Paediatric burn injury trends in Ontario, Canada: a population-based repeated cross-sectional study

BACKGROUND: The aim of this study was to measure trends in paediatric burn injury in Ontario, Canada, overall and by sociodemographic strata. METHODS: Population-based, repeated cross-sectional study using linked health and administrative databases, including all individuals 0-17 years old in Ontario, Canada from 2003 to 2022. The outcome was emergency department visits and hospitalisations for burn injury measured as an annual burn injury rate per 100 000 population. Burn injury rates were stratified by age, sex and sociodemographic factors. Trends in burn injury were estimated using Quasi-Poisson regression. RESULTS: Between 2003 and 2022, there were 79 782 reported paediatric burn injuries. Children with a burn injury had a median age of 4.0 years (IQR 1.0-12.0) and 44 191 (55%) were male. The overall paediatric burn injury incidence rate declined 37% (165 to 104 burns/100,000 population; rate ratio 0.98, 95% CI 0.98 to 0.98) with similar rates of decline observed among males and females. Among specific sociodemographic groups, large declines in incidence rates were observed in individuals aged 13-17 years old, children of adolescent mothers and rural residents. In contrast, we observed a 91% increase (63 to 120 burns/100 000 population; rate ratio 1.04, 95% CI 1.02 to 1.06) in the burn injury incidence rate among refugee immigrants. CONCLUSIONS: Paediatric burn incidence in Ontario has declined over twenty years, suggesting burn prevention efforts have been largely successful, with legislative prevention measures serving to equitably reduce burn injury. The rising trends of burn injury incidence rate among refugee immigrants suggest burn prevention efforts must be tailored to this population.