children"

Journal of Burn Care and Rehabilitation. 25(6):510-512

Children's Organizations

SickKids Research Foundation -- http://www.sickkids.ca/

Protect Your Child from Gas Fireplace Burns -- http://www.sickkids.ca/AboutSickKids/News-Room/Past-News/2010/fireplace-safety.html

Gas fireplaces are perfect for keeping you and your family warm throughout the winter, but can pose a risk for severe burns to young children and infants. Gas fireplace glass can reach a temperature of 200°C, hot enough to cause a third-degree burn, even after the fireplace has been turned off. After being turned off, the glass remains hot for at least 45 minutes. The easiest way to prevent burns is to keep the fireplace off when young children are around; if this isn’t an option, you could install a screen or hearth gate. The SickKids Burn Prevention Team has launched an awareness campaign about gas fireplace safety and burn prevention, distributing posters to schools, day care centers and medical offices across Ontario. For more information or to order posters, contact SickKids’ Burn Prevention Outreach Team at 416-813-4970.

Gas fireplaces cause serious burns, warns The Hospital for Sick Children -- http://www.sickkids.ca/aboutsickkids/news-room/past-news/2003/gas-fireplaces-cause-serious-burns,-warns-the-hospital-for-sick-children.html

Research shows that children are not only at risk for burns when the gas fireplace is in use but after use as well. The glass barrier can heat up to over 200°C (400°F) in about six minutes during use and it takes 45 minutes for the fireplace to cool to a safe temperature after a burning fire has been extinguished. Children have also been burned when the fireplace is not in use by the heat from the ignition light. "We urge the industry that makes and sells gas fireplaces to warn consumers of this burn risk and to investigate design changes to help protect children," says Julie Zettel-Rodgers, outpatient care coordinator for SickKids Burn Unit, who has treated children who have been burned for more than 18 years. Read More

Children's National Medical Center -- https://www.childrensnational.org/

Keeping Kids Safe from Winter Burns -- http://www.childrensnational.org/KeepingKidsSafe_WinterBurns.aspx

Children’s National Medical Center’s Burn Clinic has recently seen a dramatic increase in fireplace burn injuries among toddlers, ages 9 months to 2 years of age. These preventable burn injuries are caused when a child touches the screen or glass in front of the burning fireplace resulting in deep penetration of the underlying layers of skin on the hand or palm. "The fireplace burns are classified as full thickness burns, some of the most serious burns we see," said Ananth Murthy, MD, plastic and reconstruction surgeon for Children’s Emergency Trauma and Burn Services. "Glass fire screens can reach up to 245 degrees Celsius (approximately 500 F) within 5 to 10 minutes after the fire is started. Since glass holds on to the heat, it tends to stay hot even after the fire is put out." Because toddlers are new to walking, they tend to reach for solid surfaces for stability. Once they place their hands on any hot surface, they don’t have the basic instinct to pull back like an older child would. Much of this is attributed to the fact that they aren’t steady enough to catch themselves if they fall.

Facts About Burn Safety -- http://www.childrensnational.org/ForPatients/PatientEducation/BurnSafetyFactSheet.aspx#group1

Winter Burn and Fire Prevention Tips
    * Keep candles out of your baby’s reach.  Avoid any surface the baby can reach by crawling or reaching up.
    * Limit your use of space heaters and fireplaces.
    * If you do use a fireplace or space heater, make sure you have a barrier, such as a metal gate, to prevent your baby from touching it.

Burns are among the most painful injuries children can suffer.

If your child suffers a burn, act immediately by taking these steps:
    * Remove all clothing that is not stuck to injured area.  Remove only the clothing that comes away easily. Be careful not to pull or pry fabric.
    * Put cool (not cold) water or a wet cloth on the burn area.
    * Do not put butter or mayonnaise on burn area.
    * Take your child to an emergency room if:
          o Blisters are present;
          o The skin is broken; or
          o The burn is on a hand or crosses a joint – for example an elbow, wrist, or knee.
    * Otherwise, take your child to his or her primary care provider.
    * Give your child acetaminophen or ibuprofen. Follow the directions for the correct dosage.

