Smoke Exposure in Case of Li-Ion Battery Fire

Machine Translated by Google
STUDY
Smoke exposure at
Li-ion battery fire
Important gas components, case descriptions
and disposal recommendations
Smoke exposure in case of Li-ion battery fire

Time period: 2021–2022
Performer: Knowledge Center for Disaster Medicine/Surgery, Umeå University,
Responsible researcher/author: Ulf Björnstig and Erik Lindeman (some sections)
Brief summary: Gases from Li-ion battery fires contain several toxic and irritating gas
components of which hydrogen fluoride (HF) is one. However, neither Swedish nor
Norwegian authorities, responsible for poisoning issues, have noted the particularly
feared HF problem. In 2018–2020, Li-ion battery fires that required rescue efforts had an
incidence of 13 per million inhabitants per year. The Poisons Information Center's latest
recommendations for disposal are reported.
© The Swedish Agency for Community Protection and Preparedness (MSB)
MSB's contact person: Yvonne Näsman, 0102-404 030

Production: Advant
Publication number: MSB1960 - August 2022

ISBN: 978-91-7927-269-2
MSB commissioned and financed the implementation of this study report. The authors are
solely responsible for the content of the report.
Preface
This compilation of knowledge has been carried out on behalf of the Swedish Agency
for Community Safety and Preparedness (MSB), the Department for Emergency
Services and Accident Prevention, the Unit for Fire and Rescue.
Fires in Li-ion batteries have been noticed by various groups of rescue personnel,
as well as media interest. Above all, the suspicion that the hydrogen fluoride (HF)
content of the fire gases could cause severe systemic effects (effects on the functioning
of internal organs) has been at the center. Despite growing technical knowledge about
these fires, it has been shown that the knowledge of medical effects on humans has
not developed to the same extent. At a seminar on the subject, rescue personnel have
requested national guidelines on how exposed personnel and the public should be treated
(Söderholm, 2011; Westman, 2021).
The purpose of the study is to describe the state of knowledge regarding events with
fire in Li-ion batteries, especially in closed spaces, as well as what consequences these
events have generated. The assignment also includes describing the state of
knowledge regarding some important components such as HF in the fire gases and their
effect on humans, as well as developing advice on how to handle this type of event.
Since good collaboration between emergency services and ambulance medical care is the
key to successful rescue operations, facts (even somewhat specialized ones) are described
for mutual understanding of the operation's various components and possibilities.
Responsible for the report is professor emeritus Ulf Björnstig, Umeå University. Senior
physician Erik Lindeman has contributed knowledge and information from the Swedish
Poison Information Center (GIC) regarding the effect of various gas components and
the treatment of those exposed to fire gas. He has especially contributed with up-to-date
and broad knowledge of HF's effect on humans, which is presented in full in the "Appendix".
Karin Gunnvall, local coordinator and CBRNE expert, Ambulancessjukvården i
Storstockholm AB, has contributed data regarding the care of victims of Li-ion battery fires
in their area, as well as access to the instructional film produced in Region Stockholm in
collaboration with GIC. Chief physician Patrick Brandenstein,
medical management responsible physician Ambulans sjukvården and Ambulance
helicopter Västerbotten, as well as contact physician for SLAS, has contributed
with SLAS's views. SLAS is "Sweden's Management Responsible Ambulance Physician
in Collaboration", an organization within FLISA; "The Association for Managers in
Swedish Ambulance Healthcare".
The case managers Yvonne Näsman, Per-Ola Malmquist and Ulf Bergholm, MSB, have
actively participated in the project and in producing MSB data.
A number of experts have also contributed essential information for which they are
thanked: • Head of Center, Arne Broch Brantsæter, Nasjonal behandlingstjeneste for

CBRNE medicine and MD, Ph,D., Knut Erik Hovda, Norwegian National Unit
for CBRNE Medicine in Oslo, is thanked for information on Norwegian
experiences with Li-ion battery fires and Norwegian facts and recommendations
for treating such fume exposure. • Docent Anton Westman, Umeå
University, who conducted the interview with the Malmö case and contributed to the
collection of medical data from this case.
• Docent Fredrik Sjövall, head of research, Faculty of Medicine, Lunds
university, which has been helpful with the production of patient data from Scania
University Hospital, Malmö.
• Other consulted toxicologists and executives in the subject area who contributed
expert comments and advice on individual issues.
The Ethics Authority's decisions Dnr 2021-06592-02 and 2019-06137 have approved
the method for patient contact in the project.
Umeå, 20220430
Ulf Björnstig
Professor Emeritus
Knowledge center for disaster medicine/surgery
Umeå University
901 87 Umeå
Remember for emergency personnel
A. Rescue response - factors related to Li-ion battery fire

Read the event
• Identify if Li-ion battery is on fire? Irritating gases including hydrogen fluoride (HF)
are then formed. Has significance for care. • In the event
of a fire in an apartment - does it burn in furniture upholstery (polyurethane), melamine,
plastics, laminate-type worktops, cotton, or Li-ion battery? Then hydrogen cyanide can
be generated, which is an extremely toxic, but treatable, gas component.
Valuable knowledge when caring for victims.
• Smoke from a burning Li-ion battery in a closed space can pose an explosion hazard.
• In the event of a Li-ion battery fire - remember that it can burn, re-ignite and generate
heat for a long time (large batteries for
hours). • Thermal camera can identify where in a "battery pack" it is burning, as well as
whether the heat-producing process ceases or increases.
B. Rescue operation - general assessment of smoke gas exposed

• Assess whether victims have signs of having been exposed to hot or irritating gases,
ie. there is soot, caustic damage, or swelling in and around the nose or mouth, or
respiratory effects such as coughing, wheezing and/or wheezing and labored
breathing.
• If loss of consciousness is present – suspect oxygen deficiency, including CO
(carbon monoxide) and/or HCN (hydrogen cyanide) poisoning, which often work together.
• NOTE. Both CO and HCN poisoning give a deceptively fresh appearance
("cherry red skin color") - don't be fooled that the sufferer is well oxygenated.
• If there are skin burns – cool immediately with water (or burn injury gel) if
possible.
• Assess whether initial remediation is needed ie. remove clothing if there is a significant smell of smoke.
C. Rescue operation by paramedics - treatment of fumes

exposed
Standard treatment – lack of oxygen – irritant gases: • In
case of unconsciousness or signs of swelling in the upper respiratory tract – consider
intubation if it takes a long time to hospital.
• In case of severe symptoms of smoke inhalation or impaired consciousness - give
oxygen with high flow (15 l/min) via reservoir mask. In critical cases - if possible -
give 100 percent oxygen via CPAP (positive pressure) or respirator. In case of mild
symptoms, oxygen can be given on a mask or halter.
• In case of labored breathing - first give bronchodilating inhalation, which is
supplemented with inhalation of anti-inflammatory agents (cortisone) to improve
oxygen exchange in the lungs - i.e. similar to regular asthma treatment.
Treatment against specific gas components •

CO poisoning with impaired consciousness (Glascow coma scale GCS ÿ 13)
must be treated with 100 percent oxygen, which requires a tight mask, CPAP, or
intubation with a "cuffed" tube. In some places there are pressure chambers which
can be a good treatment option.
• If there is an HCN-producing fire and the victim is unconscious (GCS ÿ 13), HCN
may have contributed to this. Then hydroxy cobalamin (Cyanokit ®) – 5 g in 200 ml
of NaCl is given immediately as an infusion over 15–30 minutes.
If severe circulatory compromise (shock/cardiac arrest) or coma (GCS ÿ 9) does
not resolve on 5 g, the dose may be repeated. A less good alternative is Sodium
thiosulphate 150 mg/ml–100 ml iv. for 5–10 minutes.
• If there are signs of exposure to irritating gases in the event of a Li-ion battery
fire, HF exposure may contribute to the symptoms. Then 4 ml inhalation with
nebulized calcium gluconate (1 part calcium gluconate 10 percent injection
solution + 3 parts isotonic saline solution) is given as an addition to the
bronchodilating and anti-inflammatory treatment. If necessary, contact the
Poisons Information Center via telephone 112 or 0104-566 700.
Content
Summary _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 8
1. Introduction _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 9
2. The mission _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11
3. Some data regarding objects and victims 3.1 Data from MSB's _______________________
12
response reports _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3.2 Data 12
from the Greater Stockholm Fire Service (SSB) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3.3 14
Validation of MSB data regarding claims against healthcare data _ _ 14
4. Case descriptions _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ 16 4.1 Electric bicycle fire – IVA care 4.2 Two _______________________________________________
16
cases in Central Sweden _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 18
5. Compilation of knowledge _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 19 5.1 Fire smoke – various chemical components from a fire in a Li-ion battery _ _ 19 5.1.1
Technical battery properties _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 19 5.1.2 Thermal rush in a Li-ion battery _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ 20 5.1.3 Combustible substances and components in vehicles and Li-ion batteries _ _ _ _ _ _ 20 5.1.4 Coolant in vehicles 21 5.1.5 Interior details _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 21 5.1.6 Primer and rust protection _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 21 5.1.7 Composites such as
carbon fiber 21 5.1.8 Future electric drive batteries 21 21 21 22 23
_____________________________________________________
____________________________________________
________________________________________
5.2 Physiological effect on humans _______________________________________
5.2.1 Heat 5.2.2 Burn – extent and __________________________________________________________________
depth _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5.2 .3 Medical effects of fire gases _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
________
6. Summary and discussion _______________________________________

29
7. References ________________________________________________________________
32
8. Hydrogen fluoride (HF) in liquid and gas form _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ 36 8.1 HF in liquid form __________________________________________________________
36
8.2 HF in gaseous form _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 37 8.2.1 Inhalation exposure and risk of systemic toxicity (impact on
internal organs) 37 8.2.2 Inhalation exposure and risk of damage to airways and lungs _ _ _ _ _ 38 8.2 .3 Gaseous HF in the smoke from burning Li-ion batteries _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 8.2.4
Concentration of HF in fire smoke from Li-ion batteries _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 8.3 Absence of toxic lung effects in the literature 8.4 References appendix _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 41 38
39
______________________
40
Summary
Based on MSB's response reports, fires in Li-ion batteries, which required intervention by the
emergency services (N = 402), have been studied for the years 2018–2020. These events
have had an incidence of 13 per million inhabitants per year. The most common fire objects were
mobile phones, reading tablets/computers, batteries for hoverboards, electric bicycles and scooters.
Fires have occurred both during charging and without charging in progress. The latter has been
understood by MSB's investigators to occur especially with electric bicycle batteries.
According to MSB data, of the hundred fires where a person was judged to have been
exposed to smoke, nine percent had received some form of medical assessment – five
percent from ambulance medical care on site and four percent were reported to have
sought medical care. Electric bike battery fires had initiated the most medical contacts,
followed by hoverboard battery fires.
When validating the data regarding the personal injury outcome in MSB's statistics
against the CBRNE management unit's medical data in Greater Stockholm (twelve fires),
MSB's data on medical intervention proved to correlate well with that of medical care in
almost all cases. Of the 14 people who were transported to a healthcare facility, all were
judged to be slightly injured, except for two who were red priority (priority 1).
Both had sustained more serious heat-induced burns. No injuries related to systemic
effects (i.e. impact on the body's internal organs) through inhalation of hydrogen fluoride
(HF) had not been registered in the ambulance data. Thus, this simple validation indicates
that the MSB data provided a good idea of the healthcare need in the matched cases
and HF specific system effects were absent in the CBRNE unit's healthcare data.
The alarming corrosive and toxic effect of the much-publicized gas component hydrogen
fluoride (HFs) has not been particularly noted, neither by the Swedish Poison
Information Center (GIC), nor by the Norwegian CBRNE unit, even though Norway has the
highest proportion of e-vehicles in Europe. GIC has not found evidence in the scientific
literature that gaseous HF would cause alarming systemic effects.
This is described in Region Stockholm's and GIC's information film, which particularly
highlights HF's effects.
The fire gases can have a suffocating effect, i.e. reduce the oxygenation (oxygenation) of
the body's cells, or have a toxic (poisonous) effect. There is an opportunity to improve the
victim's chance of survival in the emergency stage by affecting, above all, oxygenation. This is
done by supplying (i) oxygen, (ii) dilating the airways with drugs, and (iii) giving anti-
inflammatory drugs in the airways. Furthermore, it is possible to give an antidote (antidote)
against hydrogen cyanide (HCN) poisoning, which blocks cellular respiration. In the event of a
fire in a Li-ion battery, the treatment can be supplemented with calcium gluconate aerosol in
the breathing air, to reduce the irritating effect of HF locally on the airways. The recommendations
are drawn up in collaboration with the Poisons Information Center and actors in the field.
8 Smoke gas exposure in case of Li-ion battery fire

