[Secondary plastic and reconstructive measures following deep-dermal burn injuries : Negligent use of bioethanol]

Aetiology of bioethanol related burn accidents: A qualitative study

BACKGROUND

Since insight into the motivation of behaviour in bioethanol related burn accidents is lacking, this study aimed to qualitatively examine influencing factors in bioethanol related burn accidents. In order to identify target points for effective burn prevention.

METHODS

Patients previously admitted with bioethanol related acute non-intentional burn injury to the three Dutch burn centres were eligible. One interviewer conducted fourteen semi-structured interviews. Interviews were transcribed and coded by two independent researchers. Conclusions were drawn based on generalised statements on the concerned topics.

RESULTS

Four overall themes in influencing factors were found, namely 1) motivation; including non-designated use and impaired judgement, 2) knowledge and education; including unknown product and properties and information overload, 3) risk perception; including poor recognisability of risks and preferred trial and error and 4) thresholds; including easy availability and unclear liability.

CONCLUSION

Trust in consumers may be over-estimated, as proper use cannot be expected. To prevent future bioethanol related burn incidents, thresholds for obtaining and using bioethanol should be increased, safe alternatives to ignite open fires and wood stoves should be provided and knowledge and warnings should be improved.

Ethanol and Methanol Burn Risks in the Home Environment

Biofuel heaters and fireplaces have in recent years been introduced for indoor and outdoor use. Due to their simplicity, they are usually equipped with few or no safety features. Worldwide, incidents resulting in major skin burn injury and long hospitalization periods have occurred when using such biofuel units. The present study analyses the characteristics of the liquids ethanol and methanol to get a scientific background for understanding related accidents. The comparably heavy vapors, especially from ethanol, may generate a pillow of combustible gas in the vicinity of the unit, particularly in quiescent indoor air conditions. It is also revealed that these fuels represent a potential severe risk, since the equilibrium vapor pressures are close to the stoichiometric fuel–air composition at normal room temperatures. Selected incidents were reviewed to understand the mechanisms involved when severe burns were received by the users. It turns out that the most severe incidents were related to refilling operations and included ignition of the fuel container vapor phase. When ignited, the container gas phase expansion propelled burning fuel from the bottle or container onto the user or other persons in the vicinity. Similar incidents involving refilling methanol for chemistry demonstrations and ethanol for endodontic (dentistry) treatment were also studied and it was shown that these accidents followed similar accident mechanisms. It may be concluded that the main contributors to burn risk are the near-stoichiometric vapor pressure of these liquids at room temperature and the close proximity of the fuel container to burning fuel. Research needs and possible technical barriers are suggested to reduce this risk for the future.