Playing with Fire – Staying Safe Using Home Oxygen Therapy

Oxygen therapy can be very beneficial to people with COPD, but you have to be careful. Every year in the US there are over 180 home fires involving home oxygen therapy equipment. These fires result in more than 70 deaths and emergency departments treat over 1,000 people for burns. The good news is that you can take steps to minimize the risk. These include above all never smoking while using oxygen therapy and being careful to avoid naked flames or sparks.

Another precaution is fitting firebreaks (also called thermal fuses, fire safety valves or fire stop valves), into the tubing from your oxygen supply. These don’t stop the fire from starting, but they can stop fire from spreading and save your life and other peoples’ lives. In Europe, firebreaks must be fitted to all oxygen installations. In the US, the Veteran’s Health Administration (VA) also takes the issue seriously. It has just made thermal fuses compulsory for all its 85,000 home oxygen users.

Here are a few of the commonly asked questions around oxygen and fire safety:

Why do I need to be careful with oxygen?
Oxygen is one of the three things a fire needs to start and keep going – the others are fuel and heat. If one of these is not there, a fire will not start, and a fire that is already burning will go out.

What precautions can I can take to avoid fire?
The most important thing you can do to reduce the risk of a fire when using home oxygen, is to not smoke. If you are finding it hard to give up smoking, there are many in ways in which your healthcare providers can support you, such as nicotine replacement therapy. Your relatives, visitors, carers, or neighbors should also be told to not smoke in your house. Make sure you have a smoke detector, that it is working, and plan safe exit routes from your home in the event of a fire. Your oxygen concentrator and any cylinders should also be positioned in a well-ventilated room, away from any naked flames, and cooking or heating appliances.

What are firebreaks?
Firebreaks are safety devices that can be very easily installed in the tubing that attaches to your home oxygen equipment – they are designed to cut off the flow of oxygen in case of a fire in the oxygen tubing. Stopping the flow of oxygen stops the fire in the tube from burning. As I said before, they do not prevent a fire from starting – and they are not a substitute for following other safety precautions like not smoking - but they can stop a fire from spreading and limit the extent of any injuries and damage to property.

Where should firebreaks be fitted?
Two firebreaks should be fitted on every oxygen installation, so two on your concentrator or cylinder and two on your portable oxygen if you use it. The first should be close to your face where the two nasal cannula tubes join, or in the mask tubing, to limit burn injuries. The second should be near the oxygen outlet – this stops the fire from spreading.

Do I need firebreaks even if I don’t smoke?
Most home oxygen fires (over 7 out of 10) are caused by tobacco smoking. But any naked flame can start a fire, such as a stove or oven, candles, matches or lighters, and gas grills. Some fire hazards may not be immediately obvious, like flammable liquids (paint thinners, cleaning fluids) and objects that can cause sparks, such as some electric shavers or children’s toys. So it’s better to be cautious and fit firebreaks.

I use cylinder or liquid oxygen. Do I still need firebreaks?
Yes. Firebreaks are recommended for all cylinder and liquid oxygen systems, as well as oxygen concentrators.

What should I do if I want a firebreak?
Your home oxygen service provider, respiratory specialist, healthcare manager and insurer should make sure they understand the safety standards that your home oxygen needs to comply with. First though, check with your home oxygen service provider whether your equipment contains firebreaks and if they are installed and positioned correctly.

Finally, remember that although home oxygen is a fire hazard – by planning ahead and following sensible precautions, you can minimize the risk of a fire, and stay safe.

Richard Radford is from BPR Medical and is a leading expert in oxygen fire safety.