Severe burns due to biofuel heater injury: A case series

•Five adults were severely burned by a biofuel heater in Queensland in June 2014.•Flame injury occurred when the operator was refilling the appliance with ethanol.•Average burn was 24.7% total body surface area, and three adults spent an average of 31 days in ICU.•An Australian Standard does not regulate these heaters, and so their safety and quality is unknown.•Cost of admission can exceed $200,000 for patients with this degree of burn.

BackgroundBiofuel heaters are a new form of flame heating for indoor and outdoor use. Fuelled by methylated spirits, they are simple structures with few safety features, and can be associated with severe burn. We report five cases of severe burns in adults that occurred when refilling these heaters.MethodsWe undertook a retrospective audit of all adults presenting to the Royal Brisbane and Women's Hospital (RBWH) with a biofuel heater-related burn between 20 and 30th June 2014.ResultsFive patients required admission for management of their burns. Three were admitted to ICU for greater than 3 weeks, and remained inpatients for up to 78 days. Two did not require ICU and were managed in the burns unit. Average total body surface area (TBSA) burned was 24.7%, and patients went to theatre up to seven times for debridement and skin grafting. Average length of stay was 41.8 days.ConclusionsBiofuel heaters are easily accessible yet there is no Australian Standard to ensure they are safe or perform in the way they were intended. As such, people using them are at undue risk of severe burn, even when following the operating instructions. These products should be removed from the market to prevent further harm and potential mortality.