Caregiver-related predictors of thermal burn injuries among Iranian children: A case-control study.
OBJECTIVE
Burns are a common and preventable cause of injury in children. The aim of this study was to investigate child and caregiver characteristics which may predict childhood burn injuries among Iranian children and to examine whether confounding exists among these predictors.


METHODS
A hospital based case-control study was conducted using 281 burn victims and 273 hospital-based controls, which were matched by age, gender and place of residence (rural/urban). The characteristics of the children and their caregivers were analyzed using crude and adjusted models to test whether these were predictors of childhood burn injuries.


RESULTS
The age of the caregiver was significantly lower for burn victims than for the controls (P<0.05). Further, the amount of time the caregiver spent outdoors with the child and their economic status had a significant positive association with the odds of a burn injury (P<0.05). A multivariate logistic regression found that Type A behaviour among caregivers was independently associated with the child's odds of suffering a burn injury (OR = 1.12, 95% CI: 1.04-1.21). The research also found that children with ADHD (Inattentive subscale: Crude OR = 2.14, 95% CI: 1.16-3.95, Adjusted OR = 5.65, 95% CI: 2.53-12.61; Hyperactive subscale: Crude OR = 1.73, 95% CI: 1.23-2.41, Adjusted OR = 2.53, 95% CI: 1.65-3.87) also had increased odds of suffering a burn injury. However, several variables were identified as possible negative confounder variables, as the associations were stronger in the multivariate model than in the crude models.


CONCLUSIONS
The caregiver's characteristics which were predictors of burn injuries among Iranian children were: being younger, high socio-economic status, Type A behavioural pattern and spending more time outdoors. In addition, the relationship between a child's ADHD scores and the odds of a burn injury may be negatively confounded by the caregivers predictor variables.
Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran.|WHO Collaborating Center on Community Safety Promotion, Karolinska Institute, Stockholm, Sweden.
Homayoun
H
Sadeghi-Bazargani
WHO Collaborating Center on Community Safety Promotion, Karolinska Institute, Stockholm, Sweden.
Reza
R
Mohammadi
Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Erfan
E
Ayubi
Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Amir
A
Almasi-Hashiani
Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran.
Reza
R
Pakzad
Driving Research Group, Cranfield University, Bedfordshire, United Kingdom.
Mark J M
MJ
Sullman
Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.|Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Saeid
S
Safiri
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity; D002056:Burns / Q000453:epidemiology / Q000209:etiology*; D017028:Caregivers / Q000706:statistics & numerical data; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D012959:Socioeconomic Factors