Cooling properties of everyday liquids

Iatrogenic Thermal Burns Secondary to Marine Sting Treatment

Hot water immersion (HWI) therapy is an effective and validated treatment for a variety of marine stings. Unsupervised, however, it poses a significant risk of thermal injury. Herein, we describe our experience of iatrogenic thermal injury secondary to marine sting treatment. A 5-year retrospective review of all iatrogenic thermal burns secondary to marine stings referred to the State Adult Burn Service was conducted. Nine patients were identified, all sustaining stings to the feet from estuarine cobblerfish, stonefish, and stingrays. All patients continued unsupervised HWI at home and sustained thermal injury to their feet. The majority were treated conservatively with dressings and elevation. One patient required surgical debridement. While heat application is an effective treatment for marine stings, further patient education is required following discharge from point of care. We recommend that first-aid treatment guidelines be updated to reflect that patients are not recommended to continue scalding water immersion at home. However, if patients wish to continue HWI, water temperature should be checked manually with a thermometer or with a nonstung limb and limited to 30 minutes immersion, with 30-minute skin recovery time between.

Establishing scald prevention measures in UK maternity units from takeaway drinks

AIM

To identify policies on the consumption of hot drinks by patients and visitors on all perinatal and postnatal wards in the United Kingdom, and to seek the opinions of members of the wider burns MDT as to whether standardised patient education or regulation of hot drinks around newborn babies is required.

METHODS

All maternity units with postnatal wards across the United Kingdom were surveyed to establish availability of hot drinks on site and whether these were permitted on postnatal wards around infants. An online questionnaire was distributed to members of the British Burn Association to ascertain opinions on hot drinks policies.

RESULTS

Hot takeaway drinks were permitted around newborn infants in 194 of surveyed postnatal wards and were only banned by two units. The online survey received 49 responses from different members of the British Burn Association. Thirty responders (61%) supported a takeaway hot drink ban, while those against the policy would alternatively encourage patient education, dedicated drinking areas and introduction of safety measures.

CONCLUSIONS

Almost every postnatal unit in the UK has access to hot drink retailers on site allowing parents and visitors to bring them into close contact with babies. With varying local regulations, this poses potentially serious consequences during feeding or carrying. We propose a standardised antenatal education be made available, together with standardised designated areas on wards for parents and visitors to consume hot drinks away from infants.

Temperature dissociation of liquids in reusable thermoplastic containers-An eco-friendly scald risk?

Recent global concern regarding the impact of plastic waste on the environment has resulted in efforts to utilise reusable drink containers. Research is lacking regarding temperature dissociation of drinks in reusable thermoplastic cups. This study aimed to compare the cooling time of two common hot drinks sold at a UK retailer, in the three vessels they are sold; ceramic, disposable paper (with and without lid) and reusable thermoplastic cups (with and without lid). All temperatures were collated from 250 ml volumes of black Americano coffee or café latte in the three different containers. The cooling time was measured every sixty seconds using a standardised digital thermocouple thermometer until a threshold liquid temperature of 43 °C was reached. All experiments were performed in triplicate and temperatures converted to a dimensionless logarithmic scale prior to statistical analysis. Cooling time was significantly slower for lidded cups irrespective of material. Unlidded thermoplastic cups significantly slowed cooling times for both black Americano coffee and café latte compared to ceramic and unlidded disposable paper cups. The growing trend in reusable cups does not in itself pose an increased risk of scald injury. However, we consider that the potentially increased ambulatory behaviour associated with using a lidded rather than unlidded cup may increase scald risk. We propose that further consumer guidance should be disseminated regarding the use of any lidded takeaway container to prevent scalds in both adults and children.

A Review of Hot Beverage Temperatures-Satisfying Consumer Preference and Safety

Hot beverages are served ubiquitously in the food-service industry as well as at residences and other venues. Coffee and tea beverages, in particular, are brewed at temperatures that are sufficiently high to cause immediate and serious risk for scald injuries. On the other hand, numerous research studies have been performed to identify the preferred consumption temperatures for hot beverages. The outcome of these mutually reinforcing studies is that the preferred drinking temperatures are significantly below the often-encountered brewing temperatures (∼200 °F). Consequently, there is great need to distinguish brewing temperatures from serving temperatures. Serving consumers beverages at very high temperatures is not only unnecessary (from a preference standpoint) but also unsafe. An appropriate range for service temperatures is (130 to 160 °F). PRACTICAL APPLICATION: Often times, hot beverages are served at temperatures near their brewing temperature; far hotter than preferred by consumers. This practice creates unnecessary risk to the consumer. A more rationale recommended range of service temperatures is 130 to 160 °F. This recommendation balances a range of consumer preferences and safety.

