Preventing burns and scalding injuries from water systems

Burns and scalding injuries from tap water occur in apartment complexes, hotels/motels, long-term care facilities, healthcare facilities, educational facilities, etc. Hot water systems throughout the United States and Canada should have thermal shock and scald protection for showers. Yet, many facilities are not taking advantage of these protective devices. Burns and scalding injuries are preventable. Use the checklist below to audit your hot water system protection devices, and address any "No" responses to reduce the risk of burns and scalding injuries.

Hot water system checklist




Testing the temperature of the water


How hot is the water that is coming out of the tap?


Is the water temperature determined using a dial stem thermometer?


Is the use of digital thermometers to measure water temperature prohibited?


Is the water allowed to run for 3-5 minutes from the faucet before the thermometer stem is inserted at an angle to register the water temperature?


Is the thermometer calibrated?


Is the water temperature checked at the point-of-use by running a hand through the water and checking the back of the hand for redness?


Plumbing considerations


Is the water heater set at 120°F (49°C)?


If the water heater is set at 140°F (60°C) to kill germs, such as Legionella bacteria (LB), then are thermostatic mixing valves used to dispense water to hot water outlets at a safe 120°F (49°C)?


Are point-of-use devices used in shower fixtures to protect against thermal shock?


Are anti-scald, thermal shock valves installed at all possible points of contact, including:

  • Sinks (bath and kitchen)
  • Bathtubs
  • Showers
  • Hot tubs
  • Whirlpools

Is a temperature actuated flow reduction (TAFR) valve installed before the showerhead or shower arm?


Are plumbing systems equipped with individual pressure balancing, thermostatic, or combination pressure balancing-thermostatic valves?


Is an existing, combination shower/tub installation equipped with a TAFR valve at both the tub spout and showerhead?


Is water from the water heater recirculating continuously?


Do energy management activities compromise the water system that depends on water recirculation to sense and control temperature?


Does the building plumbing system have redundant protection against the risk of burns or scalding injuries?


In the bathroom


When the tub is being filled, is it checked by running the back of a hand through the water to confirm that the temperature is suitable for bathing children or the elderly?


Are special tub spouts and showerheads installed that prevent hot water burns?


Can the temperature of the water be adjusted without help?


Have persons receiving services ever complained that the water is too hot?


In the event of a plumbing malfunction, are grab bars and anti-slip surfaces installed to limit slips and falls in showers and tubs?


Recordkeeping and maintenance


Is tap water temperature monitored?


Are written temperature logs maintained?


Were problems identified with the water temperature logs? (Describe)


Were actions taken to address reports of water that was too hot? (Describe)


Were any thermal shocks reported when the system was tested by flushing a toilet while running the hot water?


Are central mixing valves adjusted seasonally?


Is hard water treated to minimize mineral deposit buildup?


Is the facility evaluated to determine if conditions for hot water usage have changed since the initial design?


If a temperature element is damaged, is it replaced?



Copyright ©2015, ISO Services, Inc.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

​​​​LC FEB 2019 10-358H
171-0869 (12/18)