Area characteristics and determinants of hospitalised childhood burn injury: A study in the city of Cape Town

Objectives: To investigate the impact of local living circumstances on the level of childhood burn injuries. Study design/method: This study was an ecological investigation encompassing the 634 residential areas of the city of Cape Town (about 668,900 children aged 12 years and younger). Fifteen socio-physical features of these areas that describe the population, household, dwelling types and services were considered using data from the 2001 census. Data of childhood burn injuries were gathered from the Red Cross Children's Hospital's register over 1999-2000 (n=923). Area features were synthesized into three main dimensions using factor analysis (principal axis method). Each dimension was split into three (exposure) levels, and the effect of each dimension on childhood burn injury was measured, compiling odds ratios with 95% confidence intervals and using the most favourable exposure level as the reference category within each dimension. Results: The main dimensions of contextual exposure were defined as housing conditions (five variables), child dependency (three variables) and socio-economic barriers (three variables). Each aspect had a significant impact on the risk of burn injury, with increased Levels of exposure leading to increased risk of burns. For housing conditions (Factor 1) and socio-economic barriers (Factor 3), a graded relationship was observed with noteably increased odds for increased levels of exposure. Conclusions: The occurrence of child burn injury is highly influenced by various features of the local environment. These features may be essential targets for sustainable childhood burn injury control and prevention programmes. (c) 2005 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.