Emollients are essential in treating various skin conditions, particularly for individuals in health and social care settings. However, despite their benefits, emollients — especially those containing paraffin or oil based ingredients — pose a significant fire risk. Over time, emollients can soak into fabrics such as clothing, bedding, and dressings, making them more flammable and increasing the likelihood of serious fire incidents.
This blog post aims to highlight real-world incidents involving emollient flammability, the legal and regulatory responsibilities for organisations, and best practices for managing these risks in line with guidance provided by the Medicines and Healthcare products Regulatory Agency (MHRA), Care Inspectorate Scotland, and Care Quality Commission (CQC).
The Hidden Danger of Emollients
While emollients are a common treatment for dry skin conditions like eczema and psoriasis, they can also pose an invisible danger when they come into contact with fabrics over time. The fire risks become particularly heightened in care settings where individuals may smoke or be in close proximity to ignition sources such as electrical equipment or heating elements.
Real-Life Incidents in Care Settings
2015 Nursing Home Fatality: An elderly woman tragically lost her life when her parafiin based emollient-soaked clothing ignited from a cigarette. Despite rapid intervention by care staff, the fire spread quickly due to the inflammable nature of the fabrics.
2018 Home Care Tragedy: A man receiving home care services died after his emollient-treated clothing caught fire while he was smoking. Investigations later revealed that he and his caregivers had not been adequately informed about the fire risks associated with his prescribed creams.
These incidents underscore the importance of recognising the fire risks associated with emollients and implementing robust safety measures in care environments.
Regulatory Guidance and Legal Responsibilities
Organisations involved in health and social care have a duty to protect both staff and service users from hazards, including those posed by emollients. There are several key pieces of guidance from the MHRA, Care Inspectorate Scotland, and CQC that are critical in ensuring safety.
Medicines and Healthcare Products Regulatory Agency (MHRA)
The MHRA has issued several Drug Safety Updates on emollient flammability risks, emphasising the following:
Fire risk from paraffin-based emollients: The MHRA has warned that paraffin-containing emollients, when absorbed into dressings, clothing, and bedding, increase the flammability of these materials, even after washing.
Guidance for care providers:
Ensure all users, caregivers, and healthcare professionals are aware of the fire risks.
Include warnings in patient records, care plans, and packaging labels.
Provide clear information about the need to avoid open flames and smoking around people using emollients.
The MHRA strongly advises all healthcare professionals to include fire risk warning when prescribing emollients, particularly for individuals in long-term care settings. Additionally, MHRA recommends washing fabrics regularly to reduce the buildup of emollients but emphasises that this may not entirely remove the fire risk.
Care Inspectorate Scotland
COSHH (Control of Substances Hazardous to Health) Regulations: Emollients are considered hazardous substances under the COSHH regulations. This means that care providers must identify and assess risks associated with their use, especially the increased flammability when they come into contact with fabrics.
Fire Safety Procedures: Care homes, domiciliary care services, and supported living environments should have stringent fire safety procedures, especially when emollients are in use. This includes regular fire drills, ensuring fire safety equipment is accessible, and providing fire-retardant bedding and clothing where possible.
Individual Risk Assessment: The Care Inspectorate expects providers to conduct individual risk assessments for service users, identifying those who use emollients and any increased risks due to their environment or habits (such as smoking).
Failure to manage these risks could result in breaches of Health and Safety Executive (HSE) regulations, impacting an organisation’s compliance with the Care Inspectorate’s standards.
Care Quality Commission (CQC)
The CQC, which regulates health and social care services in England, requires providers to comply with relevant health and safety regulations. In the context of emollients, the CQC highlights the importance of:
Risk Assessments: Care providers must carry out a thorough risk assessment for any hazards, including the potential fire risks from emollient use. This includes assessing individual risk factors, such as service users who smoke or live in environments where ignition sources are present.
Clear Communication: The CQC stresses that both staff and service users need to be informed about the flammability risks of emollients. This includes providing clear written and verbal guidance about the dangers of smoking or using open flames around individuals who are using these products.
