Hot water bottle burn injuries: a 10-year retrospective analysis of incidence and potential predictors in Germany

Abstract Objectives Hot water bottles are widely used for warmth and therapeutic relief, but improper use can lead to burns, ranging from superficial to full-thickness skin injuries. Following the natural gas shortage caused by the complete halt of Russian gas supplies, European countries experienced a sharp increase in hot water bottle-related burns. However, data for Germany were not yet provided. This study examines the incidence of hot water bottle burns over a 10-year period, exploring potential correlations with natural gas prices, natural gas consumption, ambient temperature, and respiratory infection rates. Methods A retrospective single-center analysis of 88 patients who sustained hot water bottle burns from 2014 to 2024 was conducted. Patient data, including burn severity and demographic information, were extracted from hospital records. Monthly counts of acute respiratory infections (ARIs), ambient temperature, natural gas price and gas consumption data were also analyzed. A Poisson regression model was applied to assess the association between hot water bottle burns and the mentioned independent variables. Results The majority of burns (81.8 %) were second-degree injuries, primarily affecting women (81.8 %). Burns were most common on the lower trunk, thighs, and forearms. The Poisson regression model revealed that for every 1 °C increase in ambient temperature, the incidence of burns decreased by 7 % (IRR=0.93, 95 % CI: 0.88–0.97). However, no significant association was found between ARI incidence, natural gas price and burn occurrence. There was no significant increase of water bottle burns during the recent European energy crisis in Germany. Conclusions Hot water bottle burns are more frequent during colder months, particularly among women. Natural gas price or natural gas consumption seems like not playing an equivalent role in Germany as in other European countries. Public health efforts should focus on education and prevention strategies to reduce these preventable injuries. Further research should explore additional factors that may influence burn rates.