Flame time of a cigarette lighter to achieve temperature capable of inflicting a burn
Introduction
Burn/fire injuries account for almost 2% of the nonfatal injuries among children 0–19 years of age (190 per 100,000 children) [1]. Burns account for up to 20% of all abuse cases [2]. Intentional burns and scalds are found in 10% of physically abused children and 5% of sexually abused children [3]. Fifty percent of children with abusive burns may experience recurrent abuse and 30% of children with recurrent abusive burns are eventually mortally injured. Intentionally inflicted burns tend to be more extensive and severe, and undergo longer hospitalizations and increased intensive care unit admissions. Furthermore, there is a 30% mortality rate from intentional burns compared to 2% from accidental burns [2]. Diagnosing intentional burns and differentiating them from accidental burn injuries may help identify children at risk of recurrent abuse and possible death from abuse.
Cigarette lighters are frequently used in non-accidental contact burns, leaving a characteristic burn pattern on the skin (Fig. 1). A history of an accidental mechanism is often given to explain abusive burns. To aid in differentiating accidental from inflicted burns, the time and temperature needed to cause thermal injury have been studied with water and irons. The current study examines the minimum amount of time necessary to heat the metal on a cigarette lighter to a temperature capable of inflicting any clinically visible skin burn within a contact time that could be consistent with an accidental mechanism.
Section snippets
Methods
A literature search was conducted to establish the time and temperature at which partial or full thickness skin burns are acquired, regardless of the vector used. The literature search was conducted using PubMed, and then by reviewing the reference sections on the initial papers from the PubMed search. Search terms included, but were not limited to, skin burns, temperature, non-accidental, child abuse, cigarette lighter burns, partial thickness burns, and full thickness burns. The studies
Results
A review of the existing literature (Table 1) revealed that the lowest temperature documented to cause a significant burn in one second ranged from 69 °C to 98 °C [4]. If we expand the exposure time to 10 s or less, the lowest reported temperature that could cause a significant burn is 60 °C [5], [6], [7], [8]. A significant burn is defined in this study as any burn capable of leaving a mark that would be recognizable to a medical provider as a burn. This includes burns with complete epidermal
Discussion
Inflicted burns are a common manifestation of child abuse and are often misdiagnosed as accidental burns. It is important to recognize patterned burns, such as the impression of a cigarette lighter, as red flags for abusive injuries. Cigarette lighter contact burns are often blamed on accidental occurrences, but any accidental contact with a hot object is likely to only last for about one second or less in some cases. This study demonstrates that with typical use where the lighter is held
Conclusions
Cigarette lighter burns are often blamed on accidental occurrences. At least 50 s of sustained flame is needed to heat typical cigarette lighter tops to temperatures capable of inflicting clinically visible skin burns with exposure time that could reasonably be called accidental. This time is much longer than the time typically required to light a cigarette. Therefore, for a cigarette lighter to inflict a contact burn injury with typical use, there needs to be intent and preparation, making
Acknowledgements
We would like to acknowledge the following individuals for their contributions to this study: Robert T. Sponheimer CFEI, CVFI, Battalion Chief/Fire Marshall, Bensalem Township Fire Rescue Department of Public Safety; Matthew Weintraub, Esq., Bucks County District Attorney; Kevin Cornish, Bensalem Police Department, Special Investigations Unit; Loreen K. Meyer, MSN, RN, CCRN, CPEN, ENPC, St. Christopher’s Hospital for Children.
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Cited by (2)
Abusive Burns
2021, Handbook of Interpersonal Violence and Abuse Across the Lifespan: A Project of the National Partnership to End Interpersonal Violence Across the Lifespan (NPEIV)