A Growing Fire Hazard Concern in Communities: Home Oxygen Therapy and Continued Smoking Habits

Abstract

The Safe Home Care Project investigated both qualitatively and quantitatively a range of occupational safety and health hazards, as well as injury and illness prevention practices, among home care aides in Massachusetts. This article reports on a hazard identified by aides during the study's initial focus groups: smoking by home care clients on long-term oxygen therapy. Following the qualitative phase we conducted a cross-sectional survey among 1,249 aides and found that medical oxygen was present in 9 percent of aide visits (314 of aides' 3,484 recent client visits) and that 25 percent of clients on oxygen therapy were described as smokers. Based on our findings, the Board of Health in a local town conducted a pilot study to address fire hazards related to medical oxygen. Medical oxygen combined with smoking or other sources of ignition is a serious fire and explosion hazard that threatens not only workers who visit homes but also communities.

Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers

“…Six of 12 focus groups that were conducted during the Safe Home Care Project's presurvey qualitative phase brought up the problem of patients smoking while receiving home oxygen therapy. Below are examples from 3 different focus group reports by home care aides that illustrate this scenario34:…”

“…Medical oxygen combined with smoking or other sources of ignition is a serious fire and explosion hazard that threatens not only workers who visit homes but also community members (scenario 10) 34. Home cooking equipment, smoking materials, and heating equipment are leading causes of residential structure fires, injuries, and civilian home fire deaths 37.…”

“…The Safe Home Care survey results reinforced focus group findings. Medical oxygen was present in 9% of aide visits (314 of aides' 3484 recent client visits), and 25% of clients on oxygen therapy were described as smokers 34. Other HHC hazards that may not be visible in workers' compensation records but were cited by aides and their supervisors include bed bugs, infectious diseases, indoor air quality concerns (eg, secondhand smoking and the use of harsh cleaning chemicals), clutter/hoarding, and clients' pets 18…”

“…Both projects comprised 3 research phases: presurvey qualitative phase, cross-sectional survey, and postsurvey qualitative phase to interpret survey findings and recommend interventions. Detailed methods of the studies are reported elsewhere 16–19,24,26,27,30–34…”

Smoking-Related Home Oxygen Burn Injuries: Continued Cause for Alarm

“…We are not the first to recognize the risk posed by smoking on oxygen therapy to health care workers. A recent review identified that 9% of home health aid visits were to residences with home oxygen of which 25% patients were identified as smokers [12]. …”