Letters
Child health Surgery
Volume 198 - Issue 10

Burns from motorcycle exhausts among children in New South Wales: a continuing problem

Authors:  Ela J Hyland, Rachel A D’Cruz and John G Harvey

Med J Aust 2013; 198 (10): 530-530. || doi: 10.5694/mja13.10247
Published online: 3 June 2013
An audit of cases treated at a major children’s hospital reveals that significant burns from motorcycle exhausts still occur much too frequently
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To the Editor: Burns remain a common occurrence among children, with scalds accounting for 55% of these injuries in Australia and New Zealand.1 Although a less frequent mechanism, contact burns now account for up to 30% of all burns among children.1,2 The Burns Unit (BU) at the Children’s Hospital at Westmead serves the paediatric population of New South Wales and the Australian Capital Territory. Recently, our BU has identified a rise in the number of contact burns from motorcycle exhausts among children.

Following Sydney Children’s Hospitals Network Human Research Ethics Committee approval, we performed a retrospective case series review of children ≤ 16 years of age who were referred to our BU between 1 January 2008 and 31 December 2011 and who had sustained contact burns from the exhausts of either adult or children’s motorcycles.

Over the 4-year study period, there were 96 children with motorcycle exhaust contact burns, 75 (78%) of whom were male. The mean age was 8.6 years. Forty-five (47%) of the burns occurred in backyards; 16 (17%) occurred on farms; 14 (15%) occurred in sport and recreation areas; seven (7%) occurred in driveways; seven (7%) occurred on public roads; and in seven cases (7%), the location was unknown. Only 53 (55%) of the children had adequate first aid. Of the 41 children (43%) admitted to hospital, all required skin grafting (Box). The mean length of stay was 2.4 days. Out of the total of 96 children, wound infections occurred in seven (7%), and three (3%) had a history of prior burns.

A previous study from our institution first identified concerns relating to children sustaining contact burns from exhaust systems.3 Despite this, the incidence of children sustaining motorcycle exhaust burns appears to be increasing.2,3 Between 2008 and 2012, an average of 24 children per year presented to our BU with motorcycle exhaust burns, compared with 15 per year in our earlier study.2

These results indicate that there remains a need to educate the community and health professionals regarding the dangers of motorcycle exhausts. We suggest that there should be implementation of widespread advocacy for the use of protective clothing. Consideration should also be given to the introduction of legislation requiring the modification of all motorcycle exhausts, particularly those designed for children, to reduce the incidence of contact burns in this population.

Box

Burn injury to the right leg of a 13-year-old boy secondary to contact with a motorcycle exhaust: (A) on presentation; (B) as a laser Doppler image showing a deep-dermal/full-thickness burn centrally (blue); and (C) after skin grafting.

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