ISEE-189 Introduction: Several reports have described the risk of burns to children from open wood fires in poor countries, but there is little information available on community incidence and none describing the impact of preventative interventions. A randomised controlled trial currently underway in Guatemala designed to assess impacts of an improved stove on pneumonia and other health outcomes provides an opportunity to study this issue. Methods: The study sample includes 507 homes using an open fire, recruited from a rural area of western Guatemala. Eligible homes had a child under 4 months or a pregnant woman (providing the index children for respiratory illness outcomes). Health surveillance for the index child is by weekly home visits until 18 months of age, with episodes of burns/scalds recorded. Household interview includes questions on burns/scalds in older siblings of the index child, repeated 6 monthly. Homes were randomly allocated to receive a plancha chimney wood stove immediately, or when the index child reaches 18 months. Results: Index children being very young and closely supervised initially had a very low rate of burns/scalds. Preliminary analysis of 34 cases in these children after 11 months of follow-up showed similar numbers of burns in plancha and control groups (although due to OF in 2 plancha homes), with a trend towards burns in open fire homes being in older children (9.7 vs 7.1 months, p=0.1). Among 1040 siblings aged up to 8 years in study homes, 22 reported a burn/scald in the 6 months prior to baseline (42 per 1,000 per year), all under 6 years. Eight resulted from falling into the fire, eight from scalds, and six from a hot object, pot or other cause. Fifteen left scars, seven larger than 2 cm diameter, one 3x14 cm. A further 40 episodes were recalled as having occurred prior to the last 6 months with similar causes, five leaving scars at least 5 cm in diameter. Discussion: An improved stove has the potential to prevent the majority of burns/scalds, particularly the most severe episodes resulting from falling into an open fire. Initial findings indicate that burns still occur with the plancha, but this could be in part lack of experience with young children near an unfamiliar, new type of stove, and a clearer picture may emerge as they get older. This study will provide information on incidence, severity and causes, and evidence on intervention effectiveness over 18 months in children up to around 10 years. Education in the safe use of improved stoves may well be required, as is the case for home accident prevention in any society.