Published: 7 June 2019

Publications

Paraffin-based emollients and the risk of severe and fatal burns

Prescriber Update 40(2): 33-34
June 2019

Background

Although there have not been any reports in New Zealand to date, the Medicines and Healthcare products Regulatory Agency in the UK is currently aware of 11 cases in which paraffin-based emollients are suspected to have contributed to the speed and intensity of a fire, resulting in a fatal burns injury¹.

The hazards of paraffin-based emollients have been documented in the UK for over 10 years².

The New Zealand Formulary includes safety information on a fire hazard with paraffin-based emollients³. However, there has been limited safety information in New Zealand regarding these emollients and the risk of severe and fatal burns.

What’s new?

From May 2020, some paraffin-based emollients will be required to include the following warning:

Caution: This product may make dressings and clothing catch fire more easily.

This warning statement will only apply to products containing 50% or more of paraffin and in packs of 100 g or more.

Medsafe consulted on this warning statement at the end of 2018 – you can read more about it on the Medsafe website.

Avoiding the risk of burns

Healthcare professionals should provide the following advice when prescribing, recommending, dispensing (including compounding and repacking), selling or applying paraffin-based emollients to patients and their carers^1,2.

• Paraffin-based emollients are not themselves flammable.
• Clothing, bedding or medical dressings covered in paraffin-based emollients are at risk of catching fire and are the main hazard.
• Patients should not smoke, use naked flames (or be near people who are smoking or using naked flames) or go near anything that may cause a fire while paraffin-based emollients are in contact with their clothing, bedding or medical dressings.
• Change patient clothing, bedding and medical dressings regularly – preferably daily – because paraffin-based emollients soak into fabric, build up and can become a fire hazard.
• Very high-risk patients are likely to be elderly smokers, with an even higher risk for those receiving home oxygen.
• No risk has been identified for paraffin-based products with other uses, such as paraffin-based eye ointments.

Further information

A Consumer Information Leaflet, ‘Fire hazard from skin products containing paraffin’, is available on the Medsafe website (www.medsafe.govt.nz/consumers/educational-material.asp).

References

1. Medicines and Healthcare products Regulatory Agency. 2018. Emollients: New information about risk of severe and fatal burns with paraffin-containing and paraffin-free emollients. Drug Safety Update 12(5): 3. URL: www.gov.uk/drug-safety-update/emollients-new-information-about-risk-of-severe-and-fatal-burns-with-paraffin-containing-and-paraffin-free-emollients (accessed 25 March 2019).
2. Shokrollahi, K. 2017. Paraffin-based ointments and fire hazard; understanding the problem, navigating the media and currently available downloadable patient information. Scars, Burns & Healing 3: 1-2. URL: www.ncbi.nlm.nih.gov/pmc/articles/PMC5965335/ (accessed 25 March 2019).
3. New Zealand Formulary. 2019. New Zealand Formulary v81: Emollients 1 March 2019. URL: https://nzf.org.nz/nzf_6235 (accessed 29 March 2019).