Burns, scalds and poisonings from household energy use in South Africa: Are the energy poor at greater risk?

Household energy related accidents such as burns and poisonings are not included amongst the causes of health burdens from residential energy use in the Global Burden of Disease (GBD) and other similar assessments. This is a serious omission in the case of transitional developmental states, such as South Africa, where these can be significant. This study analyses the risks associated with burns, scalds and poisonings from the use of household fuels in South Africa, adopting an environmental risk transition framework. We employ quantitative data from a nationally representative household energy consumption survey and hospital treatment data on energy incident injuries from a sample of 17 hospitals around South Africa to assess the relationship between the risk of these accidents, household income and energy poverty. Previous research on risk transitions provides clear evidence of a transition away from risks associated with household pollution with rising income, and also suggests that the evidence regarding injuries appears to decrease with rising income. We, however, find that in the case of South Africa, the relationship between poverty and burn and poison incidents due to household energy use maybe non-linear. The results of our analysis suggest that the risks of burn incidents and fires initially rise with income only to decrease at higher income levels. Moreover, for households below an energy poverty threshold, the risks of energy related accidents rise with an increase in household energy use, but falls once households cross this threshold. This suggests that a pro-poor approach is needed in designing programmes that lower the overall risk of these incidents. In addition, more rapid household energy transitions that displace paraffin with LPG and candles with electricity or solar power can help reduce the incidence and burden of these accidents. •Household energy accidents are a significant health burden in developing countries.•In South Africa, poverty and energy incident risks relate non-linearly.•The risks rise with income and modern energy access then decrease at higher levels.•Pro-poor approach needed to lower overall risk and improve community sustainability.