Instant Noodles: Overlooked Burn Hazard

Featuring Dr. Greenhalgh

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Talk of burn prevention at Shriners Hospitals for Children — Northern California invariably turns to soup and instant noodles.

“There continues to be a steady rate of hot soup burns in children,” Sally Martens FPN, a provider with the burn team at Shriners Hospitals for Children — Northern California, said. “We see at least a 2 or 3 new noodle soup burns each week.”

Nobody knows exactly how many scald burns from soup and noodles there are in the state or the nation, but providers in burn units and emergency departments across the country seem to agree. They see too many of these scalding burns. Soup and noodle burns are one of the most common burns they see in children.

Want to prevent common household scald burns in children?

Our burn experts recommend using caution when preparing soup and packaged, instant noodles. In an attempt to get a handle on a precise incidence, a study published in Clinical Pediatrics this year scoured 10 years of data in the National Electronic Injury Surveillance System for scald burns related to instant soup and noodles in children 4-12 years of age. It found 4,518 cases (Clin Pediatr. 2021;60:16-19.). Based on that, the researchers estimate that there must be almost 10,000 such burns a year.

Ten percent of the burns reviewed required hospitalization or transfer for further care.

Martens says one of the most common body areas burned with soup and noodles is the lap, including the genitals, which was identified in the Clinical Pediatrics article also. These accidents often happen because children knock over a container while sitting or they pick up a hot, flimsy cup, which crushes or burns their hands, and they drop it on themselves.

The microwave is a singular culprit, according to research by the assistant chief of burns at the Northern California Shriners Hospital, Tina Palmieri, M.D.

She grew so concerned about the soup/noodles problem that she began surveying caregivers who had a child with a scald burn and continued the research for almost a year (J Burn Care Res. 2008;29:114118.). Of the 78 cases of scald burns seen in that time, 65% involved prepackaged soup and noodles.

Fifty-one percent of cases involved soup heated in the microwave.

“Considering the great numbers of burns from spilled soups, it’s likely that safety was never an important issue in product design.”

These burns can be very serious. Some of them are second and even third degree burns. According to Dr. Palmieri’s research, around 45% of scald injury patients at the Northern California Shriners Hospital are treated as an outpatient. But the remaining soup scald burns are 8% of all admissions to the hospital and the mean burn size in those cases is greater than 7% of total body surface area.

While all the soups are a risk, the noodles are a particular hazard. The noodles apparently hold heat and do not cool off as quickly as liquid. Researchers at the Baltimore Regional Burn Center who explored the noodle factor in 27 soup-burn admissions to their hospital reported that, when noodles were involved, the length of stay was significantly longer, indicating the burns tended to be of a greater severity (J Burn Care Res. 2007;28:474-77.).

David Greenhalgh, M.D., the chief of burns at the Northern California Shriners Hospital, has been battling the noodle problem with Dr. Palmieri for more than 10 years now.

Almost 15 years ago, in 2006, Dr. Greenhalgh published a study on the containers that instant soups and noodles are packaged in, examining the stability of those containers, most of which are thin and tall (J Burn Care Res. 2006;27:476-81.).

Dr. Greenhalgh found that the containers were highly unstable. The worst one tipped over at an angle of just 23 degrees

“Considering the great numbers of burns from spilled soups, it’s likely that safety was never an important issue in product design,” Dr. Greenhalgh said in his study.

Dr. Greenhalgh has received a lot of attention over the years from this particular study. He’s been on National Public Radio talking about noodles. He’s been on the CBS Morning News and CNN and in Scientific American.

He suggests that if companies are going to continue to sell their noodles in a tall cup that they should turn the cup upside down, with the broader part at the bottom, like a Yoplait container. “That would make it less tipsy,” he said.

During the coronavirus pandemic, instant noodles have become even more popular. One brand saw a double-digit sales increase in the first 5 months of 2020, according to a report from Bloomberg News in June. Market experts predict that the instant soup and noodle market will continue to grow at a rapid rate in the foreseeable future. So, what can parents do to better protect children from food scald burns?

Dr. Greenhalgh suggests these kitchen safety and burn prevention tips.

  • Avoid letting young children use the microwave or cook, especially not the 5- and 6-year-olds.
  • When using the stove, use the back burners and turn pot and pan handles away from the front edge, where children would be able to grab them.
  • Keep young children out of the kitchen when cooking. Make it a safe area they are not allowed to enter when cooking is going on.
  • Avoid table cloths because children can pull them down.
  • Avoid holding your children while cooking or eating hot food.