Investigating tea temperature and content as risk factors for esophageal cancer in an endemic region of Western Kenya: Validation of a questionnaire and analysis of polycyclic aromatic hydrocarbon content

BACKGROUND

Esophageal squamous cell carcinoma (ESCC) is common in certain areas worldwide. One area, western Kenya, has a high risk of ESCC, including many young cases (<30 years old), but has limited prior study of potential risk factors. Thermal injury from hot food and beverages and exposure to polycyclic aromatic hydrocarbons (PAHs) have been proposed as important risk factors for ESCC in other settings. The beverage of choice in western Kenya is milky tea (chai).

METHODS

Healthy individuals >18 years of age who were accompanying relatives to an endoscopy unit were recruited to participate. The preferred initial temperature of chai consumption in these adults was measured by questionnaire and digital thermometer. Comparisons of these results were assessed by kappa statistics. Concentrations of 26 selected PAHs were determined by gas chromatography/mass spectrometry in samples of 11 brands of commercial tea leaves commonly consumed in Kenya.

RESULTS

Kappa values demonstrated moderate agreement between questionnaire responses and measured temperatures. The mean preferred chai temperatures were 72.1 °C overall, 72.6 °C in men (n = 78), and 70.2 °C in women (n = 22; p < 0.05). Chai temperature did not significantly differ by age or ethnic group. The PAH levels in the commercial Kenyan tea leaves were uniformly low (total PAH < 300 ng/g of leaves).

CONCLUSIONS

Study participants drink chai at higher temperatures than previously reported in other high-risk ESCC regions. Chai is not, however, a source of significant PAH exposure. Very hot chai consumption should be further evaluated as a risk factor for ESCC in Kenya with the proposed questionnaire.

Review of the initial treatment and avoidance of scald injuries

Scald injuries, which describe burns to living tissue from hot liquids, are a very common injury that occur across geographical, social, economic, and national boundaries. Despite their ubiquitous nature, a complete understanding of the conditions which are required to cause scald burns is not yet available. In addition, clear guidance to medical practitioners is available through various guidelines however in actual situations, the extent of the burn is not fully known and this lack of knowledge complicates care. Here, a comprehensive review is made of the available knowledge of temperatures and scald durations which lead to skin-burn injuries. The range of volumes and liquid temperatures are typical of those found in heated consumer beverages. This review can help medical practitioners design initial treatment protocols and can be used by manufacturers of hot-liquid products to avoid the most severe burns. Next, within the context of this ability to quantify burn depths, a review of current burn treatment guidelines is given. Included in this review is a visual recognition of the extent of burns into the dermal layer as well as decision guidelines for selection of patients which would benefit from referral to a dedicated burn center. It is hoped that by bringing together both the quantified burn-depth information and current treatment guidelines, this review can be used as a resource for persons in the medical, manufacturing, beverage service, and other industries to reduce the human impact of scald injuries.

Comprehensive method to predict and quantify scald burns from beverage spills

A comprehensive study was performed to quantify the risk of burns from hot beverage spills. The study was comprised of three parts. First, experiments were carried out to measure the cooling rates of beverages in a room-temperature environment by natural convection and thermal radiation. The experiments accounted for different beverage volumes, initial temperatures, cooling period between the time of service and the spill, the material which comprised the cup, the presence or absence of a cap and the presence or absence of an insulating corrugated paper sleeve. Among this list, the parameters which most influenced the temperature variation was the presence or absence of a cover or cap, the volume of the beverage and the duration of the cooling period. The second step was a series of experiments that provided temperatures at the surface of skin or skin surrogate after a spill. The experiments incorporated a single layer of cotton clothing and the exposure duration was 30 s. The outcomes of the experiments were used as input to a numerical model which calculated the temperature distribution and burn depth within tissue. Last was the implementation of the numerical model and a catalogue of burn predictions for various beverage volumes, beverage service temperatures, and durations between beverage service and spill. It is hoped that this catalogue can be used by both beverage industries and consumers to reduce the threat of burn injuries. It can also be used by treating medical professionals who can quickly estimate burn depths following a spill incident.