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Paraffin based emollient creams

The use of paraffin based emollient skin creams, although generally safe to use, can become flammable when exposed to an ignition source, such as a naked flame, cigarette or heater. Emollient creams are often used for dry skin conditions such as psoriasis, eczema, bed sores and ulcers. With regular use, clothing, dressings, and bed sheets can become impregnated with the product. This build up of residue can become highly flammable and act as an accelerant when ignited.

To reduce the risk of this happening:

  • Do not smoke or allow others to smoke in your home. Consider telling your doctor, nurse or pharmacist if you normally smoke. They will be able to offer you help and advice to stop smoking.
  • Don’t use any naked flame or ignition source such as matches, lighters and candles if there is any chance of your clothing being contaminated with paraffin-based cream.
  • Don’t cook if there is any chance of your clothing being contaminated with paraffin-based cream.
  • Don’t use paraffin or oil-based cream or liquid on your skin if using oxygen equipment. Speak to your health professional or carer about using water-based cream instead.
  • Ensure that your clothes and bedding are changed regularly (preferably daily) as the paraffin soaks into the fabrics.

FAQs

What are emollient skin products?

They are moisturisers which may contain paraffin, shea or cocoa butter, beeswax, lanolin, nut oil or mineral oils and they work by covering the skin with a protective film or barrier which keeps the moisture in.

Are they only prescribed by doctors?

Emollients are commonly prescribed by GPs, nurses and other clinicians over long periods of time to treat skin conditions such as psoriasis, eczema and sores. Many of these products can also be purchased over the counter in chemists and supermarkets.

Are they safe to use?

Yes they are. We encourage their use as recommended by medical professionals and the manufacturer’s instructions.

Are they flammable?

No. If you put a match to a sample of emollient skin product it would not ignite.

So why should I be concerned?

Regular use of these products, over a number of days, can lead to them soaking into your clothing, bedding and bandages/dressings. This residue then dries within the fabric. If you then introduce an ignition or heat source such as accidentally:

  • dropping a cigarette, lighted match or lighter.
  • sitting too near to a gas, halogen or open fire.
  • catching your clothing on a hob when cooking.

you can cause a fire to develop, burn intensely and spread rapidly. This could lead to a serious injury or death. Nationally, there have been at least 56 deaths associated with emollient skin products within the last 10 years.

What can I do to make sure I’m safe?

  • Never smoke in bed.
  • Do not smoke if there is any chance your clothing or dressings could be contaminated with these products.
  • Do not cook if there is any chance your clothing or dressings could be contaminated with these products.
  • Do not sit too close to any open fires, gas fires or halogen heaters.
  • Wash your clothing and bedding daily at the highest temperature recommended by the fabric care instructions. This should reduce some of the contamination but may not remove it completely.

What can I do to make sure my friends and family are safe?

Share this information with them so that they are also aware of the potential risks.

Information for health and care professionals

We know that emollient skin products are safe to use but they can soak into clothing, dressings and bedding leaving a flammable residue. If exposed to a naked flame or a heat source, such as a cigarette, lighter, gas cooker, heater or fire, these dried fabrics can catch fire. The emollient residue will help the fire develop and spread rapidly which could result in serious injury or death.

In a hospital setting

  • Patients should be given information that includes advice about the potential fire risks of smoking (or being near to people who are smoking), or exposure to any open flame or other potential cause of ignition during treatment. In hospital units initiating therapy, this should be given in both verbal and written form.
  •  Fire safety information should be displayed prominently in every ward area where patients may be treated with significant quantities of emollient products.
  • If, against advice, a patient intends to go off the ward to smoke they should be informed of the risk and advised to wear a thick outer covering that has not been contaminated with emollients.
  • Relatives or carers should be informed if a patient does not comply with safety advice and instructions during treatment involving significant quantities of emollients.

In a community setting

  • Consider the smoking status of your patients before commencing treatment.
  • Patients and clients should be given information that includes advice about the potential fire risks of smoking (or being near to people who are smoking), or exposure to any open flame or other potential cause of ignition during treatment.
  • This information should be given on the first occasion that such treatment is prescribed or applied by a healthcare professional and a record kept confirming that the advice has been given. Regular checks should be made to ensure the advice has been given and understood.
  • Patients and their families should be provided with safety advice about regularly changing clothing or bedding saturated with emollient products (preferably on a daily basis), as the emollient soaks into the fabrics and can potentially be a fire hazard. Chairs or seating may also have the potential to become contaminated. Please note that regularly washing fabrics will reduce the contamination but may not totally remove it.
  • Encourage your patients and clients to share the advice they have been given with their family.
  • Review/inform the GP if your patient has a previous history of smoking and is displaying memory issues and/or confusion.
  • Share this information with your colleagues and teams.
  • Record the advice you have given in your patient/client’s care plan

General practitioners

  • Consider the smoking status of your patients before commencing treatment.
  • Patients should be given information that includes advice about the potential fire risks of smoking (or being near to people who are smoking) and their exposure to any open flame or other potential cause of ignition such as cooking if there is any possibility of their clothing, bandages or bedding being contaminated with these products.
  • This information should be given on the first occasion that these products are prescribed and a record kept confirming that such advice has been given. A check should be made on subsequent occasions that the advice has been received previously and understood.
  • Review your patient’s use of emollient skin products if they have a previous history of smoking and are displaying memory issues and/or confusion.
  • Consider alternative treatments where people smoke and/or have a condition which places them at high risk of fire such as memory loss, poor concentration or drowsiness.
  • Share this information with your colleagues and teams.
  • Display and disseminate appropriate information to your patients.
  • Encourage your patients to share this advice with their family.

Pharmacists

  • Ask your customers what their smoking status is when dispensing or selling emollient skin products.
  • Talk to them about the potential fire risks of using these products, especially if they are smoking, cooking or near to an open flame.
  • Record any advice you have given on their Patient Medication Record, remembering to communicate this to them at regular intervals.
  • Take care not to cover up the flammability warning on products which have them.
  • Refer people back to the GP where they smoke and/or have a condition which places them at high risk of fire such as memory loss, poor concentration or drowsiness; and add their details to their Patient Medical Record.
  • Share this information with your colleagues and teams.

Experiment: The effects of emollient creams on different materials

Staffordshire Fire and Rescue Service have conducted an experiment showing the effects of different materials impregnated with emollient creams using different ignition sources. See the video below for the outcomes of this experiment.