Differentiation of paediatric burn injury by household energy source in South Africa

Keywords: child burns, domestic energy-use, electrification, energisation

Abstract

Burn injuries remain a significant cause of death and disability in the global south, with children amongst the most vulnerable. In South Africa, burns are a critical health and economic burden in densely populated and energy-impoverished communities. This study used secondary data on burn injuries from 19 health facilities to differentiate between risk for scalds and flame burns across three household energy sources (firewood, paraffin and electricity). The sample was 2 933 cases of child burn victims, with key analytical procedures being descriptive statistics and logistic regression analysis. Results showed that 52% of burn injury admissions reported electricity as the household energy source used at the time of injury. Most burn injuries were scalds (85.3%), with infants and toddlers at greatest risk. The differentiation between wood and paraffin was associated with a threefold increase in scalds relative to flame burns, while that between paraffin and electricity indicated a sevenfold increase in scalds and nineteen times such an increase between wood and electricity. This was an indication of continued challenges for the country in addressing paediatric burns despite, and in the context of, the continued electrification of poor households. The study recommends improved regulation of electrical appliances used by low-income households, and targeted household safety education initiatives.

References

African National Congress (ANC). 1994. Reconstruction and development programme (RDP).
Alnababtah, KM., Davies, P., Jackson, CA., Ashford, RL. and Filby, M. 2011. Burn injuries among children from a region-wide paediatric burns unit. British Journal Nursing, 20(3): 158-162.
Araujo, K. 2014. The emerging field of energy transitions: progress, challenges, and opportunities. Energy Research and Social Science, 1: 112-121.
Ayoub, A., Kosatsky, T., Smargiassi, A., Bilodeau-Bertrand, M. and Auger, N. 2017. Risk of hospitalization for fire-related burns during extreme cold weather. Environmental Research, 158: 393-398.
Barnes, B., Mathe, A. and Thomas, E. 2009. Household energy, indoor air pollution and child respiratory health in South Africa. Journal of Energy in Southern Africa, 20: 4-13.
Barnes, DF., Samad, H. and Banerjee, SG. 2014. The development impact of energy access. In Halff A, BSJR, editors. Energy poverty: global challenges and local solutions. UK: Oxford Scholarship; 2014. pp. 54-75.
Barron, M. 2017. Household electrification and indoor air pollution. Journal of Environmental Economics and Management, 86: 81-92.
Boait, PJ., Dixon, D., Fan, A. and Stafford A. 2012. Production efficiency of hot water for domestic use. Burns, 54: 160-168.
Clegg, SK., Smith K, Cho J, Gielen A, Vernick JS. 2007. Newspaper coverage of residual fires: an opportunity for prevention communication. Injury Prevention, 13(2): 110-114.
Dhopte, A., Tiwari, B. and Bamal R. 2017. Epidemiology of paediatric burns and future prevention strategies - a study of 475 patients from a high volume burn centre in North India. Burns & Trauma, 5: 1-8.
DME. 1998. White Paper on the Energy Policy of the Republic of South Africa.
DME. 2003a. Electricity basic services support tariff (free basic electricity) policy.
DME. 2003b. White Paper on Renewable Policy of the Republic of South Africa.
Drago, DA. 2005. Kitchen scalds and thermal burns in children five years and younger. Pediatrics, 115(1): 10-16.
Eskom. 2017. Electricity safety month launched - keeping your community and children safe; 2017. Available from: http://www/eskom.co.za/news/Pages/Augg1.aspx
Feldman, KW., Schaller, RT., Feldman, JA. and McMillon, M. 1998. Tap water scald burns in children. Injury Prevention, 4: 238-242.
Finucane, ML., Alhakami, A., Slovic, P. and Johnson, SM. 2000. The affect heuristic in judgments of risks and benefits. Journal of Behavioural Decision Making, 13: 1-17.
