Background Since 2010, commercially available bio-ethanol fuelled burners became increasingly popular in Europe. Unfortunately, the increase in bio-ethanol use resulted in an increase in the number of burn injury victims as a result of accidents with bio-ethanol. In 2010 there were 2 victims of accidents with bio-ethanol requiring admission in a Dutch burn centre, whereas this number rose to 29 victims in 2011. To assess what caused this sudden peak in accidents with bio-ethanol, a qualitative exploring research with a interpretative variant was performed.

Methods First, field research was conducted. Three experts on bio-ethanol (burners) were questioned in order to construct sensitising concepts as a background for framing the interviews. Second, non steering semi-structured interviews were conducted among 14 victims of a bio-ethanol burn accident. Complete transcripts of the recorded interviews were divided by thematic fragments and coded according to the sensitising concepts. All the identical coded fragments were combined.

Results Bio-ethanol was often misused, that is 8 of the 14 participants used the bio-ethanol as an accelerant for lighting up a fire or barbeque instead of using it for bio-ethanol fuelled burners.

All participants had poor knowledge of bio-ethanol use and most participants did not read the conditions of use. Vapour formation in half-full bio-ethanol bottles forms a major risk for an explosion, especially when there is a flame in close proximity when using bio-ethanol. Many of the bio-ethanol bottles were half-full when the accident happened and flames were still in place when using bio-ethanol.

Conclusions Bio-ethanol is cheap and easily obtainable, which creates an image of an innocent product. Instead, bio-ethanol is a product with a high risk of accidents when misused. Our outcomes showed that during accidents with bio-ethanol, there was a lack of knowledge, bio-ethanol was used for the wrong purpose and flames were still in place when using bio-ethanol.