1 Introduction
In connection with the entire society's orientation towards the electrification of many
products and transports, the question of the risks of the fire gases that can arise from
fumigation, or fire in Li-ion batteries, has been lively discussed. Above all, knowledge of
the action of the hydrogen fluoride component (HFs) has been perceived as lacking
(Söderholm, 2011; Westman, 2021). Therefore, the Department for Rescue Services
and Accident Prevention at MSB has initiated this study. The intention was to produce
facts, based on the current state of knowledge, to shed light on the problem for people
exposed to such fire smoke. Through increased knowledge, tactics and care can be
optimized, which is one of the reasons why the MSB produces available facts.
Rescue personnel are already exposed today and will be exposed in the future to new
risks, depending on new designs, materials and drive systems in future objects and vehicles
(Technology development; MSB 2016 below). MSB has produced several reports with a
focus on technical development and fire engineering issues, which will not be dealt
with further in the present study:
Technology development:
• MSB 2020; Electric vehicles and rescue •

MSB 2016; Changes: environmental analysis passenger
cars • MSB 2013; E-vehicles' potential risk factors in the event of a traffic accident
Gas Li-ion battery: •

MSB/FOI 2015; Vented Gases and aerosol of automotive Li-ion LFP and
NMC batteries in humidified nitrogen under thermal load
Rescue operation:
• MSB 2020; Guidance, rescue operation where lithium-ion batteries are present
Protective clothing:
• MSB 2018; Protective capacity of fire protective clothing - material tests with
chemicals formed during fires and thermal rush in Li-ion batteries in e-vehicles
The electrification of road vehicles, bicycles, scooters, hoverboards, tools, etc. contributes
to an increase in the problem of Li-ion battery fires. These fires are not infrequently
characterized by high temperature, difficulty in extinguishing the fire and the fact that the
course of the fire can take a long time. Therefore, significant smoke gas concentration
can likely occur indoors and in closed spaces. A bicycle battery can, according to
Meraner, Li, and Sanfeliu Meliá (2021), as well as Willstrand, Bisschop, Blomqvist, Temple
and Anderson (2020), among many gas components produce carbon monoxide (CO), hydrogen fluoride
Smoke exposure in case of Li-ion battery fire 9

Introduction
(HF/LiPF6), hydrochloric acid (HCl), hydrogen cyanide (HCN), nitrous gases (NOx) and sulfur
dioxide (SO2) . In addition, a certain amount of explosive components such as hydrogen gas is produced.
In Willstrand et al. (2020) indicate in Tables 7 and 22 measured and/or calculated concentrations in
1,000 m3 of various gas components in the event of an e-vehicle fire in relation to health limit
values. These indicate that HCl, NO2 and SO2 , in comparison to HF, are just as important gas
components from a health point of view. HCN is not ready shown. Based on these data, significant
health consequences can be feared.
Therefore, it is of value to penetrate the issue more closely from a rescue and caretaking point of
view.
In general, Li-ion batteries have the characteristic that a thermal rush, or a fire for another reason,
can often continue without the supply of oxygen from the outside. This is because the battery itself
contains oxidizing agents. In addition, the stored electrical energy adds additional energy to the
fire. Because it is often difficult to get cooling extinguishing agents to the source of the fire, this type
of fire in larger batteries can be a technical challenge to extinguish. This in turn contributes to
generating large amounts of fire gases. Incandescence and pyrolysis occur at high fire temperatures
which can generate particularly toxic gas components.
Li-ion batteries are increasingly used in various small and large applications. Since many are
handled indoors, there is a risk of spontaneous indoor fires. This can happen not only during
charging, but also spontaneously due to so-called dendrite formation in the battery, which
produces a form of internal short circuit. A dramatic illustration of a spontaneous fire is the fire
that occurred in a cargo container with Li-ion batteries in the forward section of a jumbo jet cargo
plane. The fire was not extinguished by standard automatic oxygen-reducing/suffocating
extinguishing measures. The rudder control was burnt to pieces. The thick smoke made its
way up into the cockpit, completely obstructing visibility and incapacitating the pilots. Via autopilot,
which still had some function, an emergency landing was attempted at Dubai airport, but it crashed
in the desert (UPS Airlines Flight 6, Wikipedia, 2010; TheFlightChannel, 2018).
In the automotive industry, new construction materials such as various plastics, resins,
adhesives, carbon fiber, magnesium alloys, etc. are being introduced that may have the potential
to produce highly toxic gases and intensify a fire progression. E-vehicles with increasingly large
drive batteries (up to a weight of several tons) are on the market. Even significantly larger batteries
will be available in the future in the form of, for example, stationary battery storage. Sometimes
a large number of vehicles are gathered in closed spaces such as in garages, car
ferries and in sea transport of newly manufactured vehicles, when many thousands of cars are
transported. That parking garages can be a place where many vehicles can catch fire is
illustrated by the fire in a parking garage in Liverpool when 1,400 cars caught fire at New
Year's 2017/2018 and in Stavanger 300 cars caught fire in a parking garage in 2020. However,
both fires occurred in open parking garages. In closed garages, flue gas concentration and risks
are of course greater.
Possibly the above problem gives a somewhat pessimistic impression regarding
the future. However, there is a positive aspect in the form of improved knowledge and
tactics in response, can have significant potential for improved work environment, as well as
improved safety for response personnel and other victims. Use of modern knowledge can improve
the results, for example through the use of antidotes against the most toxic gas components
and optimal treatment of smoke inhalation in those affected. However, this requires good
cooperation between the emergency services and ambulance personnel and that you know
which topics to focus on. A good knowledge of "reading the fire" gives an indication of which
treatable fire gases are likely to be generated.

2. The assignment
The agreement on the assignment states: "The overall objective is to produce a
knowledge overview of real cases focused mainly on smaller batteries such as bicycle
batteries etc. which are not infrequently stored in closed spaces. Overall, the compiled
knowledge must also be able to contribute to the development of quality-assured methods
and techniques to support the municipal rescue services for more efficient rescue efforts.
The knowledge must be the basis for future educations".
"In addition to this, the overview can also contribute to the basis for proactive
risk elimination regarding the handling of this type of Li-ion batteries”.
"The intention of this document is that it can be used as a knowledge and
training document for rescue personnel from the emergency services, pre-hospital
healthcare and the police, in the event of a fire and especially a fire in a Li-ion battery,
as well as a planning document for efforts in various closed environments and situations".
Smoke gas exposure in case of Li-ion battery fire 11

3. Some data regarding

objects and victims
3.1 Data from MSB's performance reports

Based on MSB's response reports from the years 2018–2020, there were 402 cases reported
throughout Sweden where Li-ion batteries were stated to be the cause of the fire and/or had
burned. Small button batteries (often called Li batteries) are excluded in this study.
Given that these data are valid for Li-ion battery fires where emergency services have been
used, the incidence is 13 per million inhabitants per year, based on an average of 10.3
million inhabitants in Sweden for the current period. The fire objects are shown in Table 1.
Table 1. Frequency of events with different fire objects (354 known; column 1) and
number of events and persons (in parentheses) where health problems were taken
care of by the hospital (column 2) and by the ambulance service.
Only assessment of
Subject Total events For healthcare Ambulance medical care
Mobile phone 54 1 (1) 1 (2)
Computer/reading tablet 49 1 (1) 2 (4)
Hoverboard 45 1 (1) 5 (9)
Electric bike 42 6 (9) 5 (7)
Toy/hobby item 38 1 (2) 0
Scooter 35 1 (2) 1 (1)
Tool 25 0 1 (2)
Power bank 18 1 (2) 0
Electric moped/motorcycle 15 1 (1) 1 (2)
Truck/car/truck/boat 7 0 0
Other object 26 4 (4) 3 (12)
Amount 354 17 (23) 19 (39)
There were a total of 409 cases in the data material. However, the Li-ion battery had not been
involved in 6 car fires, plus an electric bicycle saddle was set on fire, but the Li-ion
battery was not involved here either. None of these events are therefore included in the material
presented in Table 1. The table presents the 354 cases where information was available regarding

Some data regarding objects and victims
type of battery that burned. In 48 cases such information was missing. The group "other" includes
e.g. battery for cleaning machine, battery for surfboard and boat batteries that caught fire when
charging indoors, plus various other Li-ion batteries on charge.

On one truck, a load of Li-ion batteries had caught fire when they were secondarily exposed to fire in
the truck. As a curiosity, it can be mentioned that three mobile phones and three other Li-battery-
powered objects had caught fire when they were placed on a hot stove. MSB's investigator Ulf Bergholm
has noted that especially batteries for electric bicycles seem to have a tendency to catch fire without
having been charged. See also case description under point 4.1.
Mobile phones and tablets/computers were the most common fire objects, followed by
hoverboards and electric bicycles, see Table 1.
Regarding the need for medical care, it was stated that 23 people from 17 (4 per cent) different
events sought medical care. Ambulance personnel examined on site and completed treatment of 39
people from 19 (5 percent) events, who were judged to be able to cope without further medical care.
Nine of them were from the same battery fire.
In total, 36 (9 percent) of 402 events had generated some form of healthcare or
ambulance contact for a total of 62 people. Incidents with electric bicycles accounted for 11 (31
percent) of these 36 incidents. 16 (26 percent) of the 62 people who had some form of healthcare
contact had inhaled smoke from an electric bicycle fire.
Hoverboards had the second highest frequency of events where the need for medical examination
was considered to have existed - see Table 1.
Summary
• The incidence of Li-ion battery fires that led to the intervention of the emergency services
every 13/million inhabitants and year.
• Mobile phones/tablets caused the most incidents. • Electric bike
and hoverboard batteries caused the most medical contacts. • Medical contact of some
kind was involved in barely every ten fires.
Smoke gas exposure in Li-ion battery fire 13