Training for Staff: Care organisations must ensure that staff are adequately trained to identify fire hazards associated with emollient use. This includes understanding how to minimise risks and how to act quickly in the event of a fire.
Failure to implement these precautions may result in non-compliance with CQC safety standards, potentially leading to enforcement actions.
Best Practices for Managing Emollient Fire Risks
Conduct Thorough Risk Assessments
Organisations must conduct emollient-specific risk assessments for each service user. Our Emollient Flammability Risk Assessment Template can help providers identify potential hazards, implement control measures and comply with regulatory standards.
Communicate Risks Clearly
Healthcare professionals should ensure that every individual using emollients, as well as their families and caregivers, are fully informed of the fire risks. Label emollient containers and provide written and verbal instructions about the dangers of smoking and using open flames around emollient-treated fabrics.
Implement Fire Safety Measures
Use fire-retardant bedding and clothing for individuals using emollients.
Ensure regular washing of clothing and bedding to reduce the accumulation of emollients on fabrics, though this does not entirely eliminate the risk.
Ensure no-smoking policies are enforced where emollients are in use and provide alternatives for individuals who smoke, such as e-cigarettes, which reduce the fire risk.
Train Staff
All staff working in care settings should receive training on the fire risks associated with emollients. This includes understanding how emollients increase the flammability of fabrics and what to do in case of an emergency.
Regular Monitoring and Review
Emollient flammability risk assessments should be reviewed regularly, especially when there are changes to a service user’s care plan, such as changes in emollient type or usage. This ensures ongoing safety and compliance with regulatory requirements.
Understanding the Yellow Card Scheme: Reporting Emollient-Related Safety Concerns
In addition to the steps you take to mitigate risks associated with emollients, it's crucial to know how to report any adverse incidents related to these products. The Yellow Card Scheme, operated by the Medicines and Healthcare products Regulatory Agency (MHRA), is a vital tool for reporting safety concerns and adverse effects related to medications, including emollients.
What is the Yellow Card Scheme?
The Yellow Card Scheme is a UK-wide system for reporting suspected adverse drug reactions (ADRs) and safety concerns associated with medicines, medical devices, and healthcare products. This system is particularly important for tracking incidents that may not be widely known or understood. For emollients, this includes reporting any incidents where their use has led to safety risks, such as fire hazards caused by flammable ingredients.
Why Report Emollient Safety Concerns?
By reporting incidents related to emollients through the Yellow Card Scheme, you help regulatory authorities:
Monitor Product Safety: The MHRA uses these reports to monitor the safety of emollient products and identify any patterns of risk, such as increased flammability in certain formulations.
Inform Regulatory Actions: Reports can trigger investigations, changes in product labelling, or even product recalls if a serious safety issue is identified.
Raise Awareness: Reporting incidents ensures that healthcare professionals, caregivers, and manufacturers are informed of potential risks, allowing for better risk management and prevention of future accidents.
How to Report an Incident
Anyone can report an adverse incident via the Yellow Card Scheme, including healthcare professionals, caregivers, and members of the public. If you encounter any safety concerns related to emollients, such as fire hazards, follow these steps:
Visit the Yellow Card website at yellowcard.mhra.gov.uk.
Select the relevant category, in this case, “Medicine” for emollients.
Provide details of the incident, including the name of the product, how it was used, and what adverse effects occurred (such as a fire incident).
Submit the report to ensure the incident is logged and reviewed by the MHRA.
Encouraging Reporting in Health and Social Care Settings
In care settings, it’s important to encourage staff and caregivers to report any incidents or near-misses involving emollients to the Yellow Card Scheme. This practice supports wider public safety efforts and ensures that risks related to flammable products are well-documented and addressed by the authorities.
How Slanjava Learning Ltd. Can Help?
At Slanjava Learning Ltd, we understand the critical importance of managing risks in health and social care environments, especially when it comes to emollient flammability. As part of our commitment to supporting care providers, we offer practical solutions to help you keep your staff, service users, and patients safe.
