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Characteristics of Scald Burns Caused by Child Abuse in the United States: A Systematic Review

Published online by Cambridge University Press:  07 July 2025

Wendy C. Shields Open the ORCID record for Wendy C. Shields [Opens in a new window] ,
Evelyn Shiang ,
Marisa Koontz ,
Jon Vernick  and
Shannon Frattaroli
Wendy C. Shields*
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
Evelyn Shiang
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
Marisa Koontz
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
Jon Vernick
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
Shannon Frattaroli
Affiliation:
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
*
Corresponding author: Wendy C. Shields; Email: wshield1@jhu.edu
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Abstract

Hot tap water is the most common source of scald injuries, representing a quarter of all scald injuries requiring hospitalization in the United States. Children and older adults are at increased risk of scald burns. Evidence suggests that poor knowledge of burn risks and treatment among parents and the public may contribute to the burden of scald injuries in children. Medical and injury surveillance categorizes most scald burns as unintentional injuries. However, scald burns can also lead to investigation by the justice system if the injury is suspected to result from abuse or neglect. The Department of Justice recommends assessing criminal intent in childhood scald burns based on traditional indicators derived from medical research: burn uniformity, areas of sparing, burn locations, family history, and speed of medical care. In this study, we present an overview of the existing literature on intentional scald burns in children caused by hot tap water in order to improve their identification and prevention. This systematic review aims to answer two questions: (1) What are the indicators of intentional scald burns in children according to the literature and (2) Is the body of evidence for common indicators of intentional scald burns subject to bias?

Keywords

Injury PreventionScald AbusePediatric Scald BurnHousing InjuryTap Water BurnUnintentional Injury

Information

Type
Independent Articles
Information
Journal of Law, Medicine & Ethics , First View , pp. 1 - 12
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of American Society of Law, Medicine & Ethics

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