3.2 Data from the Greater Stockholm Fire

Service (SSB)
In a report regarding fires related to Li-ion batteries within SSB's catchment area of
approx. 1.4 million inhabitants, 19 fires were reported (17 fires in 2020 plus 2 fires in
2019), see Table 2 (From & Wiberg, 2020).
Table 2. Fire objects in SSB's study (From & Wiberg, 2020)
Subject Total events
Electric bike battery 7
Electric scooter 5
Power bank 2
Electric car 2
Mobile phone 1
Computer 1
Radio controlled model 1
Total 19
If the data is representative of the number of Li-ion battery fires in the area, the incidence is 12
per million inhabitants per year (17 fires, 1.4 million inhabitants, year 2020).
The fires have occurred both during charging and during non-charging, as well
during use of the product, or after damage. Eleven (58 percent) of them occurred in
multi-apartment buildings and the rest in private residences, hotels, offices, etc. 57 percent
of the fires occurred in one's own residence.
The fires are considered to have arisen through so-called thermal rush which
generated intense energy development, however, in three cases the progress of the fire was
a slow process with mainly smoke development.
A fire that occurred in a power bank while charging a mobile phone can be illustrative (From
& Lindström, 2020). It was charging in a bed where a fire broke out during development of
dark/black smoke and the fire also spread to the floor under the bed. Two people in the family
had undergone fire protection training, but they were unable to suffocate the fire or extinguish
it with a water hose.
The people had to crawl close to the floor in order to orient themselves, because the smoke
was so thick. One person suffered burns and smoke damage and was taken to hospital.
3.3 Validation of MSB data regarding

claims against healthcare data
A comparison between these data sources can provide an understanding of the validity of
MSB's response reports in terms of data on personal injury cases. Individual persons cannot
be identified in the MSB reports. However, by matching the time and place of the intervention
against the corresponding data in the ambulance medical record system at the CBRNE
management unit; AISAB (Ambulanssjukvården i Storstockholm AB), be able to search for the
answer to how the medical condition was assessed there. You find
14 Smoke gas exposure in Li-ion battery fire

then the following for the time period where matching was possible February 2019–November 2021
(34 months):
• Number of reported events in MSB response reports in Greater Stockholm with specified
personal injury: 26. • Number of
corresponding events that were also found in CBRNE management

the unit's medical register: 12 (46 percent).
Thus, it is possible to carry out some validation of the damage cases in the twelve cases that
are in both registers. Then one finds for these twelve cases:
• That in 11/12 cases the data match acceptably/well with regard to claims and level of care.
From 6 of these 12 events, according to the healthcare data, 14 people were transported to
hospital. The next all had minor injuries, but two had more serious burns and were
classified as priority 1 according to the healthcare system's so-called screening triage. • In
one case, the MSB data indicated medical care, while the CBRNE data indicated uninjured,
implying that the person concerned was only assessed by the ambulance medical service at the scene.
Analyzing systematic biases caused by time of day for alarms, no remarkable difference is
found between the different groups from the matching of the 26 cases: • Daytime 06:00–
22:00 received 18 (69 percent) of
the alarms and night time 22:00–06:00 received 8 ( 31 percent) of the total of 26 alarms. Of the
12 cases that were in both registers, 8 (67 percent) alarms were received during the day and
4 (33 percent) at night. Of the 14 that were not found in the CBRNE data at the time of
matching, 10 (71 percent) were received during the day and 4 (29 percent) at night.
It has not been possible to carry out a complete review of injury cases from this type of event
within the ambulance healthcare system in Greater Stockholm within the framework of this
project. Defragmented organization, GDPR, confidentiality/decision rules, as well as a very large
number of records spread across different units have contributed to this being practically impossible
to study. Such data could of course have further contributed to validating the completeness of
MSB's register of action reports.
Summary
• All of the matched cases were classified as mild except for two that had
burns caused by heat.
• No special HF-related systemic effects (ie effects on internal organs

features) had been reported.
• MSB's response reports, which were matched against the CBRNE command unit's data,
showed good validity in terms of the personal injury cases.
• The CBRNE management unit in Stockholm had participated in half of
the MSB-reported damage incidents in the same area.
• No notable time of day bias was present for the different groups
in the match.

4. Case descriptions
A concern or a knowledge gap has been that the suspected aggressive fire gases would constitute
a significant risk factor for serious medical consequences. The risk has often been related to the
production of various hydrogen fluoride compounds (HF) that arise in the event of a fire in Li-ion
batteries, which are highly reactive substances.
Compilations of claims caused by fire smoke from Li-ion battery fires
largely missing in the literature. The Swedish Poison Information Center (GIC) has not noted
this HF problem in its database of real events. Not even in Norway, which has the highest
proportion of e-cars in Europe, has the corresponding body noted the alarming problem. Thus, the
responsible bodies have not noted any such special problem either in Sweden or Norway.
Here are reported events that are connected to such a fire and that can cause a
indication of symptoms upon exposure to the current fire smoke.
4.1 Electric bicycle fire – IVA care

Malmo; One early morning in October 2018, the victim (age 75), who was in the upstairs
bedroom, was alerted by the smoke alarm. It was sitting in the stairwell between the lower
and upper floors in his detached house of 126 m2 . The cause was smoke from a bicycle .
battery (Figure 1) which spontaneously caught fire in the guest room (volume 45 m3 ) on the
lower floor, even though it had not been charged .
The battery (36 V) belonged to a 2012 Orion brand bicycle. The smoke had spread via the laundry
room (45 m3 ) to the hall (18 m3 ) and via the kitchen to the smoke alarm in the stairs to the
upper floor, i.e. estimated in a volume of just over 300 m3 . When the victim passed down and
through the kitchen, he was met by such dense smoke in the hall that he had to grope blindly
through the hall (3 meters) to reach the front door. All the doors inside were open. The victim
made no attempt to extinguish the fire.
He took a few breaths during the passage through the smoke in the kitchen and hall and
estimates that the passage took about ½–1 minute. Had to cough from the smoke, but otherwise
felt okay when he came out and asked the neighbor to call the alarm. An ambulance was on the
scene within 10–15 minutes.

Case descriptions
Figure 1. Picture of the "twin" to the brown battery which was located near the brown one. Limited
damage to the floor where the burnt battery was (Photo: Ulf Bergholm, MSB's accident investigator).
Current symptoms and measures; Cough immediately after smoke exposure.

Initially felt no need for ambulance transport, however 20–30 minutes after the smoke
exposure new symptoms occurred in the form of rotatory vertigo and blurred vision.
Cleaned up primarily by removing the clothes before he was taken into the ambulance.
Nevertheless, a very strong smell of smoke was described in the ambulance, which is
why the staff worked wearing some chemical protective clothing. Already treated in the
ambulance with oxygen and repeated (x 10) cortisone inhalations. BT 139/70. The victim
was then further sanitized in the emergency department by full-body washing due to a significant smell of smoke.
Intense cough on arrival and slightly thick voice. Was intubated "prophylactically" to ensure
breathing. Was initially cared for in the ICU on a ventilator. The following medical facts
of interest were:
Urgent examinations and observations; Bronchoscopy (examination of the
airways) was initially unremarkable. Somewhat later, when the gastric tube (tube to the
stomach) was to be inserted, strong swelling in the pharynx and abundant jelly-like
mucus was noted, so it was difficult to get the tube down. X-ray of lungs showed that
there were atelectasis (collapsed lung cysts) in the left lower lobe. Was treated with calcium
gluconate in inhalation, to reduce mucosal damage caused by possible HF inhalation. Had
red colored urine, which in all probability was caused by Cyanokit® (antidote to HCN
poisoning), given earlier in the course.
EKG showed atrial fibrillation (known from before) but with fast chamber
frequency=107. Repeated eye irrigation. He was taken off the respirator after just over
a day and was then observed for a further two days before he was discharged.
Medical laboratory data related to smoke exposure that may be of interest (normal
laboratory values in parentheses); Calcium ion values in blood were around the lower
normal value initially. P-Potassium at upper normal limit.
P-lactate 4.4 (0.5–2.2) mmol/l. Ecv-Base excess -6.0 (-3.0–3.0) mmol/l, i.e. mild metabolic
acidosis. P-Myoglobin slightly elevated 141 (28–72) µg/l. A single CK value on arrival normal
(1.4 µkat/l), P-creatinine 144 (60–105) µmol/l. Other IVA laboratory data were within
normal limits. Oxygenation (oxygenation) essentially without remark both venous and
arterial.

Case descriptions
Persistent discomfort; Experienced blurred vision a few days after the care episode.
Strong muscle pain in the whole body, but mainly in the thigh muscles - gradually disappeared
in a few months. Explosive headaches and pain in the ears - pains that gradually disappeared
soon after the incident. Never had headaches before. The cleaning of the home was
unsatisfactory and the lingering smell of fire was perceived to cause deterioration upon
returning home. This delayed the time before he could move back by months.
Summary; It is very difficult to draw any definite conclusions from this single case.
Respiratory and eye symptoms may indicate exposure to irritant gases, including HF. Nothing
in the laboratory tests, or in the continued clinical course, indicates serious mucosal damage,
or systemic effects (influence on the functions of internal organs), caused by HF. It is
completely adequate to treat the airway with Calcium Gluconate aerosol together with
bronchodilators and anti-inflammatory agents according to GIC's recommendations.
However, neither the patient's exploding headache after the incident, nor the remaining muscle
pain, can be easily explained.
4.2 Two cases in Central Sweden

A cleaning machine charging in the basement had caught fire. Moderately dense smoke
(like evening fog) when the emergency services arrived at the scene. Two people without
respiratory protection inhaled the air/smoke for 1–2 minutes. A slight burning sensation in
the throat was noted in the evening, but no other symptoms and no long-term effects have been noted.
Summary
• Neither Swedish nor Norwegian authorities have noted particular problems with
hydrogen fluoride (HF) from inhalation of fire smoke from Li-ion battery fires.
• Fire smoke contains several irritating components of which HF is one.

5.
Compilation of knowledge
5.1 Fire smoke – various

chemical components from fire in Li-ion battery
The smoke from Li-ion battery fires can contain hydrogen, methane, ethane, ethylene and
propane, which are explosive. Fire smoke also contains corrosive, toxic and asphyxiating
components (Willstrand et al., 2020). The formation of toxic (poisonous) gases is most
pronounced during low-oxygen combustion and pyrolysis (Helsebiblioteket, 2021).
5.1.1 Technical battery characteristics The latest
and most modern cell type, which has a superior energy content, is today commonly
referred to as a Li-ion battery. Small button batteries called Li batteries are not discussed
here. Li-ion batteries can have very different designs depending on the application
and the manufacturer's preferences, but often contain:
• Anode, (minus electrode), made of copper which is usually coated with amorphous
carbon, graphite, graphene or a mix
of these. • A cathode (plus electrode) of aluminum that can be coated with an oxide
material, which can consist of many different components such as: nickel/manganese/
cobalt oxide, nickel/cobalt/aluminum oxide, iron phosphate oxide, titanium oxide.
In between, the electrodes are delimited by a separator seeded with a polymer.
• The cell is then filled with an organic electrolyte of e.g. alkyd carbonate, where a
lithium oxide in the form of a salt is dissolved in the electrolyte.
A battery cell contains both a chemically combustible energy store and an

electrochemical energy store, plus a variety of oxidizing substances from which oxygen
can be released if the cell is heated. Such a case can be what is called thermal rush
and it can be triggered, for example, by mechanical penetration, or temperatures above
150–190 degrees Celsius. What then happens is that the electrochemical energy
acts as a "match" and ignites the electrolyte. At the same time, oxygen is released from the
oxidation substances. Additionally, amorphous carbon, graphite, graphene, or a mix of
these help drive the thermal rush.
A comprehensive inventory of the state of technical knowledge is presented in two
RISE reports (Research Institutes of Sweden). One includes, among other things, 250
technical references in the field (Bisschop, Willstrand, Amon, Rosengren, 2019) and the
other describes in detail the state of knowledge regarding fire gases, extinguishing etc. (96
references) (Willstrand et al., 2020).

