Chemical burns in children: Aetiology and prevention

• We review chemical burns in children presenting to a tertiary burns centre.
• Chemical burn accounted for 1% of all burns, with the majority occurring in toddlers and teenagers.
• Most injuries occurred at home and involved cleaning products or aerosols.
• Less than 45% had received adequate first aid.
• Child resistant packaging and improved supervision would have prevented many of these injuries.

BackgroundChemical burns account for a small proportion of total burns in children, but may require specific first aid and different modes of prevention.MethodsA retrospective study between 2006 and 2012 of children ≤16 years treated with chemical burns at a specialist paediatric burn centre. Data were extracted from a prospectively maintained database.Results56 episodes of chemical burns occurred during the study period. The majority (54%) occurred in boys. There were 39 (72%) patients <10 years and 17 (39%) ≥10 years. Median total body surface area burnt was 1% with nine (16%) patients requiring skin grafting. Only 24 (45%) had adequate first aid. The majority (n = 46, 82%) of chemical burns occurred in the domestic setting, especially in the <10 years age group (P = 0.052). Non-intentional exposure of chemicals by an unattended child accounted for half of all (n = 22, 49%) chemical burns <10 years of age. Eight (47%) burns in patients ≥10 years resulted from self-harm. The most common aetiological agents were household cleaners and aerosols in the younger and older age groups respectively.ConclusionChemical burns remain infrequent but potentially preventable. These burns mainly occur in the domestic setting due to non-intentional exposure of household chemicals in children <10, and due to deliberate self-harm in children ≥10. The use of child-resistant packaging, similar to that used for medications, and improved parental practices could help decrease the incidence of burns in children <10.