For the folks being told by their PCPs/neurologists that they will not prescribe oxygen therapy for you citing the potential risk of fire associate with the use of home oxygen therapy because you smoke and that this risk outweighs the pain relieving benefits of oxygen therapy…  Here are a few facts you can use to challenge this obscene practice.

According to 2003-2006 data from the Consumer Product Safety Commission’s National Electronic Injury Surveillance System, home medical oxygen was involved in an average of 1,190 thermal burns (not all were home fires) seen annually at U.S. emergency rooms. Data from Version 5.0 of the U.S. Fire Administration’s National Fire Incident Reporting System (NFIRS) indicate that, in 2002-2005, U.S. fire departments responded to an estimated average of 182 home fires per year in which oxygen administration equipment was involved in ignition. Forty-six (46) people per year died in these fires.

The National Fire Protection Association (NFPA) statistics indicate that US fire departments responded to an estimated 1,602,000 fires in 2005. These fires caused 3,675 civilian deaths. There were 882 deaths from home fires attributed to smoking and 7%* of these deaths (61) involved the use of medical oxygen.  As a point of reference, cooking accounted for 32% of the house fires and 7% of the deaths (257).
(* J. Hall, M. Ahrens, K. Rohr, S. Gamache and J. Comoletti, 2006.

The Centers for Medicare and Medicaid Services (CMS) estimates the number of home oxygen users on Medicare in 2006 at 1,047,009.  These figures do not cover home oxygen users under 65 using private medical insurance or the number of home oxygen users 65 or over covered by private medical insurance not associated with Medicare, or people receiving home oxygen therapy under Medicaid.  Accordingly the actual number of home oxygen users is likely much larger than the Centers for Medicare & Medicare Services (CMS) figure of 1,047,009.

My Analysis:

As you can see there’s a difference between the number of deaths attributed to home fires where smoking and home oxygen equipment are involved by NFIRS and NFPA.  I’m sure there are other authoritative sources for information like this, but I’m confident there will be less than an order of magnitude difference.  Accordingly, for the sake of this analysis, I’ll use 64 as the larger number of the two.

Using the NFPA fire and fatality figures associated with smoking and oxygen equipment along with the 1,047,009 home oxygen users from CMS, that works out to 38 deaths per 100,000 among home oxygen users per year and 1 death per 5 million if you use the Nation’s population as is done by the CDC in calculating the death rates listed below for the leading causes of death in the US each year.

Now let’s put these figures into perspective…

2006 death rates per 100,000 in the US due to the following CDC listed causes and (Total Deaths by cause):

211 - Heart disease (631,636)
181 - Cancer (559,888)
 96 - Strokes (261,702)
 42 - Chronic lower respiratory diseases (124,583)
 19 - Influenza and Pneumonia (56,326)
 15 - Motor vehicle accidents (45,000)

The NFPA statistics indicate the following home fire deaths per year for the 1,602,000 home fires in 2005 by cause:

Cooking - 257
Smoking associated with home oxygen equipment – 64

That works out to 160 deaths per million (16 deaths per 100,000 for home cooking fires and 40 deaths per million (4 deaths per 100,000) where smoking and home oxygen equipment  were associated with home fires.

Discussion:

In looking over these death statistics, what jumps out at me is there are four (4) deaths from home fires due to cooking fires for every one (1) death due to home fires where smoking and oxygen equipment are listed as the probable cause…  More over, the death rate due to motor vehicle accidents is 3.7 times greater than deaths from home fires where oxygen equipment and smoking were involved.

This begs the following questions:

1. Does your neurologist tell you that you can’t have any food if you cook it?  

or...

2. Does your neurologist tell you not to drive to your appointments for cluster headaches?

If your PCP or neurologist tells you "Don't to confuse me with facts" after you've presented the government statistics above and still refuses to prescribe oxygen therapy for you, then you have the following options:

1. Offer to quit smoking if your PCP/neurologist will write you a prescription for home oxygen therapy. (Not a bad idea in any event and most doctors have big egos so they might just go for it.)

If that doesn't work...

2. Ask your PCP/neurologist to put this in writing by providing you with a signed written statement stating why you are being refused oxygen therapy.

If this request is refused, and you'll be looking for a new neurologist anyway, ask the following question:

3. Do you receive any incentives from GlaxoSmithKline or AstraZeneca?

Take care,

V/R, Batch

I think the dangers relating to flammability of oxygen are highly over-rated. First, oxygen by itself is not flammable or explosive, it is an accelerant. If you hold a cigarette lighter up to your face mask blasting out O2 at 15 LPM nothing happens except the O2 will either blow out the lighter, or maybe the flame will be a little brighter.

The real danger is in situations similar to laying in bed at night inhaling the O2 and smoking at the same time. You fall asleep and drop your cigarette on the bed setting it on fire. And the matress and blankets saturated with O2 burn MUCH FASTER than they would have otherwise.

If you smoke while using O2 (inhale O2... exhale... take a puff off a cigarette... exhale... inhale O2, etc), you lungs are not going to explode.

FrankF wrote on Jun 10^th, 2009 at 10:49pm:

If you smoke while using O2 (inhale O2... exhale... take a puff off a cigarette... exhale... inhale O2, etc), you lungs are not going to explode.

You are right, your lungs are NOT going to explode, but the practice you mention is a VERY dangerous, and not too bright a practice to follow!  The oxygen you are inhaling can permeate your clothing and even your hair, which makes them VERY flammable!

DO NOT smoke while using oxygen!!!

<shaking my head at the very THOUGHT of anyone doing this>

Chuck

FrankF wrote on Jun 10^th, 2009 at 10:49pm:

If you smoke while using O2 (inhale O2... exhale... take a puff off a cigarette... exhale... inhale O2, etc), you lungs are not going to explode.

You really are joking arn't you!

Barry

Yes I was. And I can't imagine wanting to smoke during a hit either.

FrankF wrote on Jun 11^th, 2009 at 8:32am:

Yes I was. And I can't imagine wanting to smoke during a hit either.

I always asked the same question.  If you were in dealing with a high Kip scale cluster (7 to 9), how could anybody in their right mind smoke.
I think smoking intensifies clusters.  It triggered them for me.
Since I quit, every area of clusters (duration, frequency, intensity, total cycle time) have been reduced for me.  Why make the pain worse?