5.1.2 Thermal rush in a Li-ion battery Vehicle
manufacturers follow a number of standards and regulations, which means that

their battery systems are well tested and that the battery's monitoring system
handles the parameters required for good safety (cf. Hasvold et al., 2007). The
safety is probably significantly lower in smaller batteries such as for bicycles, hoverboards etc.
(Perfect Hoverboard, 2021).
In case of fire, Li-ion cells emit light and heavy light gray gases, as well as dark, almost
black, gases with a large proportion of amorphous carbon and graphite. The heavy gases are
relatively flammable and you can see how they "creep" along the substrate. The light gases look
more weightless and follow the direction of the wind.
Li-ion cells can also "gas" without fire and then there is a risk of sudden ignition of the
gases and perhaps explosion, which is valuable for rescue personnel to know. Re-ignition
can occur even if
apparently open flames have been extinguished in a battery fire. It is then important to
continue to cool the battery. Thermal camera is recommended to record thermal activity in the
battery.
Do not be surprised if thermal activity continues for a long time after extinguishing. Tests
carried out under controlled conditions on traction batteries for cars have shown temperatures
close to 500 degrees Celsius for several hours, therefore it is important to cool and watch for
the temperature to drop before e.g. recovery of a vehicle is carried out.
Read more:
PO Malmqvist (2021), Utkiken, MSB, has produced an information film

regarding fire in Li-ion batteries which can be found here [retrieved: 2021-01-31].
5.1.3 Combustible substances and components in vehicles and Li-

ion batteries The commonly occurring
chemical liquids in a car also contribute to a vehicle fire, i.e. washer fluid, glycol, brake and air
conditioning fluid, as well as hydraulic and engine oil. These liquids add energy to the fire,
especially at high temperatures in the course of the fire. Regarding toxicity, all fire gases
that come out of the vehicle can be considered to have a high degree of toxicity. Fire
smoke contains components such as HF, HCl (hydrochloric acid), SO2 (sulfur dioxide), CO
(carbon monoxide), CO2 (carbon dioxide) and a small amount of nitrous gases (NOx),
plus some metals (Zn, Pb, Cu) may be present (Willstrand et al., 2020).
Lecoq et al. (2012) reported a comparison between two vehicles of the same model
and make, one of which had an e-hybrid system and the other only a regular combustion
engine. Two different makes were tested ie. a total of four cars. The fire spread from the
passenger compartment. There was a peak of HF early in the fire progression in both models
to be followed 20–25 minutes later by peaks when the drive battery caught fire in the e-hybrid
model. The total amount of HF was 2–2.5 times greater from the cars with e-hybrid drive.
However, based on today's situation, small drive batteries, 15.5 and 23.5 kWh respectively,
were tested (Lecocq et al., 2012). Fire tests have also been carried out at RISE by
Willstrand et al. (2020). In Table 18, multiple amounts of HF are stated in e-vehicles versus cars
with internal combustion engines, but small amounts of HCN in both. HF and HCl reached
"health-hazardous" levels the fastest.

5.1.4 Refrigerant in vehicles The
presence of refrigerant R134a and, in newer vehicles, R1234yf, which constitute

common air conditioning fluids, has received some attention. Concerns about the
production of toxic gases in case of fire (ignition temperature of R1234yf is 410
degrees Celsius) have been raised by Daimler AG and German authorities
(Kraftfahrt Bundesamt, 2013). Fire tests have been made of R1234yf at FOI Umeå
which show the presence of, among other things, hydrogen fluoride (HF) (Magnusson et al., 2016).
5.1.5 Interior details In addition,
interior details made of various plastics (ABS and PVC) and polyurethane in
seats, gluing etc. develop toxic (poisonous) gas when burned, including
hydrogen cyanide (HCN) (US Department of Transportation, 1991).
5.1.6 Primer and rust protection

The rust protection on modern vehicles has been significantly improved compared to
vehicles from the 80s and older. The rust protection is built up with something called "ED
dipping". One of the intermediate layers is based on polyurethane to give a filling effect.
However, polyurethane can develop hydrogen cyanide (HCN) when heated to temperatures
around 150 degrees Celsius and higher. This also applies to glue that is used to e.g. glue
windshield to body.
5.1.7 Composites such as carbon fiber

Carbon fiber can be expected to produce so-called nanoparticles that may be unsuitable
for inhalation, but they are not dealt with in depth here. See also a guide on the handling of
carbon fiber composites in the event of accidents (MSB, 2021), as well as Bisschop et al.
(2019) and Westman (2021). Respiratory protection is recommended against airborne
fibers after, for example, damage to, or fire in, fiber composites (Bisshop et.al., 2019).
5.1.8 Future electric drive batteries

At the time of writing, research is underway on a broad front to develop the electric drive
batteries of the future, which have greater energy density than today's batteries. Today, Li-
ion cells have an energy content that corresponds to one fiftieth (1/50) of the energy content
of fossil fuel per kilogram.
5.2 Physiological effect on humans
5.2.1 Heat
General effect of heat on the body: A person without clothing or other protection can
endure staying in dry air at temperatures of up to +120 degrees Celsius for a few minutes.
The corresponding limit for air saturated with water vapor is lower, around + 80 degrees
Celsius. In the case of an engine compartment fire in a modern car, one can expect it to take
3–5 minutes (personal communication M. Lindkvist) before fire reaches the passenger
compartment. The temperature in the fire can be very high - so high that metal melts.

In the case of fires, burns are mainly caused by heat radiation and contact with hot objects,
liquids or gases. The heat radiation decreases with the distance from the source.
Objects between the radiation source and the person being irradiated can cast a "shadow".
Clothing can thus provide some protection for a limited time.
The skin: Conduction (conduction of heat) occurs if a hot object comes into direct
contact with the skin. Convection means that heat is transported using hot air or flue gas. The
amount of heat transferred depends on the temperature of the air/gas, speed of movement
and humidity, as well as on the exposure time and any protective clothing.
The respiratory tract: In general, it can be said that if a person does not have burn
injuries on the face, or soot around the respiratory tract, the risk of burns in the respiratory
tract is relatively low. If, on the other hand, the face, especially around the nose and mouth,
has burns, the respiratory tract may have been damaged by the heat. Dry hot air has a low
heat-carrying capacity and rarely causes burns below the trachea, but swelling and
breathing difficulties in the parts above do occur. Hot water vapor contains a greater amount
of heat and can therefore cause damage further down in the lungs.
Respiratory insufficiency (respiratory failure) can occur minutes to hours after exposure
to fire smoke. It is often difficult to distinguish between what is an effect of the heat and
what is an effect of toxic and irritating gases and soot. Effects of large skin burns can
secondarily also affect breathing.
5.2.2 Burn – extent and depth When assessing a burn, the extent,
depth and location of the damage must be taken into account. The burn victim's age and
other injuries and illnesses are also important for treatment and prognosis.
In adults, the spread of burn damage can be roughly calculated using the so-called 9-rule.
The head constitutes 9 percent, the back and front of the torso each 18 percent, each arm 9
percent, each leg 18 percent and genitals 1 percent of the body surface. A palm is about 1
percent.
The depth of the burn can be difficult to determine in the emergency phase. You get
some help from the appearance of the injury and from how the wound surface responds to
pressure and pain stimuli. In a superficial epidermal burn (sometimes called a first-degree
burn), only the epidermis is damaged. The skin is red, swollen and tender, but without
blisters. A partial skin burn (can be divided into superficial and deep partial skin damage,
sometimes called a 2nd degree burn) includes the epidermis and dermis. This damage
produces an inflammatory reaction in the form of swelling, redness, tenderness, blistering and superficial cell decay.
A full skin burn (sometimes called a 3rd degree burn) involves a breakdown of all the skin's
cell layers including pain cells and blood vessels. The skin is pale brown and parchment-
like and the sufferer does not react to painful stimuli.
The location of the burn is of great importance. Burns in the respiratory tract are very
serious and can cause the airway to swell again and obstruct breathing. Partial and full skin
burns covering more than 50 percent of the body surface can roughly be said to be life-
threatening.
22 Smoke exposure in case of Li-ion battery fire

5.2.3 The medical impact of fire gases
5.2.3.1 General
Exposure to fire smoke is a common cause of death in fires indoors, in airplanes or

boats. The acute effect of fire gases consists partly of a suffocating effect, i.e. they
cause a lack of oxygen in the body's cells. In addition, many gas components have a
toxic or irritating effect. Three important, often cooperating mechanisms that cause
oxygen deficiency are: 1. low oxygen

level in the inhaled air, 2. blocking of oxygen uptake in red blood cells
(carbon monoxide CO), 3. blocking of cellular respiration (hydrogen cyanide HCN).
The effects of the action of the various components add up more or less. In case of massive
exposure, a situation with a lethal dose of several components can of course exist.
However, there are likely borderline cases where elimination of one or more components
contributes to survival. A difficulty can be identifying the contribution of different components
in the event of flue gas exposure/poisoning. Here, the components that can be influenced with
appropriate emergency treatment are described in the first instance.
CO and HCN thus both inhibit the oxygenation of the body's cells.
Note that these patients may appear deceptively fresh, as CO gives a "cherry red color" to
the blood and therefore one may be fooled into thinking that the sufferer is well oxygenated.
HCN means that the body's cells cannot assimilate oxygen from the blood, which can also
give the impression that the affected person is well oxygenated.
However, the cyanide-poisoned patient can also give a cyanotic (oxygen-poor) impression,
which complicates the assessment (Curry and Spyres, 2015).
The symptoms of exposure to fire gases are as follows: • Pain
and irritation in the eyes and impaired vision, which may limit the possibilities of leaving
the scene. • Pain in the respiratory
tract and chest. In the worst case, risk of pulmonary edema,
i.e. fluid overflowing into the lungs.
• Effects on consciousness due to lack of oxygen, as well as toxic and irritating
fire gases.
• Burns on unprotected skin and in the airways at high gas temperatures.
The fire gases can contain corrosive and toxic components from many different burning
substances. These can all contribute to worsening the situation exercising what the lack
of oxygen causes. In order to initially obtain a hypothesis about the content of the flue
gases, one can "read the fire", i.e. assess what is burning (see section 5.1).
Based on this information about the fire, you can get a basis for a primary assessment of
which treatable components you are dealing with.
How severely affected the victim is is determined by the substance's concentration
in the body's target organs and the time that toxic concentrations are maintained.
The amount of ventilation (breathing depth and breathing rate) is important. Consideration
must also be given to the rate at which the harmful substance can be absorbed by the
body and the duration of exposure. The effect may come on quickly, as with HCN
(seconds–minutes), or be delayed for hours as with nitrous gases.
Combined effects are of course difficult to diagnose.
Gas components that are important to take into account in order to optimally control a
treatment are, for example, carbon monoxide (CO), hydrogen cyanide (HCN), hydrogen fluoride (HF),

hydrochloric acid (HCl), nitrous gases, (NOx), sulfur dioxide (SO2 ) to name a few, which is
why correct and optimal treatment of the former already in the area of damage is of
great importance for the outcome.
HF poisoning in the event of an e-car fire is basically not described in the medical
scientific literature (Westman, 2021). In the treatment recommendations from the Norwegian
Poison Information (Helsebiblioteket, 2017, 2021), the problem has been well described and
the recommendations are broadly the same as the Swedish GIC, whose recommendations
are described in this report.
Below, some pre-hospital treatable conditions are highlighted, which with the right
treatment can contribute to increasing the chance of survival for the sufferer.
Read more:
The factual content is from MSB's decision support and from the Swedish Gift
Information Center (GIC).
5.2.3.2 Oxygen - lack In the event of a fire

in a closed room, a lack of oxygen can occur because the fire consumes oxygen. This
deficiency can be exacerbated when using extinguishing agents that displace oxygen,
such as Novec 1230. Normal air contains 20.9 percent oxygen. The body can handle a
certain lowering. It has not been possible to show any serious disturbance in brain function at
15 percent oxygen in the breathing air. At lower oxygen levels, however, brain function begins
to deteriorate. At 14.4–11.8 percent oxygen in ambient air (equivalent to the partial
pressure at altitudes between 3,000–4,500 meters altitude), breathing and heart rate begin
to increase and judgment and maximum work capacity are reduced. Manifest oxygen
deficiency occurs at 11.8–9.6 percent oxygen in the surrounding air, which corresponds to the
partial pressure of oxygen at altitudes between 4,500–6,000 m. The symptoms consist of a
clear deterioration of higher mental processes and neuromuscular control. Judgment is
impaired. Cardiac activity and breathing are increased. Critical oxygen deficiency occurs
at 9.6–7.8 percent oxygen in the surrounding air, which corresponds to an altitude of
6,000–7,600 m.
At this level, clouding, loss of consciousness, cessation of breathing, circulatory
failure and death occur.
Treatment: If consciousness is affected - give 100 percent oxygen, preferably with
positive pressure (CPAP or intubation). In case of mild symptoms, oxygen can be given
on a mask or halter.
5.2.3.3 Carbon monoxide (CO)

Carbon monoxide dislodges the oxygen molecules from the hemoglobin in the red blood
cells. This is because CO settles on the hemoglobin > 200 times easier than the oxygen
molecules do. Thereby, carboxyhemoglobin (COHb) is formed, which cannot transport
oxygen. However, COHb gives the blood a deceptive "cherry red" color. CO poisoning is
estimated to contribute to a significant proportion of fire-related deaths. Concentrations of
> 1,000 ppm CO in the breathing air produce symptoms such as headache, dizziness,
nausea, fainting and, in more severe cases, coma and respiratory failure, depending on
the CO concentration and time. During the active phase of a fire and in connection with
firefighting, levels of many tens of thousands of ppm can occur. Children react more
adversely to carbon monoxide than adults.