Francioli, AP. 2018. Investigating energy usage among low income households and implications for fire risk. Master of Philosophy in Distaste Risk Science and Development Research thesis, Stellenbosch University.
Furjuoh, SN. 2006. Burns in low- and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns, 32(5): 529-537.
Gaunt, C. 2003. Electrification technology and processes to meet economic and social objectives in Southern Africa. Unpublished doctoral thesis, University of Cape Town. 2003.
GBD. 2013. Mortality & Causes of Death Collaborators. 2014. Global, regional and national age-specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013. The Lancet, 385: 117-171.
Geels, F. 2002. Technological transitions as evolutionary reconfiguration processes: a multi-level perspective and case study. Research Policy, 31(8/9): 257-1274.
Geels, F., Kern, F., Fuchs, G., Hinderer, N, Kungl, G., Mylan, J., et al. 2016. The enactment of socio-technical transition pathways: a reformulated typology and a comparative multi-level analysis of the German and UK low-carbon electricity transitions (1990–2014). Research Policy, 45(4): 896-913.
Gevaart-Durkin, A., Swart, D. and Chowdhury, Z. 2014. A study of energy-related injuries from hospital admissions among children and adults in South Africa. Burns, 40: 1209-1218.
Gooday, G. 2018. Domesticating electricity: technology, uncertainty and gender London: Routledge; 2008.
Haines, F., Smith, KR. and Anderson, D. 2007. Policies for accelerating access to clean energy, improving health, advancing development, and mitigating climate change. The Lancet, 370(9594): 1264-1281.
Howells, M., Victor, DG. and Gaunt T. 2006. Beyond free electricity: the costs of electric cooking in poor households and a market-friendly alternative. Energy Policy, 34: 3351-3358.
International Energy Agency (IEA). 2016. World energy outlook: the world's energy needs to continue to grow, but many millions are left behind; 2016. Available from: https://www/iea.org/Textbase/npsum/WEO2016SUM.pdf .
Johnson, D. 2018. Electrical risks lack respect. Available from: https://www.ishn.com/articles/97058-electrical-risks-lack-respect.
Kagan, RJ., Peck, MD., Ahrenholz, DH., Hickerson, WL., Holmes J., Korentager, R., et al. 2013. Surgical management of the burn wound and use of skin substitutes: an expert panel white paper. Journal of Burn Care Research, 34: e60-79. doi: 10.1097/BCR.0b013e31827039a6.
Kimemia, D. and Van Niekerk, A. 2017. Energy poverty. shack fires and childhood burns. South African Medical Journal, 107(4): 289-291.
Kimemia, D., Vermaak, C., Pachauri, S. and Rhodes B. 2014. Burns, scalds and poisoning from household energy use in South Africa: are the energy poor at greater risk? Energy for Sustainable Development, 18: 1-8.
Kowsari, R. and Zerriffi H. 2011. Three-dimensional energy profile: a conceptual framework for assessing household energy use. Energy Policy, 39: 7505-7517.
Laitner, JA. 2007. The contribution of the social sciences to the energy challenge. Washington: American Council for an Energy-Efficient Economy, ACEE.
Lambe, F., Jurisoo, M., Wanjiru, H. and Senyagwa J. 2015. Bringing clean. safe, affordable cooking energy to households across Africa: an agenda for action. New Climate Economy working paper, based on a background paper to the Africa Progress Panel 2015 report Power, People, Planet: Seizing Africa’s Energy and Climate Opportunities.
Lowell, G., Quinlan, K. and Gottlieb, L. 2008. Preventing unintentional scald burns: moving beyond tap water. Pediatrics, 122(4): 799-804.
Lu, N. and Katipamula, S. 2005. Control strategies of thermostatically controlled appliances in a competitive electricity market. In IEEE Power Engineering Society General Meeting, pp. 202-207.
Marquard, A., Bekker, B., Eberhard, A. and Gaunt, T. 2007. South Africa's electrification project: An overview and assessment (Working Paper).
McLoughlin, E. 1995. A simple guide to burn prevention. Burns, 21(3): 226-229.
Meadowcroft, J. 2009. What about the politics? Sustainable development, transition management, and long-term energy transitions. Policy Science, 42: 323-340.
Murphy, JT. 2001. The energy transition in rural east Africa: is leapfrogging and alternative? Technological Forecasting and Social Change, 68(2): 173-193.
