Home Radiator Burns Among Inner-City Children -- Chicago, September 1991-April 1994

Contact with hot surfaces is a cause of substantial morbidity among children (1,2). In 1993, an estimated 1881 children visited emergency departments for treatment of burns related to nonvehicle radiators in the United States (3). This report summarizes the investigation of radiator burns among children aged 0-19 years living in a Chicago housing project and provides recommendations for preventing radiator burn injuries.

From September 1991 through April 1994, a total of 10 children were treated in one pediatric clinic in Chicago for burns resulting from contact with home radiators. The children ranged in age from 7 months to 5 years; six were aged less than 2 years, and six were boys. Cases were identified by monitoring pediatric visits to the clinic for children who had burns associated with contact with a home radiator.

Eight of the burns occurred in a housing project in an inner-city neighborhood on the west side of Chicago near the clinic. In 1995, a total of 3318 persons resided in the housing project. The housing project includes 15 buildings, 11 of which are heated by steam radiator systems operating at 180 F-230 F (82 C-110 C). Four buildings are heated by hot water radiator systems operating at 120 F (49 C). All eight burns to housing project tenants were in the section served by steam radiators.

Eight of the 10 children suffered partial thickness burns that were treated in the outpatient clinic. Burns were distributed among the leg/foot, head, and arm/hand. Two children were hospitalized for full-thickness burns. One was a 16-month-old child who touched an exposed steam radiator pipe, resulting in severe burns to the palm of her hand that required a skin graft. The other was a 7-month-old infant who fell out of bed and became wedged between the bed and the radiator, resulting in multiple burns to her left hand, left arm, left ear, and left side of the head that required treatment in a burn unit. Two other children (aged 10 months and 31 months) also were burned when they became trapped between a bed and a steam radiator.

After the investigation determined that the burns incurred by the children were associated with contact with uncovered radiators, each family was encouraged to contact the housing authority for proper repairs. In addition, physicians instructed parents about the proper location of beds or cribs in proximity to steam radiators. Details of the cases were sent to the housing authority in June 1994.

All 169 units in the two buildings where more than one child was burned were inspected beginning in August 1994; 133 (79%) of these units were missing radiator covers, insulation surrounding radiator pipes, or both. In addition, of the 104 housing units in these two buildings in which children aged less than 10 years resided, 89 (86%) were missing such radiator protection.

During November 1994-August 1995, the housing authority replaced or repaired needed radiator covers and pipe insulation in all units of the 11 project buildings served by steam radiators. One child came to the health center for treatment of a radiator burn while these repairs were being made. The child had been burned in a building served by steam radiators that had not yet been repaired. An evaluation of this intervention is planned.

Reported by: K Quinlan, MD, Dept of Pediatrics, Univ of Chicago, Illinois. Div of Unintentional Injury Prevention, National Center for Injury Prevention and Control, CDC.

Editorial Note

Editorial Note: The findings in this report underscore the potential effectiveness of a public health response to a specific local pattern of injury. Although childhood burns resulting from contact with wood-burning stoves (4,5), kerosene heaters (6), and floor furnaces (7-9) have been reported, this is the first description of burns related to radiators used for home heating.

The age distribution and hospital admission rate of the 10 children reported in Chicago are consistent with patterns of radiator burns reported for the United States (3). Of all emergency department visits for burns related to home radiators in the United States during 1993, 22% resulted in hospital admission, and 68% involved children aged 0-4 years. Among children aged 0-4 years who visited the emergency department for such an injury, 16% slept in a bed that was too close to a radiator (3).

Unprotected radiators and their pipes were directly related to injury risk for the children in this report. Building codes in Chicago require radiators to be covered in public places (e.g., churches, day-care facilities, and schools) but not in private or public housing. Steam radiator systems are found primarily in older buildings. The buildings served by steam radiators in the housing project in this report were constructed during the late 1950s, and the buildings served by hot water radiators were built during the 1960s.

Temperature is a critical factor in thermal injury. Contact with temperatures in the range of steam radiators can cause an instantaneous full-thickness burn of adult human skin. Children's skin is probably more susceptible than that of adults to thermal injury. In comparison, hot water radiators operate at a lower temperature than steam radiators and present a lower risk for thermal injury.

Risks for burns from home radiators can be reduced by keeping the unit covered and the pipes insulated. In addition, beds, couches, and chairs should be kept at a safe distance from radiators to avoid contact burn injury. Recognition of steam radiator burns in other communities may prompt investigations similar to that in Chicago and improvement of heating systems to prevent burn injury.

References

1. Quinlan KP. Injury control in practice: home radiator burns in inner-city children. Archives of Pediatrics and Adolescent Medicine 1996;150:954-7.

2. Rossignol AM, Boyle CM, Locke JA, Burke JF. Hospitalized burn injuries in Massachusetts: an assessment of incidence and product involvement. Am J Public Health 1986;76:1341-3.

3. US Consumer Product Safety Commission. National Electronic Injury Surveillance System: 1993 product summary report. Washington, DC: US Consumer Product Safety Commission, 1994.

4. Remensnyder JP, von Ryll Gryska P. Hazards of wood-burning stoves to children {Letter}. N Engl J Med 1981;304:915-6.

5. Yanofsky NN, Morain WD. Upper extremity burns from woodstoves. Pediatrics 1984;73:722-6.

6. Rismiller R. Kerosene heaters -- a new burn threat to children. Clin Pediatr 1983;22:203.

7. Waller JA. Tic-tac-toe burns: the hazard of exposed floor-type room heaters. N Engl J Med 1961;265:1256-7.

8. Berger LR, Kalishman S. Floor furnace burns to children. Pediatrics 1983;71:97-9.

9. Grossman ER. Floor furnace burns {Letter}. Pediatrics 1984;73:568-9.

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