The Children's Hospital (Denver) -- http://www.thechildrenshospital.org

Gas Fireplace Glass Door Burn Prevention -- http://www.thechildrenshospital.org/conditions/skin/burn/fireplace-glassdoor-burnprevention.aspx

Keeping your child safe around a gas fireplace.
Hand burns from gas fireplace glass doors are preventable.
    * Never leave your child alone in the room with the fireplace when it is on or until 45 minutes after it is turned off.
    * Use a fireplace screen or gate around your gas fireplace during use to keep your child away from the glass door.
    * Use these safety tips when visiting other homes

Fireplace Facts
    * The glass barrier of a gas fireplace door can heat up to more than 200º F in approximately 6 minutes.
    * It takes an average of 45 minutes for the gas fireplace glass to cool to a safe temperature after a burning fire has been extinguished.
    * The Children’s Hospital  Burn Center has seen a 50% increase in burns of the hand from gas fireplace glass doors since 2006.

Hand Burn Basics
    * Contact with the glass of gas fireplace doors can result in second or third degree burns.
    * Burns of the hand can result in hand dysfunction causing long term impairment and disability.
    * Treatment of burns of the hand are time intensive, costly, painful, and can require long term therapy of the hand.

Safety Tip: Remember GLASS
    * "G" for Gate: Place a gate or screen around the gas fireplace glass doors to provide a barrier between your child and the fireplace doors.
    * "L" for Look: Look where your child is while the gas fireplace is on.
    * "A" for Aware: Be aware that the glass of a gas fireplace door can heat up to more than200°F in approximately six minutes.
    * "S" for Switch: Make sure the on/off switch is not in reach of your child.
    * "S" for Shut off: Once the fuel source to a gas fireplace is shut off it takes an average of 45 minutes for gas fireplace glass

First Aid

Follow these steps when treating any minor burn:
   1. Remove ALL clothing and jewelry.
   2. Run cool water over the burn for several minutes. Do not place any home remedies including butter, ointments or ice on burned areas.
   3. Cover the burn with a clean bandage or clean cloth.
   4. Take ibuprofen or acetaminophen to relieve any pain.
   5. Consult with your family physician if the burn does not heal in two to three days or signs of infection appear.

The American Burn Association recommends that burns of the hand be treated by a physician.

Gas Fireplaces Pose Burn Hazard -- Burn Prevention Foundation -- http://www.burnprevention.org/userfiles/file/HaveaBurnSafeWinter06.pdf

Temperatures of the glass in front of the glowing flame from a gas log can range from up to 392º in 6.5 minutes to 473º in 14 minutes of use. There are no flickering, crackling exposed flames to send a warning signal of HOT to curious outstretched fingers of young children. Therefore, parents need to be extremely cautious and vigilant of their youngsters around gas fireplaces. Prevention is the key.

• Supervision is of utmost importance. Do not leave a child unattended in a room where a gas
log is burning.
• Teach older preschoolers to observe a “NO Zone” - at least 36 inches away from the fireplace.
(This is the same “NO Zone” established around the kitchen stove).
• Light the fire when children aren’t watching. If a remote control is used, keep it out of reach of
children.
• Burn the gas fireplace when children are asleep.

Mayo Clinic -- Child Safety: How To Prevent Burns -- http://www.mayoclinic.com/health/child-safety/CC00044

SafeKids, Madison -- Beware Of Burns brochure -- http://www.publichealthmdc.com/family/safetyAndInjuryPrevention/documents/Burns200808.pdf

Children's Burn Trust -- http://www.cbtrust.org.uk/

 

Fireplace Safety -- BC Children's Hospital -- http://www.bcchildrens.ca/KidsTeensFam/ChildSafety/SafetyStation/fireplace/default.htm

Between 1998-2002, Children’s Emergency treated 52 children for burns caused by hot fireplaces. Almost three quarters of the patients were oe year of age or younger. Almost all patients were burned by touching hot surfaces -- not open flames.

