The effect of education and safety equipment on burn and scald prevention practices and on childhood thermal injuries: update of a systematic review and meta-analysis

Abstract

ObjectiveChildhood burns and scalds are a significant public health problem. This systematic review and meta-analysis evaluates whether home safety education and the provision of safety equipment increases burn and scald prevention practices and reduces thermal injuries.MethodA range of bibliographic databases were searched until April 2009. Search methods also included other electronic sources; hand searching of conference abstracts, IPJ and reference lists. We included randomised controlled trials (RCTs), non-RCTs, and controlled before and after studies (CBA), involving children and young people aged 0–19 years, and their families.ResultsPreliminary results indicate that 49 studies met the inclusion criteria (29 RCTs, 6 non-RCTs, 13 CBAs and 1 CBA or non RCT). 27 studies were included in at least one meta-analysis. Families receiving home safety education +/– safety equipment were significantly more likely to have a functional smoke alarm (OR 1.83, 95% CI 1.22 to 2.73) and to have safe hot-tap water temperatures (OR 1.51, 95% CI 1.11 to 2.07). There was some evidence that interventions increased the prevalence of fireguards (OR 1.39, 95% CI 1.00 to 1.94). The prevalence of fire extinguishers was increased only by interventions providing these (OR 4.67, 95% CI 1.78 to 12.25).ConclusionsHome safety education and the provision of safety equipment are effective in improving the prevalence of functioning smoke alarms and safe hot tap water temperatures. They may be effective in increasing the prevalence of fireguards and fire extinguishers. Further work is required to explore the effect of improving safety practices on thermal injury occurrence.

Mixed treatment comparisons using aggregate and individual participant level data

“…Unfortunately, the investigators were only successful in obtaining IPD for a proportion of the studies. Additional details on the included studies can be found in related literature [10,11,19,20].…”

“…">Motivating example: The effectiveness of home safety education and the provision of safety equipment for the prevention of accidents in preschool children and the impact of socioeconomic characteristicsThe motivating example for this paper comes from an evaluation of the effectiveness of home safety education and the provision of functioning smoke alarm safety devices for the prevention of accidents in preschool children. Studies were identified as part of a more general and updated Cochrane systematic review of safety equipment [10,19]. The primary intention of this review was to obtain IPD from all relevant studies and to subsequently synthesise these in a meta-analysis.…”

“…Unfortunately, the investigators were only successful in obtaining IPD for a proportion of the studies. Additional details on the included studies can be found in related literature [10,11,19,20].The review included nonrandomised and randomised controlled trials (RCTs), and controlled beforeand-after studies. Although the initial Cochrane review [10] identified much of the relevant literature base, it did not consider comparative studies that did not have usual care as a comparator (e.g.…”