Background Burns in Nepal impose a significant health burden, especially within slum communities. The shift towards liquefied petroleum gas (LPG) stoves, driven by urbanization and efforts to curtain biomass fuel use, has introduced hazards associated with the informal LPG market and use of faulty equipment. Understanding unique challenges faced by people who live in slums adopting these technologies is essential for developing targeted prevention initiatives.

Objective We aimed to describe common risk factors for fires/burn injuries and identify cookstove hazards in slum households across Kathmandu.

Methods We used population proportional sampling and random walk methodology to survey 192 households in five slum communities. Surveys were adapted from verbal autopsies and the Johnson cookstove assessment. Descriptive statistics were performed.

Results 192 households were surveyed with 94% of respondents were females aged 38±13 years. 95% of households reported using LPG stoves, 2.6% open fires, 2.1% traditional mud stoves, and 0.5% kerosene stoves. Over the past 12 months, 10 households reported burn injuries. An additional 10% of respondents reported that their clothes had caught fire before. Among households with LPG stoves, few included key safety features such as automatic shutoff (15.6%), safety valve (30.2%), on/off mark on the stove (39.5%), and on/off mark on the gas valve (47.4%). Of 102 households that sought out servicing for their stove, 38 reported having their stoves serviced 1–3 months ago, with gas leaks/gas pipe (18.4%) and burner issues (18.4%) being the most common problems. Of those who checked for gas leaks, 77% relied on smell, 21% on sound, and only 1% were aware of the recommended soapy water check. Our soapy water check identified 11 out of 173 stoves with gas leaks (6.4%).

Conclusions The high prevalence of burn incidents and suboptimal LPG cookstove safety in Nepal’s slums emphasize the urgent need for targeted interventions. Interventions will need to address low standards in LPG cookstove engineering, poor access to affordable LPG refill and safety check stations, and insufficient knowledge regarding gas leak risk and testing.