CO's properties: •
CO is slightly lighter than air. • CO
also binds to myoglobin found in the muscle cells, as well as to

cytochrome C in the mitochondria (the cell's energy factory). The heart and brain are
particularly affected by CO poisoning.
• CO is exhaled through the lungs and the rate at which CO is eliminated is

related to the oxygen pressure in the environment.
Treatment: In normal air, the CO content in the body is halved in 3–4 hours. If the victim
receives 100 percent oxygen, this time is reduced to 30–40 minutes.
Such treatment requires a completely tight mask and should normally be given for at least 6
hours. If oxygen can be given at a pressure of 2.5 atmospheres in a pressure chamber, the
half-life is reduced to 22 minutes.
5.2.3.4 Hydrogen cyanide (HCN)

HCN is highly toxic. Its discoverer, the famous Swedish chemist CW Scheele, accidentally
dropped a bottle on the floor in 1786 and was exposed to HCN, resulting in his death. HCN
in the form of hydrocyanic acid was used in the gas chambers during the 1940s under the
name Zyklon B.
Hydrogen cyanide (HCN), can be developed in an apartment fire from, for example,
polyurethane (which is often found in furniture upholstery), melamine, plastics, laminate worktops,
cotton, wool, etc. In fire tests in cars, HCN mainly arose during heating/burning of
polyurethane from the upholstery of the seats, as well as from the glue and interlayer varnish of
the body sheet. HCN can also be released during a fire in Li-ion batteries (Meraner et al., 2021;
Willstrand et al., 2020).
HCN is a colorless gas that is lighter than air and in pure form has a bitter almond-like odor,
which, however, cannot be distinguished in fire smoke. In addition, a certain part of the
population has a genetic disposition which means that one cannot feel this smell/taste. The
boiling point is 25.7 degrees Celsius.
The mechanism of action is briefly as follows. When HCN reaches the lungs, the substance
passes through the alveoli and via the arteries of the bloodstream to the cells of the body.
There, the so-called electron transport chain is blocked in the mitochondria (which are the
cell's energy producer). Then the cells' normal energy production is switched off and they
stop working, which is of particular importance for the cells of the brain, heart and liver
(Anseeuw, Delvau, Burillo-Putze et al., 2013). Since the oxygen is not consumed in the
cells, this means that the venous blood can contain more oxygen than usual when it goes
back to the heart.
Toxicity; Lethal concentration within 10 minutes is 181 ppm, instant killing: 270 ppm.
According to the Swedish Work Environment Authority (2018), the maximum value for exposure
for a maximum of 15 minutes is 3.6 ppm (4 mg/m3) .
HCN influence should be suspected in the event of an HCN-producing fire ("read the fire")
and when the victim has soot around the nose and in the respiratory tract. When inhaled, the
symptoms can come on in seconds, but can also take a few minutes. In mild cases (level of
consciousness according to Glascow Coma Scale GCS ÿ 14) there is headache, clouding,
hyperventilation (increased breathing rate), dyspnoea (labored breathing) and possible taste/
smell of bitter almonds or metal. In more severe cases, cold, moist skin occurs, increasing
loss of consciousness. Moderate poisoning (GCS 10–13) and severe poisoning (GCS ÿ 9) mean,
in addition to increasing loss of consciousness, also an increasing risk of convulsions,
circulatory disturbances, respiratory failure and pulmonary edema

(Anseeuw et al., 2013). Because the blood has not delivered oxygen to the cells, the venous blood
you see on the mucous membranes and nail bed has a redder color than usual. However, in the
case of simultaneous lack of oxygen and/or circulatory impact, the affected person can sometimes
show cyanosis (sign of lack of oxygen), so the condition can be difficult to assess - which
further emphasizes the importance of information about what is burning, i.e. of "reading the fire".
Treatment: According to the recommendation of the GIC, the unconscious (GCS ÿ 13)
adult patient, in the event of a fire where there is a risk of HCN exposure, is given Hydroxycobalamin
(Cyanokit ® ) – 5 g 200 ml NaCl as an infusion over 15–30 minutes. The earlier you give
the antidote the better, i.e. preferably in the area of injury.
If severe circulatory compromise (shock/cardiac arrest) or coma (GCS ÿ 9) does not resolve on 5
g, the dose may be repeated.
An alternative is Sodium thiosulphate 150 mg/ml – 100 ml IV given over 5–10 minutes. This
option is cheaper, but significantly less effective than Cyanokit®.
Caution in cardiopulmonary resuscitation has previously been recommended because of the
feared HCN content in exhaled air. However, this risk is assessed as very low, when the exposure
occurred via fire smoke Regarding dosage for
children and other related questions - get information from GIC, telephone 112 or 010-4566700.
5.2.3.5 Hydrogen fluoride (HF)

This section is an extract from "Appendix", which is a comprehensive knowledge compilation
of HF's medical effects in both liquid and gas form, which was written by senior physician Erik
Lindeman, Poison Information Centre.
Read more
HF has potentially unpleasant properties. However , HF in fire gas form rarely

seems to reach such high levels that it can pose a threat to humans. See
instructional film by Gunnvall, Molander, Lindeman (2021).
The presence of HF in fire smoke from Li-ion battery fires has attracted a lot of attention both in
the media and among authorities and rescue organizations.
In recent years, the Poisons Information Center (GIC) has been repeatedly contacted by rescue
services who have expressed concern and uncertainty about the risks HF in fire smoke from
burning batteries poses during rescue and extinguishing work.
However, the GIC has not been consulted in a single case where fire smoke exposure led to
poisoning symptoms that could be judged to indicate a toxic (poisonous) effect of HF. Nor has
GIC's monitoring of the environment indicated that HF in smoke from burning Li-ion batteries
poses any particular acute toxicological problem.
HF can be formed in a fire that gasifies the electrolyte in Li-ion batteries, as well as in a fire in
other products containing fluorine compounds (e.g. air conditioning fluids or fire extinguishing
systems). HF then occurs as one of many toxic and irritating components in the fire smoke and it
has been unclear to what extent HF contributes to significantly increasing the toxicity of the smoke.
Basic facts about concentrations: The detection limit for the pungent pungent odor characteristic
of gaseous HF is 0.02-0.13 ppm and human exposure tests have shown that eye and respiratory
irritation becomes apparent at 5 ppm, but that levels up to about 30 ppm "can be
tolerated" (National Research Council, 2014).

HF concentration in fire smoke from Li-ion batteries: In measurements in the

smoke plume from burning Li-ion batteries in cars of various sizes, HF
concentrations of 150–450 ppm have been measured during short-term peaks, while
the levels during most of the fire course are around or below 50 ppm (Truchot et
al., 2018; Larsson, Andersson, Blomquist, Mellander, 2017). In the event of a battery
fire in a closed space, higher concentrations could conceivably arise, but published
empirical studies do not indicate that this occurs in practice. In a study conducted for
MSB, it was found impossible to achieve detectable levels of gaseous HF in a test
container filled with the fumes from two Li-ion batteries subjected to thermal
runaway (Wingfors et al., 2021). An explanation for this finding could be that the
chemical reactivity of gaseous HF means that the gas quickly binds to various surfaces
to which it is exposed and thus disappears from the atmosphere.
This phenomenon has been demonstrated in a Dutch study where the smoke from five
Li-ion batteries was directed into a small smoke tent. Levels of gaseous HF dropped
from initial 100 ppm to 5 ppm in 20 minutes – see also Figure 3 in reference van Veen
and Kop pen (2020). The Dutch study also raises questions about the absolute amounts
of HF generated in the smoke from burning Li-ion batteries. The total amount of
fluoride ion on the most contaminated surfaces in the smoke tent (after eight Li-ion
, acm2
batteries were fired up) amounted to 220 µg/100 very low amount.
Summary: The low concentrations of HF that appear to occur in practice in
Li-ion battery fires make it unlikely that gaseous HF makes the smoke from these
fires significantly more toxic than other fire smoke.
The high sensitivity of humans to even small amounts of gaseous HF in inhaled air
makes it inconceivable that potentially acutely toxic concentrations (>50–100 ppm) could
remain unnoticed. Gaseous HF cannot cause pulmonary edema as

only symptoms and it is excluded that exposure to smoke from burning Li-ion batteries
could give rise to systemic toxicity (i.e. toxic effect on the body's internal organs) such as
heart attack.
Treatment: In case of severe exposure with symptoms from the respiratory tract, the
usual treatment (bronchodilator and anti-inflammatory agent) can be supplemented with
inhalation of nebulized, i.e. finely divided aerosol, of calcium gluconate which is an antidote
to HF. Please contact the Poisons Information Center for advice.
5.2.3.6 General information about other fire gases In

homes and modern vehicles, more and more materials are used that can give rise to
malignant components in the fire gases. In fire tests with e-vehicles and battery fires, a
large spectrum of different gas components have been identified that are unfavorable when
inhaled. As examples, in addition to CO, HCl (hydrochloric acid), NOx (nitrogen oxides),
SO2 and various hydrocarbon compounds can be mentioned (Lecocq et al., 2012;
Willstrand, 2020). Furthermore, explosive gases such as H2 (hydrogen gas) can also be
formed in the event of a fire in a Li-ion battery according to Meraner et al. (2021). Metal
substances are more of a problem for the environment than an acute health problem according to Willstrand et al. (2020).
Treatment: Inhalation of fire gases is treated according to standard advice with the
addition of special treatment for HCN and HF exposure (see “Remember for emergency
personnel” on page 5). The treatment should be started pre-hospital and the more
serious consequences should be dealt with within qualified healthcare.
Summary
• Many corrosive and toxic components occur in connection with
Li-ion battery fire.
• Important to "read the fire" in order to be able to infer in this way which special treatable
components are likely. • Corrosive gas components are
treated medically much like asthma with bronchodilators and anti-inflammatory agents.
• There are good antidotes against special components such as HCN and HF.

6. Summary and
discussion
According to MSB's response statistics for the emergency services in the years 2018–2020
for fires in Li-ion batteries, the incidence was 13 responses per million inhabitants per year.
Common causes were fire in mobile phone/reading tablet/computer, hoverboard, electric and scooter.
Fire in larger batteries, as in the latter, provided the greatest need for medical assessment.
However, there was no case registered from a fire in an e-car/vehicle with suspected smoke gas
inhalation. The amount and content of the smoke gases depends on the make and size of the
battery, what catches fire around it and how long smoke development lasts (Bisschop et al., 2019;
Willstrand, 2020). In some events, explosions are noted, indicating the presence of explosive gases
(cf. Meramer et al., 2021). Common, however, is that the fire gases contain a number of complex
toxic and corrosive components that can adversely affect the person who inhales the gases
(Willstrand et al., 2020).
In just under one in ten incidents, affected persons received medical assessment according to
MSB data. In half of these cases, it was stated that a medical facility had been sought (4 percent),
while in the other half (5 percent) of the cases, the ambulance staff on the spot made an
assessment of the condition and that no further medical assessment was necessary.
When validating the stated care effort in the MSB's statistics against the CBRNE management
unit's medical data in Greater Stockholm, for a limited number of cases, the MSB's data
proved to correlate well with the healthcare's in almost all cases. Of those who were
transported to a medical facility (14 people), all were judged to be slightly injured, except for two
who were given red priority (priority 1) due to serious burns. No injuries related to systemic
effects (effect on internal organs/circulation), caused by inhalation of HF, had not been recorded in
the management unit's medical data for the matched group.
This validation thus indicates that the MSB data provided a good idea of the healthcare need
in the matched cases. The fact that the CBRNE management unit did not have data for half of
the cases reported in the MSB data is considered to be due to the fact that not all incidents are
alerted, or that another ambulance unit was on site.
No systematic difference depending on time of day could be identified. Similar problems have
been noted at the Kemambulansen in Perstorp (Björnstig, Westman, Saveman, Björnstig, 2020).
However, it has not been possible to investigate whether health care overall handled cases that
MSB data did not report, due to complicated confidentiality/decision rules, defragmented organization,
etc.
Neither the Swedish Poison Information Center nor the Norwegian equivalent have noted
any cases with typical HF systemic effects (on internal organs/circulation), which supports the
hypothesis that these cases are very rare (cf. Bisschop et al., 2019). The Norwegian national
CBRNE unit has not noted any particular HF problem, even though Norway has the most e-cars
in Europe. This may depend

