Recently a relative was sent home from the hospital with her own oxygen supply. It wasn’t a cylinder of compressed oxygen but an oxygen concentrator, a device that takes room air and removes a lot of the nitrogen by passing the air through a zeolite canister. These devices can supply 50 – 95% oxygen. About 1 million people over the age of 65 are on home based Long Term Oxygen Therapy (LTOH) supported by Medicare. Many of them need oxygen because they have chronic lung disease brought on by their addiction to cigarettes (not the case for my relative, however). Cigarettes. Oxygen. Not a good combination:
At 2:10 a.m. on December 14, 2007, a fire occurred in a public housing project for the elderly in Westbrook, Maine. Approximately 60 residents were evacuated; six were transported to a hospital for smoke inhalation. The fire was caused unintentionally by a woman aged 57 years who was an overnight guest of a relative who lived in the housing project. The visitor had ignited the fire while simultaneously smoking and using an oxygen concentrator. (CDC, Morbidity and Mortality Weekly Reports)
It’s not often we have a YouTube clip of the exact event described in a CDC MMWR report but that’s the case here:
Oxygen doesn’t explode. It is an accelerant, that is, it makes other things burn faster and more fiercely. This includes cigarettes:
Cigarettes on their own are the leading cause of house fires in the US. Unfortunately this event, smoking while oxygen therapy is in use nearby, is not unique or even Darwin Award material. While many people know that enriched oxygen atmospheres and flame are a bad combination, addictive behavior is addictive behavior. CDC cites estimates ranging from 5% to over 40% of people on LTOH continue to smoke. Prior to this case there were five case series in the medical literature involving 79 hospitalizations for burns and five deaths. After the Maine episode a survey was done of four states (Massachusetts, Maine, New Hampshire and Oklahoma) for the eaight years 2000 to 2007:
A total of 38 cases were identified: five in Maine, three in New Hampshire, 11 in Massachusetts, and 19 in Oklahoma. All incidents involved a single fatality except for one fire that resulted in two deaths. The overall fatality rate for the four states was 3.8 deaths per 10 million population per year. The highest fatality rate was in Oklahoma (6.7 per 10 million population), followed by Maine (4.8), New Hampshire (2.9), and Massachusetts (2.1). Decedents ranged in age from 9 to 87 years (median: 67 years); the death of a child aged 9 years was the only fatality involving a minor. Twenty-four (63%) decedents were female. Thirty-four (89%) of the decedents were on LTOT and were smoking at the time the fire began; three (8%) were household members of smokers on LTOT who survived, and one (3%) was a nonsmoker on LTOT who was unintentionally ignited by a smoker who lived in the household and survived. Twenty-two (58%) decedents died on the day of the fire, and seven (18%) died the following day. The remaining nine (24%) decedents survived a median of 15 days (range: 3–41 days). (CDC, MMWR)
Cigarettes cause chronic obstructive lung disease, heart disease and cancer in the smoker and increase the risk of these diseases to by-standers from second hand smoke. The cigarette industry destroys lives through disease and property by fire. Their product ruins countless lives. Cigarettes should be made prohibitively expensive with high taxes. Yes, that tends to penalize the poor more because they smoke more and have less disposable income. It is a regressive tax.
But it doesn’t penalize them as much as cancer or being burned out of their homes.