The MHRA has distributed a warning about the risk to patients who use emollients and the potential harm caused by their capacity to increase the severity of burns in case of fire. We have long been aware that paraffin-based products present an additional risk so we know not to use things like white soft paraffin around the nose when patients are receiving oxygen therapy.
Evidence now indicates that this may apply to any emollient and that healthcare professionals and patients should be aware of these risks.
Risk of ignition
It is important here to remember that the risk is about FIRE. A patient using emollients is not necessarily at risk unless there is a chance of a spark or other form of ignition to start a fire. In a ward or home environment where air is circulating there should be no major risk – we are not looking at spontaneous combustion! It is essential to be aware of the risk of ignition from cigarettes, lighters, possibly e-cigarettes and candles. A fire can only start if there are the three elements – oxygen, heat and fuel –but for a fire to start in the absence of a spark, a very high temperature is required. In addition, we should be aware that paraffin and other products only burn at these elevated temperatures, so although they can increase the severity of a burn, they are not alone responsible for causing fires.
With that in mind, the MHRA warning contains the following information.
Advice for healthcare professionals:
- Emollients are an important and effective treatment for chronic dry skin conditions and people should continue to use these products. However, you must ensure patients and their carers understand the fire risk associated with the build-up of residue on clothing and bedding and can take action to minimise the risk
- When prescribing, recommending, dispensing, selling, or applying emollient products to patients, instruct them not to smoke or go near naked flames because clothing or fabric such as bedding or bandages that have been in contact with an emollient or emollient-treated skin can rapidly ignite
- There is a fire risk with all paraffin-containing emollients, regardless of paraffin concentration, and it also cannot be excluded with paraffin-free emollients. A similar risk may apply for other products which are applied to the skin over large body areas, or in large volumes for repeated use for more than a few days
- Be aware that washing clothing or fabric at a high temperature may reduce emollient build-up but not totally remove it
- Warnings, including an alert symbol, are being added to packaging to provide a visual reminder to patients and those caring for them about the fire hazard
- Report any fire incidents with emollients or other skin care products to the Yellow Card Scheme.
The CQV has also drawn attention to this document from the MHRA.