Summary and discussion
that HF is such a reactive substance that it has had time to react with the "surroundings"
before it is inhaled, which is why the amount in gaseous form is limited and not at all at
the levels theoretical calculations sometimes indicate (Willstrand et al., 2020; Gunnvall et al., 2021) .
Nor do the levels in completed practical trials appear to be dangerously high for firefighters
wearing protective clothing when exposed to HF in gaseous form (Wingfors, 2021).
From the available data, fires appear to have occurred both during charging and
spontaneously, of which the MSB noted that e-bike batteries not infrequently seem to
catch fire spontaneously. The 2019 Nobel Prize winner in chemistry, Professor John
Goodenough, 97 years old, received the award for his many years of work with Li-ion battery
development and safety. He mentioned in his award interview that a remaining problem,
which he was still working on, was to reduce the risk of dendrite formation in the batteries,
i.e. that which causes internal short circuit and spontaneous fire. Hopefully this risk will decrease in the future.
Data regarding victims identified through MSB's response reports showed modest impact
in most cases. In many cases, these do not seem to have required special treatment. In one
case caught by MSB's accident investigators, the victim was treated in a respirator with
complete therapy against smoke gas and HF exposure with good results. However, he had
persistent muscular pains for several months, which seem to be difficult to explain.
Neither CO poisoning nor lack of oxygen (oxygenation) had been present, which can
sometimes cause muscle damage (Kim, Woo & Kang, 2019).
It cannot be ignored that this victim, who was exposed for ½–1 minute to very dense
fire smoke, exhibited blurred vision and burning eyes, intense coughing and later swelling of
the upper respiratory tract. This can combine with aggressive gas components that can
form in the event of a fire in these batteries such as HF, HCl, NOx, SO2 . This
victim probably still had modest exposure and his care may illustrate a model for aggressive
smoke gas treatment.

Summary and discussion
The common denominator of the standard treatment for exposure to smoke gas is
to improve the oxygenation of the body's cells. This involves treatment with oxygen, as
well as bronchodilating and anti-inflammation drugs (cortisone), to improve the
exchange of oxygen in the lungs. In order to break the HCN effect, Cyanokit® is
given as soon as possible in case of severe effects (loss of consciousness/coma) and
soot in/around the nose and respiratory tract. This means that you should make sure you
have access to this substance when responding to a fire, as well as bringing calcium
gluconate solution to reduce the effect of HF on the airways if a Li-ion battery burns. See
also the section on treatment recommendations page 6.
The dose of unfavorable fire gas components the victim is exposed to is determined
by the concentration of the substance in air/smoke and the time. It is often difficult to
calculate the contribution of individual components from a smoke plume containing
a large number of components, which can also vary over time. Regarding HF, it can be
mentioned that in a thesis from Oslo (Lund, 2006), healthy subjects were exposed for one
hour to HF at levels considered acceptable from an occupational safety point of view (< 2 ppm).
The examinations showed some mucosal involvement in the airways even at these low
levels, mostly localized in the upper part, which was verified with inflammatory indicators.
In addition to Lund's data, the US Environmental Protection Agency (2014) also includes
data from various animal experiments. The data is scattered. Reference is made, among
other things, to experiments with Rhesus monkeys where the LD50 has been calculated,
i.e. the dose where 50 percent die. The LD50 for 1 hour exposure to HF gas was 1,775 ppm.
At the current state of knowledge, one can thus consider and treat HF in gaseous form
according to standard treatment for irritating gases. However, the precautionary
principle means that if exposure to HF in gaseous form has occurred and the victim has
signs of inhalation of irritating gas, one should supplement the standard treatment for
irritating gases with inhalation of nebulized calcium gluconate solution and contact the
Poison Information Centre. In Norway, calcium tablets are recommended pre-hospital in
severe cases (Helsebiblioteket, 2017), which is no longer the case according to the updated
recommendations from GIC in Sweden. The
fire gases from indoor fires where Li-ion batteries are present can contain many
components that you should of course avoid inhaling. In addition to corrosive and oxygen-
inhibiting components, hydrogen gas can sometimes be present, which can initiate an
explosion. This can be valuable to consider during a rescue operation.
Conclusion:
• "Reading the fire" is a significant factor in initially forming one
understanding of what burns and which fire gases you have to deal with.
This is important information for choosing the best treatment strategy.
• With the current state of knowledge, it can be judged that the gas component HF
rarely, or not at all, produces systemic effects on the body's internal organs. It is an
irritating gas among other irritating gases, with an effect mainly on the upper
respiratory tract. • The damaging effects of a Li-ion battery fire can be reduced if you
treat the oxygen-inhibiting components aggressively according to established
standard methods for irritating gases, and are prepared to immediately use
available antidotes (antidotes) against HCN and HF.

7. References
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Lambert Y, Sabbe M. Cyanide poisoning by fire smoke inhalation: An European
expert consensus. European Journal of Emergency Medicine. 2013;20:2-9.
The Work Environment Agency. Hygienic limit values 2018:1. https://www.av.se/
globalas sets/filer/publikationer/foreskrifter/hygieniska-gransvarden-afs-2018-1.pdf
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Bisschop R, Willstrand O, Amon F. Fire Safety of Lithium-Ion Batteries in
Road Vehicles. RISE Report 2019:50. ISBN 978-91-88907-78-3. Research
Institutes of Sweden. Borås. 2019. https://www.diva-portal.org/smash/get/
diva2:1317419/FULLTEXT02 [retrieved: 2022-02-01] .
Björnstig J, Westman A, Saveman BI, Björnstig U. "The chemical ambulance in
Perstorp - valuable competence in CBRNE - events. Knowledge center for disaster
medicine, Umeå University. Umeå. 2020.
Curry S, Spyres M. Cyanide: Hydrogen Cyanide, Inorganic Cyanide Salts, and

Nitriles. In Brent et al. (eds.) Critical care Toxicology. Springer International
Publishing, Switzerland. 2015.
From A, Lindström F. Fire in a building. Greater Stockholm fire service Dnr 360-
203/2020. Stockholm. 2020-02-28. Stockholm. 2020.
From A, Wiberg G. Lithium-ion related fires 2020. Final report. Greater Stockholm's
fire service. 2020-12-02. Stockholm. 2020.
Gunnvall K, Molander B, Lindeman E. Instructional film. Pre-hospital capability

when responding to fires in lithium-ion batteries. Region Stockholm. 2021.
https://youtu.be/vaspu8f_X_w [Retrieved: 2021-01-31].
Hasvold Ø, Forseth S, Johannessen T, Lian T. Safety aspects of large lithium
batteries. Norwegian Defense Research Establishment. Report 01666-2007.
Kjeller, Norway. 2007.
Helsebiblioteket, 2017. https://www.helsebiblioteket.no/forgiftninger/gasser-og
chemikaler/hydrogenfluorid-flussyre-og-hydrogenfluoridgass-forstehjelp-ved
forgiftning [ retrieved: 2021-01-31].
Helsebiblioteket 2021. https://www.helsebiblioteket.no/forgiftninger/
gases-and-chemicals/battery-fire-lithium-ion-battery--treatment-recommendation
-wood-poisoning [ retrieved: 2021-01-31].
Kim SG, Woo J, Kang GW. A case report on the acute and late complications
associated with carbon monoxide poisoning: Acute kidney injury, rhabdo
myolysis, and delayed leukoencephalopathy. Medicine (Baltimore). 2019
May;98(19):e15551. doi: 10.1097/MD.0000000000015551.

References
Kraftfahrt-Bundesamt. Projektbericht über Versuche mit Fahrzeugen zur Ent

flammung und HF-Exposion mit Fahrzeugklimaanlagen bei Verwendung von
R1234yf. Kraftfahrt-Bundesamt – KBA 1-8 (2013). Flensburg. 2013.
Larsson F, Andersson P, Blomqvist P, Mellander BE. Toxic fluoride gas emissions
from lithium-ion battery fires. Sci Rep. 2017;7(1):102.
Lecocq A, Bertana M, Truchot B, Marlair G. Comparison of the fire consequences of
an electric vehicle and an internal combustion engine vehicle. 2nd International
Conference on Fire in Vehicle – FIVE 2012, Sep 2012, Chicago, United States.
Lund K. Effects of Experimental Hydrogen Fluoride Exposure on Upper and
Lower Airways in Healthy Volunteers. Thesis. Faculty of Medicine, University of
Oslo No.268. Oslo. 2005. ISBN 82-8072-173-8.
Magnusson R, Hägglund L, Gustafsson Å, Bergström U, Lejon C. Identification and

brief toxicological assessment of combustion products of the refrigerant
HFO-1234yf. FOI Report, FOI-R--4285—SE. Umeå. 2016.
Malmquist PO. Fires in Lithium-ion batteries 2021-12-12. https://www.youtube. com/
watch?v=g2o_e7FQcaM [Retrieved: 2021-01-31].
Meraner C, Li T, Sanfeliu Meliá C. Degassing from lithium-ion batteries in the home.
RISE report 2021:17. Trondheim. 2021. https://risefr.no/media/publikas joner/
upload/2021/rise-rapport-2021-17-avgassing-fra-lithium-ion-batterier-i hemmet.pdf
[ retrieved: 2021-01-31] .
MSB. Handling of carbon fiber composites in accidents. The authority for social security
and preparedness. Publication MSB 1747. Karlstad 2021. ISBN 978-91-7927-136-7.
https://rib.msb.se/filer/pdf/29870.pdf [retrieved: 2022-01-31].
National Research Council (US) Subcommittee on Acute Exposure Guideline
Levels. Acute Exposure Guideline Levels for Selected Airborne Chemicals:
Volume 4. Washington (DC): National Academies Press (US); 2014.
Perfect Hoverboard. Do hoverboards still catch fire in 2021? https://perfecthov
erboard.com/do-hoverboards-still-catch-fire [Retrieved: 2021-01-31].
Söderholm T. Project electric hybrid vehicles. Survey of 100 emergency services.
Compilation of received responses. Dnr 2011-1687 MSB, Karlstad. 2011-08-31.
TheFlightChannel, 2018. Boeing 747 Crash in Dubai | Fatal Delivery | UPS Airlines
Flight 6. https://www.youtube.com/watch?v=EfdrhtvzYZU [Retrieved: 2022-02-01]
Truchot B, Fouillemn F, Coiilet S. An experimental evaluation of toxic gas emissions
sions from vehicle fires. Fire Safety Journal. 2018;97:111-118.
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UPS Airlines Flight 6, Wikipedia 2010. [Retrieved: 2022-02-01]
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US Environmental Protection Agency (EPA) 3. Hydrogen Fluoride. Acute Exposure
Guideline Levels. In Acute Exposure Guideline Levels for Selected Airborne
Chemicals. Volume 4. National Research Council of National Academies.
The National Academic Press. Washington, DC 2004:123-186. van
Veen N, Koppen A. Emergency responses in smoke from Li-ion batteries.
In: FIVE 2020. Research Institutes of Sweden. Borås. 2020.

References
Westman A. Future chemical risks for emergency services and the general public during
fires in modern vehicles. MSB report 1723. MSB, Karlstad. 2021. ISBN: 978-91-7927-123-7.
Willstrand O, Bisschop R, Blomqvist P, Temple A, Anderson J. Gases from Fire in Electric
Vehicles. RISE Report 2020:90. Research Institutes of Sweden. Borås. 2020. http://
ri.diva-portal.org/smash/get/diva2:1522149/FULLTEXT01.pdf [retrieved: 2022-02-01].
Wingfors H, Magnusson R, Thors L, Thune M. Gaseous HF in fires in confined spaces-risks

for skin absorption during interventions. MSB report MSB1723. MSB, Karlstad. 2021.
ISBN: 978-91-7927-123-7.