During operation, the glass temperature on a gas fireplace reaches 200° Celsius (390° F). A child who touches a surface this hot will be burned instantly, and may require weeks of rehabilitation.

 Safety Tips

• Fireplaces should be kept off during your baby's waking hours.
• Wait 45 minutes after turning off your fireplace for the glass to cool down before allowing your baby near it.
• Install a switch lock to prevent toddlers from reaching up and turning on the fireplace, or put a cover plate over the switch in warmer months.
• If you use your fireplace as a source of heat, install a gate or barrier to prevent your baby or toddler from severe burns.

For more information, see the Safety Station's fireplace safety tip sheet.

RESEARCH

The gas fireplace: a new burn hazard in the home -- http://www.ncbi.nlm.nih.gov/pubmed/9934642
J Burn Care Rehabil. 1999 Jan-Feb;20(1 Pt 1):86-9; discussion 85.
PubMed: U.S. National Library of Medicine National Institutes of Health

Becker L, Cartotto R.
Department of Surgery, Queen's University, Kingston, Ontario, Canada.

Gas fireplaces have become popular in recent years. This article presents the first reported case of a burn injury from contact with the glass front of a gas fireplace. An investigation of the surface temperature of the glass fronts of gas fireplaces was undertaken to clarify the risks posed by these units. Surface temperature measurements of the glass fronts of 3 common gas fireplace models were obtained using a thermocouple probe. Glass temperatures reached 200 degrees C within 6.5 minutes of ignition, climbing to 245 degrees C at 14 minutes after ignition. Glass temperature continued to rise beyond this point, but it could not be monitored because the adhesives securing the thermocouple probe melted. Glass temperatures of 50 degrees C were recorded at 30 minutes after the unit was shut off. The temperatures of the glass fronts of glass fireplaces are sufficient to cause cutaneous burns within seconds of contact both while the fireplace is in use and up to one half hour after it has been turned off. Current industry safety standards are not directed at the prevention of contact burns. We recommend that (1) mechanical guards be installed to create a barrier in front of the glass; (2) strict warning labels be applied to the units and ignition switches; and (3) burn prevention information be distributed with the owner's manual for these products.
PMID: 9934642 [PubMed - indexed for MEDLINE]

Contact Palm Burns in Toddlers from Glass Enclosed Fireplaces -- http://journals.lww.com/burncareresearch/Abstract/2004/01000/Contact_Palm_Burns_in_Toddlers_from_Glass_Enclosed.11.aspx
Dunst, C. M. MD; Scott, E. C. MD; Kraatz, J. J. MD; Anderson, P. M. RN; Twomey, J. A. MD; Peltier, G. L. MD
Journal of Burn Care & Rehabilitation: January/February 2004 - Volume 25 - Issue 1 - pp 67-70

We have seen an alarming increase in the incidence of pediatric palm burns associated with gas fireplaces. The increasing popularity of these units places more children at risk. Medical records of patients under the age of 5 years who sustained hand burns from contact with the glass enclosure of gas fireplaces from 1996 through 2002 were reviewed. Thirty-nine patients were identified, with a mean age of 12.8 months. A 15-fold increase in incidence was observed. Thirty-three patients suffered superficial second-degree burns that were treated conservatively. Twenty-one percent of children developed significant wound complications requiring intensive therapy including extension splinting or surgery. Pediatric burns resulting from palmar contact with the glass enclosures of gas fireplaces have emerged as an avoidable new danger within the home. Although most of these injuries heal with conservative treatment alone, many require surgery or other intensive management to regain acceptable function.

