Domiciliary oxygen and smoking: an explosive combination

Home oxygen therapy has been used to provide symptomatic relief of breathle ssness for more than 20 yr. Continuous low-flow oxygen can improve exercise tolerance and decrease pulmonary hypertension in patients suffering from c hronic obstructive airway disease. The majority of these patients have been long-time smokers. Despite routine warnings about potential dangers, a con siderable number of patients will continue to smoke whilst on oxygen. The i ncidence of burn injuries related to this practice is not known. Reports of such incidents are, however, very rare. Twenty-one patients who sustained head and neck burn injuries secondary to cigarette related ignition of thei r oxygen delivery system were admitted to our burn unit over a 7-yr period (1990-1997). All patients (mean age 60.4 yr) had been informed about the as sociated risks but did not shut off their supplemental oxygen system during smoking. The mean size of their burn injuries was 2% of the total body sur face, mainly affecting the face, ears, and neck. The average duration of th e hospital stay was 3.6 days. Two patients required split-thickness skin gr afting. Whether chronically ill patients on domiciliary oxygen who continue to smoke covertly are amenable to medical advice to abandon this habit is questionable. A more aggressive education about the explosive nature of the ir activity should help to prevent them from using tobacco and oxygen at th e same time. (C) 1998 Elsevier Science Ltd for ISBI. All rights reserved.