Free Emollient Flammability Risk Assessment Template
To assist organisations in effectively managing the fire risks associated with emollient use, Slanjava Learning Ltd provides a free Emollient Flammability Risk Assessment Template. This comprehensive tool is designed to help care providers:
Identify Hazards: Assess the level of risk associated with the use of emollients in your care setting, including identifying service users at higher risk (e.g., smokers or those near ignition sources).
Implement Control Measures: Develop and apply strategies to minimise the fire risks, such as using fire-retardant bedding, enforcing no-smoking policies, and regular monitoring of emollient use.
Ensure Compliance: Stay compliant with regulatory guidance from the MHRA, CQC, and Care Inspectorate Scotland, ensuring your care environment meets all health and safety standards.
Download our free template to begin your assessment and improve the safety of your care setting.
Fire Marshal/Warden Training
In addition to risk assessment support, Slanjava Learning Ltd offers Fire Marshal/Warden Training specifically tailored for health and social care environments.
This training will equip your staff with the knowledge and skills to:
Recognise Fire Hazards: Understand the specific fire risks associated with emollients and how to address these risks within your care setting.
Respond to Emergencies: Learn how to respond effectively to a fire emergency, including evacuation procedures and the safe use of fire safety equipment.
Maintain a Safe Environment: Ensure that fire safety protocols are followed, and that your care setting is fully compliant with legal fire safety requirements.
Our Fire Marshal/Warden training empowers your team to create a safer environment and respond confidently in the event of a fire-related incident.
Conclusion
Emollient-related fire incidents are a hidden danger in health and social care settings, but with the right precautions, they are entirely preventable. The guidance provided by the MHRA, CQC, and Care Inspectorate Scotland underscores the importance of risk assessments, clear communication, and rigorous fire safety measures.
By following these guidelines, care providers can ensure that emollients are used safely, protecting both staff and service users from the devastating consequences of fire.
Interested in learning more? You can book onto one of our accredited Fire Marshal/Warden or Medication Administration courses by calling 0141 459 0894 or emailing hello@slanjavalearning.co.uk
Kind regards,
Slanjava Learning
-slàinte mhath-
The information provided is for guidance and not a substitute for medical advice. The author bears no liability for inaccuracies or mistreatment, and professional medical consultation is advised.
References:
MHRA (Medicines and Healthcare products Regulatory Agency), 2020. Paraffin-based skin emollients on dressings or clothing: fire risk. [online] Available at: https://www.gov.uk/drug-safety-update/paraffin-based-skin-emollients-on-dressings-or-clothing-fire-risk [Accessed 1 October 2024].
Care Quality Commission (CQC) (2018). Fire risk from use of emollient creams. [online] Available at: https://www.cqc.org.uk/guidance-providers/learning-safety-incidents/issue-3-fire-risk-use-emollient-creams (Accessed: 1 October 2024).
London Fire Brigade, 2020. Elderly and disabled at risk from flammable creams, LFB warns. [online] Available at: https://www.london-fire.gov.uk/news/2020-news/august/elderly-and-disabled-at-risk-from-flammable-creams-lfb-warns/[Accessed 3 October 2024].
BBC News, 2017. The hidden fire risk of skin creams. [online] Available at: https://www.bbc.com/news/uk-england-42022626 [Accessed 2 October 2024].
The Guardian, 2018. Fire risks in skin creams could have caused hundreds of deaths. [online] Available at: https://www.theguardian.com/society/2018/jan/29/fire-risk-in-skin-creams-could-have-caused-hundreds-of-deaths[Accessed 2 October 2024].
MHRA (Medicines and Healthcare products Regulatory Agency), 2020. Yellow Card Scheme: Reporting adverse incidents. [online] Available at: https://yellowcard.mhra.gov.uk/ [Accessed 2 October 2024].
Thank you for the free Emollient Risk Assessment!