A couple of years ago while working for a home health agency in Riverside County, I arrived at a patient's home who had severe COPD. She had just gotten out of the hospital for COPD exacerbation and I was there to do a follow-up and make sure she was adequately managing her medications and home oxygen.
As I began my assessment, to my dismay she lit up a cigarette while wearing her oxygen cannula. When I kindly asked her to put it out, she replied "this is my house and I will smoke if I want". I agreed with her that yes, it was her house, but that it was unsafe for both she and I if she lit up while attached to her oxygen and that if she did not put the cigarette out, I would have to discontinue my visit. Although she did extinguish her cigarette, the story remains fresh in my mind to this day as deaths due to cigarette smoking and oxygen are on the rise.
According to the CDC, approximately 1 million people in the United States receive long-term oxygen therapy, (LTOT) most of whom suffer from chronic lung disease. Between 2000 and 2007, the CDC conducted a study involving four states: Maine, Massachusetts, New Hampshire and Oklahoma. A total of 38 deaths were identified during this time frame involving fires: five in Maine, three in New Hampshire, 11 in Massachusetts and 19 in Oklahoma. Of these, 34 (89%) of the people who died were on LTOT and were smoking at the time the fire started.
Fires related to smoking are the leading cause of house fire fatalities in the United States. Although the precise number is unknown, the CDC estimates that between 10% to 43% of patients using LTOT at home continue to smoke in its presence placing themselves and others in the home in great danger.
If you are using LTOT, here are some helpful safety tips:
- Do NOT use oxygen around open flames, such as matches, cigarette lighters, candles or cigarettes.
- Do NOT use oxygen around other sources of heat, such as electric or gas heaters and/or stoves.
- If you are using supplemental oxygen, avoid using lotions or creams containing petroleum -- the combustion of flammable products containing petroleum can also be supported by the presence of oxygen.
- Store oxygen cylinders safely in a secure, upright position in an approved place for storage.
- Turn oxygen supply valves off when not in use.
- Pay close attention to the safety instructions recommended by your oxygen supply company, regarding safe usage and storage of supplemental oxygen.
For more information, read Oxygen Therapy and COPD.
Are you a smoker who smokes while using oxygen? Please take the attached, anonymous poll.
CDC MMWR. Fatal Fires Associated with Smoking During Long-Term Oxygen Therapy --- Maine, Massachusetts, New Hampshire, and Oklahoma, 2000--2007. August 8, 2008 / 57(31);852-854.