Appendix
8. Hydrogen fluoride
(HF) in liquid and gas form
The episode is written by senior physician Erik Lindeman, Poison Information Centre.
The reference list in this section has a deliberately different layout than in the previous text to
avoid confusion.
Hydrogen fluoride (HF) can be formed in a fire that gasifies the electrolyte in Li-ion batteries,
as well as in a fire in other products containing fluorine compounds (e.g. air conditioning
fluids or fire extinguishing systems). HF then appears as one of many toxic (poisonous) and
irritating components in the fire smoke and it is unclear to what extent HF contributes to
significantly increasing the smoke's toxicity.
The presence of HF in battery fire smoke has attracted attention both in the media and with
authorities and rescue organizations. The Poison Information Center (GIC) has been
contacted on several occasions by representatives of emergency services from different parts
of the country, who have expressed concern and uncertainty about the risks HF in the fire
smoke from burning batteries poses to them and their colleagues. However, the GIC has not
been consulted in a single case where fire smoke exposure led to poisoning symptoms
that could be judged to indicate a toxic effect of HF. Nor has GIC's monitoring of the
environment indicated that HF in smoke from burning Li-ion batteries poses any particular acute
toxicological problem.
The knowledge we have about the toxic effects of HF comes mainly from the liquid form
of the substance, which is called hydrofluoric acid. But the toxicity of hydrofluoric acid varies
greatly with both the route of exposure and – above all – with concentration. It is difficult
to extrapolate from experiences from notorious accidents with highly concentrated hydrofluoric
acid to estimate risks with diluted hydrofluoric acid or with HF in the smoke from burning
batteries. However, it is likely that such an extrapolation contributed to creating the attention and
concern over HF in battery fire smoke that exists in society. The following text is an attempt
to, on the basis of the available literature, make a more nuanced assessment of the risk HF
poses in its various "forms"; with different concentrations and in different phases.
8.1 HF in liquid form

Anhydrous hydrofluoric acid (> 70 percent) is one of the strongest acids we know and
has a well-deserved reputation as a very dangerous substance. Several of the pioneers of
chemical science (including Humphrey Davy) were seriously injured when they first came across
the subject in the 19th century. Hydrofluoric acid therefore came to be called "the Tiger of Chemistry".
In case of skin exposure, painful injuries quickly occur which penetrate deeper into the skin
over the course of minutes–hours. Then there is also an uptake of fluoride ions into the blood,
which can cause severe "systemic toxicity". The fluoride ion is very reactive and attacks many
important structures in the body. Among other things, it forms
Smoke exposure in case of Li-ion battery fire 36

Hydrogen fluoride (HF) in liquid and gas form
insoluble salts with calcium and magnesium ions, which can lead to a pronounced
lack of these electrolytes (hypocalcemia and hypomagnesemia), which in turn can
lead to cardiac arrest. Even a small skin exposure to anhydrous hydrofluoric acid (<
1 percent of the body surface) can lead to life-threatening systemic toxicity. The
substance's ability to destroy storage containers (both glass and metal) and the fact
that it vaporizes strongly ("smokes") at room temperature increase the risks.
Anhydrous hydrofluoric acid occurs as an industrial chemical and is surrounded by
rigorous safety, which has contributed to making
exposures very unusual in Sweden.1 Diluted hydrofluoric acid (5–20 percent) is used for cleaning metal sheets
and welding joints (so-called "pickling agent"). Baits are often mixtures that also
include other toxic substances (e.g. nitric acid). GIC receives several calls each
month regarding accidental occupational skin exposure to mordants. Untreated, such
exposure can lead to painful skin lesions/necrotic ulcers, which can progress over
the course of several days. However, diluted hydrofluoric acid is a weak acid (comparable
to vinegar), which greatly limits the fluoride ion's ability to pass the skin barrier, and
systemic toxicity only occurs with very large skin exposure or after ingestion. Early
treatment (with washing and application of calcium gluconate gel) also prevents
ulceration in almost all cases.
Summary
• Hydrofluoric acid has a well-deserved reputation as a highly toxic chemical. •
Skin exposure to the anhydrous form can lead to severe skin damage and
to life-threatening systemic toxicity.
• Skin exposure to the diluted form can lead to skin damage, but very rarely to systemic
toxicity.
8.2 HF in gaseous form
8.2.1 Inhalation exposure and risk of systemic

toxicity (impact on internal organs)
Gaseous HF is an irritant gas whose ability to cause damage, like liquid hydrofluoric
acid, depends on its concentration (measured in parts per million, ppm). Anhydrous
hydrofluoric acid "fumes" and in connection with industrial accidents can form a fog of
gaseous HF in very high concentration, where exposure to gas becomes difficult to
distinguish in practice from exposure to liquid acid. In the published literature, there
are several cases where systemic toxicity and respiratory damage have occurred
during exposure to fuming anhydrous hydrofluoric acid and gaseous HF mist, but in
all cases, tangible skin damage has been present at the same time and the exposure
is characterized by a combination of skin exposure, aspiration and possibly also
ingestion of liquid acid in addition to inhalation exposure.2–11 In the scientific literature,
there are no examples of cases where isolated inhalation of gaseous HF has led to
systemic toxicity, and in experimental animal exposure to gaseous HF the animals
die because the lungs are destroyed before they suffer systemic toxicity.12

Summary
• Inhalation of gaseous HF as the only route of exposure is not considered to lead
to systemic toxicity.
8.2.2 Inhalation exposure and risk of

damage to airways and lungs
Gaseous HF is highly water-soluble and therefore gives rise to clear symptoms from the
mucous membranes of the eyes, nose, mouth and larynx. The gas cannot cause lung symptoms
without first causing serious symptoms from the upper respiratory tract. In this respect, HF
differs from water-insoluble irritant gases (e.g. nitrous gases), which cause few symptoms from
the upper respiratory tract and instead reach high concentrations in the lungs, where they can
cause pulmonary edema (fluid effusion) with delay. Despite this, it is often claimed that gaseous
HF can give rise to pulmonary edema and that pulmonary edema can debut with a delay.
However, the published cases where a deep lung injury/pulmonary edema occurred (usually
in the form of an autopsy finding) are, however, exclusively about either injuries where the
upper airway (mouth, pharynx and trachea) is most severely affected and which were probably
partly caused by aspiration of liquid hydrofluoric acid; 3,9,13 or in cases where the pulmonary
edema arose as a result of circulatory collapse (heart failure) caused by fluoride ion uptake via
a different route of exposure than the lungs (ie skin absorption or ingestion).10,13,14 ( See also section 8.3).
Animal experimental exposure to gaseous HF gives rise to a spread of damage typical of a
water-soluble irritant gas, where the upper respiratory tract is affected to a much greater extent
than the lung. In rats, which breathe exclusively through the nose and have winding
nasopharyngeal ducts with large mucosal surface area, > 99 percent of administered HF is
absorbed in the upper airway. In order for it to be possible to study the lung-damaging effects
of HF in rat experiments, the animals must be fed the gas via a tracheal tube.12,15
Summary
• Toxic pulmonary edema as an isolated symptom is not considered to
occur during exposure to gaseous HF, either acutely or after latency.
8.2.3 Gaseous HF in the smoke from burning Li-ion batteries

Basic facts about concentrations: The detection limit for the pungent, pungent odor
characteristic of gaseous HF is 0.02–0.13 ppm. Exposure tests on humans have shown
that irritation from the eyes and respiratory tract becomes noticeable at 5 ppm, but that levels
up to about 30 ppm "can be tolerated".12 The
American Environmental Protection Agency has determined levels which (in case of exposure
for more than ten minutes) risk causing damage at 95 ppm ("AEGL-2") and death at 170
ppm ("AEGL-3"). These values are based on a compilation of the lowest lung-damaging and
lethal exposure over the corresponding time period in tracheally intubated rats. To obtain the
AEGL levels, the lowest lethal or (observably) harmful dose has been divided by an uncertainty
factor

factor", UF) of 10, among other things to compensate for possible differences in sensitivity
across species boundaries. The actual lethal doses for HF (without applied UF) are thus
tenfold higher and agree relatively well between different species (including Rhesus
monkeys). Few/no deaths occur when exposed to concentrations below rising 1000
ppm (for up to 60 minutes), while exposure doses > 5000 ppm for a short time (2-5
minutes) produce pronounced respiratory damage with significant mortality in rats, mice,
rabbit and guinea pig.12
Two volunteer subjects were exposed (1934) to 120 ppm gaseous HF, a level
described as inconceivable to tolerate for more than one minute due to excruciating
burning of the eyes, nose, mouth and exposed skin. Thirteen workers at an oil refinery
were exposed to 150–200 ppm without developing other than transient moderate
symptoms, and in an unpublished study cited by the US Environmental Protection
Agency (EPA), seven workers are said to have survived a brief exposure to 10,000 ppm
without long-term sequelae (consequences).12,16
8.2.4 HF concentration in fire smoke from Li-ion batteries In measurements in the
smoke plume from burning Li-ion batteries of various sizes, HF concentrations of 150–
450 ppm have been measured during short-term peaks, while during most of the course
of the fire the levels are around or below 50 ppm.17,18 In the event of a battery fire in a
closed space, higher concentrations could conceivably occur, but published empirical
studies do not indicate that this occurs in practice.
In a study conducted for MSB, it was found impossible to achieve detectable levels of
gaseous HF in a test container filled with the fumes from two Li-ion batteries subjected to
thermal runaway.19 One explanation for this finding could be that the chemical reactivity
of gaseous HF causes the gas to quickly bind to various surfaces to which it is exposed
and thus disappear from the atmosphere. This phenomenon has been demonstrated in a
Dutch study where the smoke from five Li-ion batteries was directed into a small smoke tent.
The levels of gaseous HF dropped from an initial 100 ppm to 5 ppm in 20 minutes (see
also Figure 3 in ref 20). The Dutch study also raises questions about the absolute
amounts of HF generated in the smoke from burning Li-ion batteries. The total amount of
fluoride ion on the most contaminated surfaces in the smoke tent (after eight Li-ion
batteries were ignited) amounted to 220 µg/100 .20 By way of comparison, it can be mentioned that
cm2, one person survived a subcutaneous injection of fluoride ion (via diluted hydrofluoric
acid) of 350 mg, i.e. a dose 1,500 times higher than the Dutch study's 220 µg.37
Summary
• The very low concentrations of HF that appear to occur in practice in Li-ion battery fires
mean that gaseous HF is unlikely to significantly make the smoke from these fires more
toxic than other fire smoke. • The high sensitivity of humans to even small amounts of
gaseous HF in inhaled air makes it inconceivable that potentially acutely toxic concentrations (>
50–100 ppm) could remain unnoticed. • Gaseous HF cannot cause pulmonary edema as the
only symptom and it is excluded that
exposure to smoke from burning batteries could cause systemic toxicity (cardiac effects).
• In case of heavy exposure with symptoms from the respiratory tract, you can supplement sed
usual treatment (bronchodilators and anti-inflammatory agents) with inhalation of nebulized
calcium gluconate. Contact the Poisons Information Centre.