 

 

During the past 7 years, we have observed an alarming increase in the incidence of pediatric palm burns associated with gas fireplaces. As new, glass-enclosed gas fireplaces emerge as popular alternatives to conventional, open-hearth wood-burning fireplaces, a new potential for burn injury has entered the home. Today, more than 70% of fireplaces installed burn natural gas. 1 These fireplaces are praised for their convenience and efficiency as well as their use of clean-burning fossil fuel. However, they also pose a risk of burn injury secondary to the heat they generate as it conducts through the glass enclosures. With the increasing popularity of gas fireplaces, the incidence of pediatric burns, specifically toddlers, resulting from contact with the hot glass enclosing these units is on the rise. Previous reports of pediatric contact burns have identified hot irons, oven doors, heaters, and hot coals as main sources of these injuries. 2 The aim of this report is to alert readers to the potential danger of burn injury in the pediatric population associated with contact of the glass enclosures of gas fireplaces. We hope that focusing on this emerging problem will help generate much-needed improvements in gas fireplace burn prevention.

 

Gas fireplace contact burns in young children
Zettel JC, Khambalia A, Barden W, Murthy T, Macarthur C.
Burn and Plastic Surgery Program, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.
J Burn Care Rehabil. 2004 Nov-Dec;25(6):510-2.

Contact burns from domestic appliances are common in young children. Recently, gas fireplaces have been recognized as a potential cause of contact burns in young children. We sought to quantify the frequency of gas fireplace contact burns in young children, to identify the etiology of contact, to describe the clinical presentation, and to describe clinical outcomes. Children with gas fireplace contact burn injuries presenting to The Hospital for Sick Children in Toronto (1999-2002) were identified using three data sources: the Canadian Hospitals Injury Reporting and Prevention Program Database, the Burn Unit Registry, and the Rehabilitation Services Database. Demographic, clinical, and outcomes data were collected on all children. During the 4-year study period, 27 children presented to the hospital because of a gas fireplace contact burn (approximately 9% of all contact burns). The median age of the children was 14 months (range, 8-36 months), with 16 boys (59%). Most children were burned in their own home. With regard to etiology, 10 children (37%) lost their balance near the fireplace, 2 (7%) walked too close to the glass front, and 8 (30%) touched the glass front out of curiosity. Almost half (44%) of the children burned the palms and digits of both hands. The median total burn surface area was 1% (range, 0.2-2.5%). In total, 30% of children were admitted to hospital, and 11% required skin grafts.. All children had full wound closure after 4 to 43 days. Given the etiology of these burns (loss of balance or curiosity), passive prevention, such as barriers or changes in the composition of glass panels, may be the most effective approach to combat them.

 

Glass front of gas fire places: a clear and present danger.
Naqui Z, Enoch S, Shah M.
Booth Hall Children's Hospital, Charlestown Road, Blackley, Manchester M97AA, UK.
Burns. 2005 Feb;31(1):72-5.

BACKGROUND: Glass fronted gas fires have become a popular addition to many homes as a source of heat energy. The flames, however, provide curiosity for young children attracting them towards the hot glass plate resulting in contact burns. Our study aimed to ascertain the features and pattern of morbidity of such injuries, and to address preventive measures. METHODS: Retrospective analysis of children with contact burns who were treated in our unit over an eight-year period. The cases were identified from the burns database, and their case-notes and follow-up records reviewed. RESULTS: Thirty-five children (M: 20; F: 15; Age range: 6 months to 10 years) were identified. The total body surface area of the burn was between <1 and 5%. Hand or fingers were the commonest sites involved. The depth was variable with 21 children sustaining superficial and seven deep dermal burns. All but one child were treated conservatively. Follow-up visits ranged from one to 24 (median: five); follow-up period was from 2 days to 1 year (median: 17 days). CONCLUSION: Although glass plate contact burns may be minor and superficial, they nevertheless affect a vital anatomical area. They also result in psychological distress for the child, and stress and time off work for parents. Awareness and measures to prevent such injuries should therefore be addressed by the responsible authorities.
PMID: 15639369 [PubMed - indexed for MEDLINE]

Case 1: Hand burns in a 13-month-old --Paediatr Child Health > v.10(2); Feb 2005

Contact burns are common in young children and typically involve the hands. Fireplaces are the second most common source of burn in infants, exceeded only by hot beverage scalds. Read More

Last modified: 02/21/10