Geographical analysis of socioeconomic factors in risk of domestic burn injury in London 2007-2013

Purpose: This study aims to explore the geographical distribution of burn injuries in Greater London and the association of socioeconomic factors in areas at risk. Methods: Data on burn injury cases classified as occurring in patients' own homes in Greater London and admitted to a specialised burns service for >= 1 day during a 7-year period were obtained from the International Burn Injury Database (iBID). Age- and gender-adjusted standardised incidence ratios (SIRs) were calculated for each Lower Layer Super Output Area (LSOA) in Greater London. Bayesian methods were used to calculate relative risks as best estimates of spatially-smoothed SIRs. Results: Of a total of 2911 admissions to specialised burns services in Greater London in the study period, 2100 (72.1%) cases occurred in patients' own homes. Percentage of ethnic minorities (p = 0.005), Income Deprivation Affecting Children Index (p < 0.001), Health Deprivation and Disability Score (p = 0.031), percentage of families with 3 or more children (p = 0.004) and Barriers to Housing and Services Score (p = 0.001) remained independently associated with the relative risk of paediatric domestic burn injury in a multivariate linear regression model. Percentage of ethnic minorities (p <0.001), Health Deprivation and Disability Score (p <0.001) and Barriers to Housing and Services Score (p = 0.036) remained independently associated with the relative risk of adult domestic burn injury in a multivariate linear regression model. Conclusions: Socioeconomic factors are associated with an increased risk of burn injury in Greater London, but may be more important in children than adults. The specific factors identified are ethnicity, poor general health, household structure, housing issues and income deprivation affecting children. (C) 2014 Elsevier Ltd and ISBI. All rights reserved.