Tuesday, February 16, 2010

Smoking and Home Oxygen: Doubling the Danger

State Fire Marshal Stephen Coan, Colleen Ryan, MD, Michele Reyen, MPH, and Paul Currier, MD launch the home oxygen safety campaign at MGH on January 21, 2010.

As the baby boomer generation ages, the prevalence of patients using portable medical oxygen to treat pulmonary diseases is on the rise. While this treatment helps patients live richer lives with increased independence, it’s critical that those who use home oxygen understand the associated risks. Normally, the air we breathe every day contains around 20 percent oxygen. The air delivered to patients using this therapy contains nearly 100 percent, making it extremely flammable. Individuals using home oxygen need to be particularly vigilant in keeping the system away from candle flames and other heat sources in the home. Additionally, there is an extremely elevated risk to smokers who use home oxygen.

Smokers who use home oxygen may understand the need to turn the tank off before lighting up, but may not realize that the danger persists, even when the oxygen isn’t flowing. Oxygen can build up not only in the home, but on the hair, clothes, and body of the patient and ignite when a heat source—like a cigarette—comes close to the face, causing severe burns.

“We see too many cases where patients are badly burned because they were smoking while using home oxygen,” says Colleen Ryan, MD, a surgeon in the Sumner Redstone Burn Center at Massachusetts General Hospital (MGH). “These injuries are completely preventable and it’s important that patients and their families understand the risk.”

Ryan is a member of State Fire Marshal Stephen D. Coan’s Task Force on Home Oxygen Safety. On Thursday, January 21, Coan, Ryan, MGH staff, and state fire officials unveiled a new public awareness campaign designed to educated doctors, patients, and family members about the risks of smoking and portable medical oxygen.

“Tragic blazes such as the Quincy fire on December 26, 2009, the Whitman fire last May, and the South Boston fire of 2002 — where a smoker using home oxygen ignited a fire resulting in the death of an eight-year-old girl — highlight the risks associated with home oxygen use,” says State Fire Marshal Coan.

Along with putting the patient at risk, home oxygen fires are a major public health concern. Since 1997, home oxygen has been involved in 24 fire-related fatalities in Massachusetts, caused more than 50 serious injuries, seven firefighter injuries and 69 identifiable incidents. In 2009 alone there were five severe fire incidents with home oxygen; one involved a candle and four involved smoking.

There is no safe way to smoke when using home oxygen. Until patients quit, they can practice safer smoking. Should an individual need to smoke, it’s important to first turn off the tank, and wait 10 full minutes before going outside to smoke. This practice should decrease the amount of oxygen in the home and on the person. The best way for patients to protect themselves, their families, neighbors, and emergency responders is to quit smoking. To start, patients should have a conversation with their doctors to find out what resources are available. MGH offers a wide range of assistance programs through its Tobacco Treatment Service. For more information on help quitting, smokers can call (617) 726-7443, email tobaccotreatment@partners.org, or visit the Tobacco Treatment Service  online. Patients using home oxygen should speak with their doctors and vendors about the possible risks involved with the equipment. For more information on the dangers of portable medical oxygen please visit the Department of Fire Safety.

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