Wood and Coal Burning Stoves as a Risk Factor for Falls in Rural, Geriatric Patients: A Case Series

Abstract

In rural communities, geriatric patients often rely on wood or coal stoves for heat and food preparation. These stoves present serious fall risks: besides fume inhalation and exposure to benzene, carbon monoxide, and polycyclic aromatic hydrocarbons, the physical act of loading a stove can present a serious biomechanical challenge to frail patients. Moreover, since rural housing is often isolated, patients who suffer falls in these contexts can remain immobilized on the ground for hours or even days. In this brief report, we present two geriatric cases in which coal-burning stoves likely played a causal role in a patient's fall and complicated post-rehab discharge planning. Both cases involve frail, elderly females with significant comorbidities found on the floor in farmhouses that smelled of fumes from coal-burning stoves who suffered physiological consequences related to their particular anatomical risk factors. One patient required ICU treatment for severe rhabdomyolysis, while the other suffered an acute compression fracture that required prolonged pain management and intensive physical therapy. Despite the sparseness of the literature on coal or wood stoves as a risk factor for geriatric falls, these cases highlight the value of asking specifically about these stoves in fall risk assessment and discharge planning for rural, geriatric patients.