Fire Risk Associated with Emollient Use.

Emollients, which are commonly used in social care settings to treat dry skin conditions such as eczema and psoriasis, are widely recognised for their benefits in maintaining skin integrity and comfort for Service Users. However, their use also presents a significant fire risk that is often underestimated or overlooked.

This risk arises from the flammable nature of both the emollients themselves and the residue they leave on skin, clothing, bedding, and other fabrics. As social care environments frequently accommodate vulnerable individuals, such as the elderly or those with mobility difficulties, it is crucial to fully understand the hazards associated with emollient use and implement robust safety measures.

The Care Quality Commission (CQC) identify that it is the responsibility of care providers to be aware of the risks associated with emollients use. They highlight that emollient related fires have been responsible for the death of people in care settings. This blog seeks to raise awareness of this important issue.

The Nature of Emollients and Their Flammability

Emollients are moisturising substances that come in various forms, including creams, ointments, gels, and lotions. Many emollients contain paraffin or other oil-based ingredients, which are highly flammable.

When applied to the skin, emollients can transfer onto fabrics through direct contact or absorption. Over time, repeated application and contact can cause a build-up of residue, increasing the risk that these materials will ignite if exposed to a naked
flame or a heat source.

The fire risk persists even after washing, as emollient residues are not always fully removed from fabrics. This means that bedding, clothing, and seating may remain flammable, posing a latent hazard to Service Users in their own homes or within care settings.

The risk is particularly acute in environments where Service Users may smoke, use candles, or rely on electrical equipment that can generate heat.

Incidents and Evidence

There have been several documented incidents across the UK where fires have been linked to emollient residue on clothing and bedding. These events have sometimes resulted in serious injury or fatalities, highlighting the importance of awareness and prevention.

Investigations into these incidents typically reveal that the ignition source is a cigarette, lighter, or another open flame, which comes into contact with contaminated fabrics. The fire can spread rapidly, especially when the affected individual is unable to escape due to mobility limitations.

Factors Contributing to Increased Risk

– Frequency of Use: Regular and repeated application of emollients increases the likelihood of residue build-up on skin and fabrics. This includes use over extended periods of time.
– Type of Emollient: Paraffin-based emollients are particularly flammable, but even non-paraffin products can pose risks, so all emollients need a risk assessment.
– Smoking and Open Flames: Service Users who smoke or use candles are at higher risk, as these are common ignition sources.
– Limited Mobility: Individuals who are unable to move quickly or independently may be less able to escape in the event of a fire. So, risk assessments need to consider issues such as mobility and cognitive function.
– Residential Care: The communal nature of some care settings means that fire can spread rapidly, affecting multiple Service Users and staff.

Risk Management and Prevention Strategies

In 2020 the Medicines and Healthcare products Regulatory Agency (MHRA),
https://www.gov.uk/guidance/safe-use-of-emollient-skin-creams-to-treat-dry-skin-conditions, released some guidance to users of emollients to:
– Avoid smoking
– Change and wash clothes and bedding
– Keep cream off furniture
– Tell relatives and carers
– Tell your healthcare professional

To mitigate fire risk associated with emollient use, therefore social care providers must adopt a proactive approach to hazard management. This includes:
1. Education and Training: Staff should receive training on the fire risks of emollients, including how to identify contaminated fabrics and the importance of safe handling. Tell them at your next team meeting, or better still share this blog.
2. Risk Assessments: Regular risk assessments should be conducted, focusing on Service Users who use emollients and their proximity to ignition sources. Special care should be taken to assess and manage the risk among smokers, who may need to be prompted to;
– ensure they manage their ash carefully
– extinguish cigarettes completely (perhaps in water or sand) when finished
– Use a fire-retardant blanket when smoking / invest in fire retardant bedding

3. Safe Storage: Emollients should be stored safely, away from heat and open flames.
4. Hygiene and Cleaning Protocols: Laundering of clothing and bedding should be frequent and thorough. Where possible, contaminated fabrics should be replaced rather than washed, as residues can persist.
5. Smoking Policies: In residential care settings, strict policies should be implemented to restrict smoking to designated areas, ideally away from Service Users who use emollients.
6. Service User Awareness: Service Users and their families should be informed about the risks, especially if they smoke or use other ignition sources. Care providers should document that they have done this.
7. Emergency Preparedness: In residential care settings, fire safety plans should be regularly reviewed, and staff should practise evacuation procedures to ensure swift response in an emergency.
8. Regulatory Guidance and Best Practice

The MHRA and the National Fire Chiefs Council (NFCC) have released advice to healthcare professionals, it is worth sharing this sheet with staff.

Other advice from the CQC and the Health and Safety Executive (HSE) highlights the importance of risk assessments, staff training, and the safe use and storage of emollient products. Adhering to these guidelines is not only a matter of compliance but also a critical component of Service User and staff safety.

Best practice dictates that emollient use should be carefully documented, and care plans should address potential fire risks. Regular audits can help ensure that safety protocols are followed, and any lapses are quickly corrected.

Balancing Therapeutic Benefits and Safety

It is important to balance the therapeutic benefits of emollient use with the necessity of fire safety. However, care providers must remain vigilant and take steps to minimise fire risk wherever possible.

By fostering a culture of safety and awareness, social care providers can continue to deliver high-quality care while protecting Service Users from preventable harm.

Summary

In this blog we have considered something of the nature of the risks posed to Service Users and staff by emollients, especially where the people using the emollient smoke.

We have identified the necessity for risk assessments for emollient use and the generation of strategies for risk management as well as the need to raise staff awareness about the risks from emollients.

Bettal’s policy suite includes one covering the use of emollients.

If you have run a domiciliary, homecare, agency and you are looking for ongoing support with policies, procedures and a whole lot more, browse our website or get in touch:
Email: info@bettal.co.uk
Telephone: 01697741411

Peter Ellis MA MSc BSc(Hons) RN
Consultant
Bettal Quality Consultancy