Ntsoko, L. Statistics on electrification in South Africa; 2016 [cited 2018 June 28]. Available from: http://www.ee.co.za/article/department-energy-acknowledges-results-statssa-electrification.html.
Parbhoo, A., Louw, QA. and Grimmer-Somers, K. 2010. Burn prevention programs for children in developing countries require urgent attention: a targeted literature review. Burns, 36: 164-175.
Ramakimar, R. 1996. Energizing rural areas of developing countries using IRES. In IECEC 96 Proc 31st Intersociety Energy Conversion Engineering Conference, 1536-1541.
Rayner, R. and Prentice, J. 2011. Paediatric burns: a brief global review. Wound Practice & Research. 2011; 19(1): 39-46.
Rode, H., Berg, M. and Rogers A. Burn care in South Africa. 2011. Annals of Burns and Fire Disasters, 25: 7-8.
Rybarczyk, MM., Schafer, JM., Elm, CM., Sarvepalli, S., Vaswani, PA., Balhara, KS., et al. 2017. A systematic review of burn injuries in low- and middle-income countries: epidemiology in the WHO-defined African region. African Journal of Emergency Medicine, 7: 30-37.
Schmid, DM. 2017. The kitchen stove: a major cause of burn and scald injuries. Available from: https://www.personalinjurylawjournal.com/burn-injuries/the-kitchen-stove-a-major-cause-of-burn-and-scald-injuries/.
Schwebel, D., Swart, D., Hui, S., Simpson, J. and Hobe, P. 2009. Paraffin-related injury in low-income South African communities: knowledge, practice and perceived risk. Bulletin of the World Health Organization, 87: 700-706.
Sierra-Zuniga, F., Castro-Delgado, E., Caicedo-Caicedo, C., Merchan-Galvis, AM. and Delgado-Noguera M. 2013. Epidemiological profile of minor and moderate burn victims at the University Hospital San Jose, Popayan, Colombia, 2000-2010. Burns, 39: 1012-1017.
Still, J., Craft-Coffman, B., Law, E., Colon-Santini, J. and Grant J. 1998. Burns of children caused by electric stoves. Journal of Burn Care Rehabilitation, 19(4): 364-365.
Tinto, EM. and Banda, KG. 2005. The Integrated National Electrification Programme and political democracy. Journal of Energy in Southern Africa, 16(4): 26-33.
Toon, MH., Maybauer, DM., Arceneaux, LL., Fraser, JF., Meyer, W., Runge, A., et al. 2011. Children with burn injuries - assessment of trauma, neglect, violence and abuse. Journal of Injury and Violence Research, 3: 96-110.
UNICEF. 2004. Children and burns. Available from: http://who.int/violence_injury_prevention/child/injury/world_report/Burns_english.pdf?ua=1.
Van Niekerk, A., Govender, R., Hornsby, N. and Swart, L. 2017. Household and caregiver characteristics and behaviours as predictors of unsafe exposure of children to paraffin appliances. Burns, 43: 866-876.
Van Niekerk, A., Menckel, E. and Laflamme, L. 2010. Barriers and enablers to the use of measures to prevent pediatric scalding in Cape Town, South Africa. Public Health Nursing, 27(3): 203-220.
Van Niekerk, A., Reimers, A. and Laflamme, L. 2006. Area characteristics and determinants of childhood burn injury in Cape Town. Public Health, 120(2): 115-124.
Van Niekerk, A., Rode, H. and Laflamme, L. 2006. Incidence and patterns of childhood burn injuries in the Western Cape, South Africa. Burns, 30(4): 341-347.
Van Niekerk, A., Titi, N., Lau, U. and Arendse N. 2012. Childhood burns in South Africa: towards evidence for prevention action and policy. In Van Niekerk A, Suffla S, Seedat M, editors. Crime, Violence and Injury in South Africa: 21st century solutions for child safety. Johannesburg: PsySSA Press; 2012. pp. 8-22.
Wesson, HK., Bachani, AM., Mtambeka, P., Schulman, D., Mavengere, C., Stevens, KA., et al. 2013. Pediatric burn injuries in South Africa: a 15-year analysis of hospital data. Injury, 44: 1477-1482.
WHO. 2016. Household air pollution and health; 2016 [cited 2017 November 30]. Available from: http://www.who.int/mediacentre/factsheets/fs292/en/.
WHO. 2017. Burns; 2017. Available from: http://www.who.int/mediacentre/factsheets/fs365/en/.
Ziramba, E. 2008. The demand for residential energy in South Africa. Energy Policy, 36: 3460-3466.
Views
  • Abstract 117
  • pdf 7
Views and downloads are with effect from 11 January 2018
Published
2020-06-14