Cooking-related burns: a neglected public health crisis
Household energy transitions have the potential to dramatically improve health outcomes, but the focus has largely been on reducing exposure to air pollution. However, concerns have been raised about the substantial burden of preventable injuries like cooking-related burns, which disproportionately affect vulnerable populations in low- and middle-income countries (LMICs).
Drawing on a first-of-its-kind national survey from Ghana, our analysis reveals the staggering scale of the cooking-related burn crisis. We estimate over 300,000 severe cooking-related burns occur in Ghana each year, with working-age females experiencing the highest incidence at 17 per 1,000 person-years – over 8 times higher than working-age males.
Notably, we found no child burns in households primarily using liquefied petroleum gas (LPG), while the odds of severe burns were more than doubled among adults using solid fuels like wood and charcoal compared to LPG. These findings suggest that expanding access to clean cooking fuels like LPG not only reduces air pollution, but can also substantially mitigate the burden of cooking-related injuries.
However, the story is more complex. LPG expansion must be accompanied by robust safety training and awareness campaigns to address perceptions of LPG as an “unsafe” option. Integrating burn prevention strategies into clean cooking programs is critical, as are national burn registries to better understand the full epidemiology and impact of this neglected public health issue.
The hidden epidemic of cooking-related burns
Burn injuries are a major global public health concern, resulting in over 7 million injuries, 18 million disability-adjusted life-years lost, and 250,000 deaths annually worldwide. Yet the burden is starkly unequal, with over 90% of all burns occurring in LMICs. Within these countries, children and adult women are particularly vulnerable.
Cooking-related fires and scalds are a leading cause of burns in LMICs, where the use of open flames, solid fuels, and unsafe cooking equipment is common. However, data on the epidemiology and risk factors for cooking-related burns remain scarce, hampering the development of effective prevention strategies.
To address this knowledge gap, we conducted a nationally representative survey of household energy use and cooking-related burns in Ghana. By reaching beyond hospital-based data, our study sheds light on the true scale of this hidden public health crisis.
Severe cooking-related burns: an overlooked national crisis in Ghana
Our survey of 7,389 Ghanaian households revealed that severe cooking-related burns are a disturbingly common occurrence, with 129 cases reported in the previous 12 months. Extrapolating to the national population, this translates to an estimated over 300,000 severe cooking-related burns each year in Ghana.
The burden falls disproportionately on working-age females, who experience an incidence rate over 8 times higher than their male counterparts. We estimate that Ghanaian women aged 15-64 sustain approximately 160,000 severe cooking-related burns annually.
In contrast, no child burns were reported in households primarily using LPG for cooking. However, the odds of severe burns were more than doubled among adults in households using solid fuels like wood and charcoal compared to LPG.
These findings align with growing evidence that clean cooking fuel transitions not only reduce air pollution exposure, but can also yield substantial benefits in terms of injury prevention. Switching from biomass to LPG appears to be a key intervention for tackling the cooking-related burn crisis in Ghana and similar LMIC contexts.
Cooking fuel choice and burn risk: Navigating the complexities
While our results suggest LPG expansion can reduce cooking-related burns, the story is more nuanced. LPG is sometimes perceived as a “risky” option due to concerns about explosions, which can lead to devastating, multi-casualty incidents. Ensuring the safe delivery and use of LPG is therefore crucial.
The Ghanaian government’s plan to provide LPG access to 50% of the population must be accompanied by robust safety training and awareness campaigns. Changing deep-seated perceptions about the dangers of LPG is essential to promote its widespread, safe adoption.
Additionally, our findings highlight that the risk factors for child and adult burns differ. While solid fuel use emerged as a key household-level risk for adults, larger household size was a risk factor for children. Prevention strategies must be tailored accordingly, addressing both fuel choice and broader household dynamics.
Beyond air pollution: Integrated approaches to clean energy transitions
Household energy transitions have typically focused on the health benefits of reducing air pollution exposure. However, our study demonstrates that these transitions can yield additional, often overlooked, dividends in terms of injury prevention.
Integrating burn prevention strategies into clean cooking programs is a critical next step. This could include incorporating the validated Clean Cooking Alliance Burns Surveillance Module into household energy surveys, building local capacity for burn care, and developing education campaigns on safe cooking practices.
Importantly, national burn registries are needed to fully characterize the epidemiology and impact of cooking-related burns. Our study relied on self-reported data, which likely underestimates the true burden. Hospital-based registries alone miss the many individuals who do not seek formal care. A comprehensive system incorporating both community and facility-based data is essential.
By expanding the scope of potential health benefits, the Ghana case study illustrates how clean energy transitions can advance a holistic vision of environmental health. Policymakers, practitioners, and researchers must work together to ensure these transitions optimize both air quality and injury prevention outcomes, ultimately improving the lives of the most vulnerable populations.
Conclusion: Elevating the burn prevention agenda
Cooking-related burns represent a significant, yet often overlooked, public health crisis in LMICs. Our national assessment in Ghana reveals the staggering scale of this preventable injury, with working-age females bearing the brunt of the burden.
Crucially, this study demonstrates that household energy transitions aimed at reducing air pollution can simultaneously mitigate the risk of severe cooking-related burns. Expanding access to clean fuels like LPG, when paired with robust safety training, holds immense potential to address both the air pollution and injury prevention challenges faced by LMIC communities.
However, realizing these dual benefits requires a paradigm shift. Burn prevention strategies must be integrated into clean cooking programs, and national burn registries established to guide evidence-based policymaking. Only by elevating the burn prevention agenda can we truly harness the transformative power of household energy transitions.
