Scald prevention campaigns: do they work?

The aim of this study was to quantify the effectiveness of the Queensland "Hot Water Burns Like Fire" campaign. Cross-section temperature sampling of households' bathroom hot water taps was conducted in Brisbane in 1990 before the intervention (n = 872) and in 2002 to 2003 after the intervention (n = 871). In both surveys, temperature was measured with thermometers held under running water from the bathroom hot tap until the reading stabilized (2 minutes). In 2002 to 2003 the interviewer also recorded whether or not the householder believed a tempering valve was installed in the home. The main injury outcome measure was all scald injury-related admissions at hospitals in Queensland from July 1990 to June 2003. The difference between the mean hot water tap temperature in 1990 and in 2002 to 2003 was determined with independent sample t-tests (P < .05). Rates of hospital admissions were grouped into two categories: scald injuries per year prior to the introduction of the hot water tempering valve legislation (April 1998) and scald injuries per year post-legislation. The difference between the preintervention and postintervention mean rates was determined with t-tests (P < .05). Additionally, the rates were plotted on a scatter plot by year, and a linear regression analysis was used to quantify the relationship with rates of scald-related injuries and year. The temperature in homes where the occupants reported having a tempering valve (mean = 55.5 degrees C) was significantly lower than in homes whose occupants reported not having a tempering valve (mean = 60.1 degrees C) or did not know whether they had a tempering valve (mean = 61.8 degrees C) (P < .01). However, the comparison of the hot water temperature between 1990 and 2002 to 2003 showed a significantly higher mean hot water temperature in 2002 to 2003 (P < .01). There was a significantly higher mean scald injury rate after the introduction of the "Hot Water Burns Like Fire" campaign (170.36/100,000) than before (113.41/100,000; P = .01). The linear regression line of best fit of these data has a slope of 10.43 (P < .01) and an r of 0.79. The results of this study suggest that the Queensland "Hot Water Burns Like Fire" campaign has not led to a significant reduction in hot water temperature or scald injury rates. The lack of effect identified in this study provides further evidence of the strong need to conduct rigorous evaluations of all major health promotion campaigns to add to the evidence base for such activities.