8.3 Absence of toxic lung effects in

the literature
The notion that inhalation of gaseous HF can cause pulmonary edema seems to stem
from a number of case reports published in the 1960s, describing industrial workers
whose faces were exposed to gaseous HF (100,000 ppm) or to anhydrous hydrofluoric
acid.7,9,10 The patients died within 2–10 hours and autopsy showed hemorrhagic
(bloody) pulmonary edema in all cases in addition to severe skin damage. The authors
assess that a deep lung injury contributed to or caused the deaths, but in the two cases
where the course is described in more detail, it is clear that the patients died of cardiac
arrest caused by systemic toxicity, not respiratory failure.
Hemorrhagic pulmonary edema can be seen at autopsy even after death where the lung
was not primarily exposed to hydrofluoric acid and is probably caused by circulatory
collapse and resuscitation measures (resuscitation).13,21 In 1965, an influential case series
was published on pulmonary edema with onset after latency in exposure to chemicals.22
Most of the cases in the article concerns chemicals that are well known to give rise to such
a process (nitrogen dioxide, ozone and dimethyl sulfate among others), but here they
have also included a case with exposure to hydrofluoric acid. From the few details given, it
appears that the patient received anhydrous hydrofluoric acid on his face and arms. The
patient died after ten hours and can hardly have been symptom-free until he was
tracheostomized three hours into the course (the "latency period"). The autopsy showed
severe caustic damage to the trachea, which can be assumed to be due to aspiration of
anhydrous hydrofluoric acid. This course of poisoning is inconsistent with the main message
of the article, but helped spread the notion that gaseous HF can cause pulmonary edema with latency.
There are also many published cases where lung damage is associated with HF even
though the patients were simultaneously exposed to other chemicals that actually better
explain the course (often other acids, e.g. nitric acid whose vapors contain nitrous gases).23–
27 In other published cases where HF is alleged to have caused an isolated lung injury,
it is not clear that any exposure to HF occurred at all.28–30 There are certainly individual
case descriptions/case series and research on volunteer subjects that suggest that HF
exposure can cause airway inflammation/reactive airway disease (RADS),31–33 but
this is not unique to HF and has no obvious acute toxicological implications. At the same
time, there are several follow-up studies after industrial accidents (with a total of several
thousand potentially exposed individuals) where many were affected by eye irritation, sore
throats and coughs, but where no cases of pulmonary edema (whether acute or delayed)
were highlighted.16,34–38

8.4 References appendix

1. Björnhagen V, Höjer J, Karlson-Stiber C, Seldén AI, Sundbom M. Hydro fluoric
acid-induced burns and life-threatening systemic poisoning – favorable outcome
after hemodialysis. J Toxicol Clin Toxicol 2003;41(6):855–60.
2. Chela A, Reig R, Sanz P, Huguet E, Corbella J. Death due to hydrofluoric
acid. Am J Forensic Med Pathol 1989;10(1):47–8.
3. Yuanhai Z, Xingang W, Liangfang N, Chunmao H. Management of a Pa
tient With Faciocervical Burns and Inhalational Injury Due to Hydrofluoric Acid
Exposure. Int J Low Extrem Wounds 2014;13(2):155–9.
4. Yamaura K, Kao B, Iimori E, Urakami H, Takahashi S. Recurrent ventricular
tachyarrhythmias associated with QT prolongation following hydrofluoric acid
burns. J Toxicol Clin Toxicol 1997;35(3):311–3.
5. Dote T, Kono K, Usuda K, Shimizu H, Kawasaki T, Dote E. Lethal inhalation
exposure during maintenance operation of a hydrogen fluoride liquefying tank.
Toxicol Ind Health 2003;19(2-6):51–4.
6. Greco RJ, Hartford CE, Haith LR Jr, Patton ML. Hydrofluoric acid-in duced
hypocalcemia. J Trauma 1988;28(11):1593–6.
7. Dieffenbacher PF, Thompson JH. Burns from exposure to anhydrous
hydrofluoric acid. J Occup Med Jun 4; 1962;4:325–6.
8. Pu Q, Qian J, Tao W, Yang A, Wu J, Wang Y. Extracorporeal membrane
oxygenation combined with continuous renal replacement therapy in cutaneous
burn and inhalation injury caused by hydrofluoric acid and nitric acid. Medicine
2017;96(48):e8972.
9. Greendyke RM, Hodge HC. Accidental death due to hydrofluoric acid.
J Forensic Sci 1964;9(3):383–90.
10. Mayer L, Guelich J. Hydrogen fluoride (HF) inhalation and burns. Arch
Environ Health 1963;7:445–7.
11. Watson AA, Oliver JS, Thorpe JW. Accidental death due to inhalation of
hydrofluoric acid. Med Sci Law 1973;13(4):277–9.
12. National Research Council (US) Subcommittee on Acute Exposure Guideline
Levels. Acute Exposure Guideline Levels for Selected Airborne Chemi cals:
Volume 4. Washington (DC): National Academies Press (US); 2014.
13. Manoguerra AS, Neuman TS. Fatal poisoning from acute hydrofluoric acid
ingestion. Am J Emerg Med 1986;4(4):362–3.
14. Tepperman PB. Fatality due to acute systemic fluoride poisoning following a
hydrofluoric acid skin burn. J Occup Med 1980;22(10):691–2.
15. Dalbey W, Dunn B, Bannister R, et al. Acute effects of 10-minute exposure to
hydrogen fluoride in rats and derivation of a short-term exposure limit for humans.
Regul Toxicol Pharmacol 1998;27(3):207–16.
16. Lee DC, Wiley JF 2nd, Synder JW 2nd. Treatment of inhalational
exposure to hydrofluoric acid with nebulized calcium gluconate. J Occup
Med 1993;35(5):470.
17. Truchot B, Fouillen F, Collet S. An experimental evaluation of toxic gas
emissions from vehicle fires. Fire Saf J 2018;97:111–8.
18. Larsson F, Andersson P, Blomqvist P, Mellander BE. Toxic fluoride gas
emissions from lithium-ion battery fires. Sci Rep 2017;7(1):102.

19. Wingfors H, Magnusson R, Thors L, Thunell M. Gaseous HF in fires in

confined spaces [Internet]. MSB 1717 – February 2021 [cited 2022 Mar 15];
Available from: https://rib.msb.se/filer/pdf/29507.pdf 20. van
Veen N, Koppen A. Emergency responses in smoke from Li-ion batteries FIVE
2020. In: Willstrand O, editor.
21. Mayer TG, Gross PL. Fatal systemic fluorosis due to hydrofluoric acid burns.
Ann Emerg Med 1985;14(2):149–53.
22. Kleinfeld M. Acute pulmonary edema of chemical origin. Arch Environ
Health 1965;10:942–6.
23. Bennion JR, Usaf M, Franzblau A. Chemical Pneumonitis Following
Household Exposure to Hydrofluoric Acid. Am J Ind Med 1997;31:474–8.
24. Steverlynck L, Baert N, Buylaert W, De Paepe P. Combined acute inhalation
of hydrofluoric acid and nitric acid: a case report and literature review. Acta
Clin Belg 2017;72(4):278–88.
25. Skolnik S. Acute inhalation exposure to hydrogen fluoride: Acute inhalation
exposure to hydrogen fluoride. J Occup Environ Hyg 2010;7(6):D31–3.
26. Tsonis L, Hantsch-Bardsley C, Gamelli RL. Hydrofluoric acid inhalation
injury. J Burn Care Res 2008;29(5):852–5.
27. Shin JS, Lee SW, Kim NH, et al. Successful extracorporeal life support
after potentially fatal pulmonary edema caused by inhalation of nitric and
hydrofluoric acid fumes. Resuscitation 2007;75(1):184–8.
28. Zierold D, Chauviere M. Hydrogen fluoride inhalation injury due to a fire
suppression system. Mil Med 2012;177(1):108–12.
29. Kono K, Watanabe T, Dote T, et al. Successful treatments of lung injury
and skin burn due to hydrofluoric acid exposure. Int Arch Occup Environ
Health 2000;73 Suppl:S93–7.
30. Lee YJ, Jeong IB. Chemical pneumonitis by prolonged hydrogen fluoride
inhalation. Respir Med Case Rep 2021;32:101338.
31. Franzblau A, Sahakian N. Asthma following household exposure to
hydrofluoric acid. Am J Ind Med 2003;44(3):321–4.
32. Dayal HH, Brodwick M, Morris R, et al. A community-based epidemiologic
study of health sequelae of exposure to hydrofluoric acid. Ann Epidemiol
1992;2(3):213–30.
33. Lund K, Dunster C, Ramis I, et al. Inflammatory markers in bronchial
Veolar lavage fluid from human volunteers 2 hours after hydrogen fluoride
exposure. Hum Exp Toxicol 2005;24(3):101–8.
34. Choe MSP, Lee MJ, Seo KS, et al. Application of calcium nebulization for mass
exposure to an accidental hydrofluoric acid spill. Burns 2020;46(6):1337–46.
35. Na JY, Woo KH, Yoon SY, et al. Acute symptoms after a community hy
drogen fluoride spill. Ann Occup Environ Med 2013;25(1):17.
36. Wing JS, Brender JD, Sanderson LM, Perrotta DM, Beauchamp RA.
Acute health effects in a community after a release of hydrofluoric acid. Arch
Environ Health 1991;46(3):155–60.
37. Gallerani M, Bettoli V, Peron L, Manfredini R. Systemic and topical effects of
intradermal hydrofluoric acid. Am J Emerg Med 1998;16(5):521–2.
38. Waldbott GL, Lee JR. Toxicity from repeated low-grade exposure to hydrogen
fluoride – case report. Clin Toxicol 1978;13(3):391–402.

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MSB1960 - August 2022 ISBN 978-91-7927-269-2

Smoke Exposure in Case of Li-Ion Battery Fire

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Smoke exposure in case of Li-ion battery fire

© The Swedish Agency for Community Protection and Preparedness (MSB)

MSB's contact person: Yvonne Näsman, 0102-404 030

Publication number: MSB1960 - August 2022

thanked: • Head of Center, Arne Broch Brantsæter, Nasjonal behandlingstjeneste for

Remember for emergency personnel

A. Rescue response - factors related to Li-ion battery fire

B. Rescue operation - general assessment of smoke gas exposed

C. Rescue operation by paramedics - treatment of fumes

Treatment against specific gas components •

response reports _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3.2 Data 12

from the Greater Stockholm Fire Service (SSB) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3.3 14

Validation of MSB data regarding claims against healthcare data _ _ 14

cases in Central Sweden _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 18

Technical battery properties _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 19 5.1.2 Thermal rush in a Li-ion battery _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 21 5.1.6 Primer and rust protection _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 21 5.1.7 Composites such as

carbon fiber 21 5.1.8 Future electric drive batteries 21 21 21 22 23

5.2 Physiological effect on humans _______________________________________

5.2.1 Heat 5.2.2 Burn – extent and __________________________________________________________________

depth _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 5.2 .3 Medical effects of fire gases _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

6. Summary and discussion _______________________________________

8. Hydrogen fluoride (HF) in liquid and gas form _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

8 Smoke gas exposure in case of Li-ion battery fire

• MSB 2020; Electric vehicles and rescue •

Gas Li-ion battery: •

Smoke exposure in case of Li-ion battery fire 9

10 Smoke gas exposure in case of Li-ion battery fire

Smoke gas exposure in case of Li-ion battery fire 11

3. Some data regarding

3.1 Data from MSB's performance reports

Mobile phone 54 1 (1) 1 (2)

Computer/reading tablet 49 1 (1) 2 (4)

Hoverboard 45 1 (1) 5 (9)

Electric bike 42 6 (9) 5 (7)

Toy/hobby item 38 1 (2) 0

Scooter 35 1 (2) 1 (1)

Power bank 18 1 (2) 0

Electric moped/motorcycle 15 1 (1) 1 (2)

Other object 26 4 (4) 3 (12)

Amount 354 17 (23) 19 (39)

12 Smoke gas exposure in case of Li-ion battery fire

Some data regarding objects and victims

charging indoors, plus various other Li-ion batteries on charge.

Smoke gas exposure in Li-ion battery fire 13

Some data regarding objects and victims

3.2 Data from the Greater Stockholm Fire

Table 2. Fire objects in SSB's study (From & Wiberg, 2020)

Subject Total events

Electric bike battery 7

Radio controlled model 1

3.3 Validation of MSB data regarding

14 Smoke gas exposure in Li-ion battery fire

Some data regarding objects and victims

corresponding events that were also found in CBRNE management

• No special HF-related systemic effects (ie effects on internal organs

Smoke gas exposure in Li-ion battery fire 15