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

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Highlights

  • 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.

Abstract

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.

Section snippets

Introduction and motivation

Despite the primacy of energy in people's lives, most sub-Saharan Africans live in energy poverty. About 80% of Sub-Saharan Africans primarily rely on solid fuels for meeting household energy needs, whilst about 7% use paraffin in their homes (World Bank, 2013, UNDP and WHO, 2009). The use of paraffin and solid fuels has been associated with fires, poisonings, and household air pollution related health losses (Polsky and Ly, 2012, Lam et al., 2012, Truran, 2009). Lack of access to modern energy

Energy use patterns in low income households

Energy consumption patterns amongst low income South African households show a strong correlation with spatial location and socioeconomic characteristics (DoE, 2009). Rural–urban divide, climatic conditions, and locality have a large influence on energy choices. Choices seem to be largely influenced by availability and affordability, with woody biomass being more commonly deployed in rural provinces, coal on the Highveld, and paraffin in urban provinces. Multiple fuel use is common in both

Data and methods

The analysis of risk at a household level required the use of three data sets. Data on fires and on paraffin-related household incidents were obtained using Paraffin Safety Association of Southern Africa (PASASA) household survey data. Information on energy-related injuries was obtained from hospital admission data, also collected by PASASA. The frequency of types of fuel use was determined using the 2008/2009 South African Department of Energy (DoE) survey on the socioeconomic impact of

Results

The results below are presented for all households with total household incomes of less than R1600 per month in 2008 prices, that reside in urban informal areas and that acquire at least one of the six energy sources (candles, coal, electricity, gas, paraffin and firewood). In the DoE, 2009 data, this amounts to 595 households, 286 of which are electrified. The DoE dataset contains weights that can be used to produce estimates that are nationally-representative of electrified and

Discussion and conclusions

Household energy related accidents such as fires, burns and poisonings are an important cause of ill health in South Africa. This research assesses the risks of such incidents across key provinces in South Africa amongst poor informal settlement inhabitants. We analyse how these risks are distributed across different subpopulations and relate to general poverty and energy poverty, specifically. Our findings carry broad implications for policymakers on how to prioritize and target actions to

Acknowledgments

Our gratitude goes to DoE and Mr Dehran Swart of PASASA for providing the datasets used in the analytical section of this study. We are grateful to DST and NRF for sponsorship of the inaugural SA-YSSP 2012/2013 programme where most of this project was carried out. Lastly, we appreciate the University of the Free State for coordination and hosting of the SA-YSSP programme.

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