20 Dec MHRA extends fire risk to emollients containing any amount of liquid paraffin
Emollients are moisturising creams, ointments, lotions and gels applied to the skin to treat dry skin conditions such as eczema and psoriasis. We’ve known since 2008 that ointments with more than 50% liquid paraffin are a fire risk (1).
Obviously, the ointments themselves don’t catch fire on skin, it’s when they soak into fabrics repeatedly placed next to skin with ointment on that problems occur. So that’s clothing, towels, bedding or bandages etc. The liquid paraffin builds up in the fabric which can then catch fire if it comes into contact with naked flames such as lighters, cigarettes, candles, gas cookers or heaters etc. The fire that results, burns more easily, fiercely, and it harder to extinguish.
In May 2018, CQC was notified of a fire at a care home in Lancashire. Nine residents were evacuated, luckily no one was injured. The fire started in the laundry room after emollient creams reacted with cotton towels (2). Although washing fabrics at high temperatures reduces the residue in the fabric, it doesn’t remove it completely (3).
Chris Bell, The National Fire Chiefs Council’s lead for emollients, said:
“There have now been in excess of 50 deaths in the UK where the build-up of emollients on bedding, dressings or clothing may have contributed to the speed and intensity of the fire. Many of these fires were caused by people who smoked and were unaware of the fire risks associated with emollient build-up on fabrics.”
New advice – what’s changed?
A new MHRA alert issued on the 18th December 2018 (3) has extended the risk to any moisturising ointment, cream, or any other product applied to the skin with any amount of liquid paraffin (not just 50%). It also states there are concerns over paraffin-free emollients if applied to large areas of skin, in large amounts repeatedly for more than a few days.
What action should you take?
A 2016 MHRA update alert (4) reminded health and social care professionals to advise people who are using emollients of the fire risk, specifically:
- not to go near anyone smoking or using naked flames (e.g. candles, gas cookers or heaters)
- change people’s clothing and bedding regularly because emollients soak into fabric and can become a fire hazard
We’d also add the following advice to this:
- wash fabric that has come into contact with emollients as a hotter temperature
- For someone who has bedding or clothing likely to be impregnated with emollient cream: don’t have candles, electric blankets, overload plug sockets, or place hot hairdryers/hairstraighers on the bed.
By Michael Stewart MRPharmS and John Greene MRPharmS. The Medication Training Company
(1) Drug Safety Update Jan 2008; Vol 1, Issue 6: 10. Accessed online at https://www.gov.uk/drug-safety-update/paraffin-based-treatments-risk-of-fire-hazard
(2) Care Quality Commission; Guidance for providers, learning from safety incidents – Issue 3: Fire risk from use of emollient creams. Accessed online at https://www.cqc.org.uk/guidance-providers/learning-safety-incidents/issue-3-fire-risk-use-emollient-creams
(3) Care Quality Commission; Guidance for providers, learning from safety incidents – Issue 3: Fire risk from use of emollient creams. Accessed online at https://www.cqc.org.uk/guidance-providers/learning-safety-incidents/issue-3-fire-risk-use-emollient-creams
(4) Drug Safety Update volume 9 issue 9, April 2016: 9. Accessed online at https://www.gov.uk/drug-safety-update/paraffin-based-skin-emollients-on-dressings-or-clothing-fire-risk