Other Titles
PechaKucha Presentation
Abstract
Purpose: Determine statewide home oxygen fire incidence and reduce risk.
Introduction: Patients using home oxygen therapy (HOT) face a high risk of burns and death. Smoking is the primary cause, and the number of HOT users who smoke is rising. HOT fires are a growing problem, threatening the lives of patients, family, friends, neighbors, home health workers, and first responders. Unfortunately, there is no way to accurately track HOT fires and outcomes. This project aimed to analyze statewide burn center, fire, and EMS data of HOT fire-related burns to better understand the scope of the problem, address fire prevalence, and reduce risk.
Methods: State fire marshal and inspectors, epidemiologists, injury prevention at 5 burn hospitals, and EMS were contacted about HOT fires and injuries from 2020-2023. Manual text query search of HOT-related terms was performed for deidentified admissions data and EMS data where HOT listed as a med.
Results: There are no ICD-10-CM codes for HOT-related injuries, creating a variance in data availability and making a complete estimate of statewide incidence impossible. Alternative injury codes and narrative free text fields showed: National Fire Incidence Reporting System (NFIRS) mean of 3.5 HOT fires/year (range 0-6) with 10 injuries, and 2 deaths; Fire inspectors mean of 10.3 HOT deaths/year (range 5-15) representing 10% of fatal residential fires; Death certificates mean of 10.3 HOT deaths/year (range 7-13), 93.3% attributed to smoking; Four burn centers mean of 17.9 HOT admissions/year each (range 13-31) with combined 4-year total 285 HOT admissions (range 51-124). One hospital could not identify HOT data due to no specific coding. Trauma epidemiology has no HOT data, as mandatory state reporting excludes burns. EMS data reported mean of 15.5 HOT burn calls/year. EMS data is currently being analyzed.
Conclusion: HOT fire-related deaths are occurring 20x more than reported in state data. Comparison to national data suggests 33% of HOT patients nationwide were treated by 4 hospitals in one state. This implausible finding can be explained by the lack of specific ICD-10-CM codes and substantial gaps in data tracking.
Applicability: Validates the need for HOT-specific ICD-10-CM codes addressing HOT fire injuries. These codes would allow for more accurate diagnosing and future data collection, inform statewide risk-reduction measures, and represent a benchmark from which other states can explore their own data and incidence rates.
Notes
References:
Ahrens, M. (2019). Home fires started by smoking [Research Report]. National Fire Protection Association. https://www.nfpa.org/-/media/Files/News-and-Research/Fire-statistics-and-reports/US-Fire-Problem/Fire-causes/ossmoking.ashx
Ahrens, M. (2021a). US fire death rates by state [Research Report]. National Fire Protection Association. https://www.nfpa.org//-/media/Files/News-and-Research/Fire-statistics-and-reports/US-Fire-Problem/osstate.pdf
Ahrens, M. (2021b). US fire death rates by state (Supporting Tables) [Research Report]. National Fire Protection Association (NFPA). https://www.nfpa.org/education-and-research/research/nfpa-research/fire-statistical-reports/fire-deaths-by-state
BPR Medical Ltd. (2019). Study report: The prevalence and impact of home oxygen fires in the U.S. http://www.firebreaks.info/wp-content/uploads/2019/09/BPR-Study-Report-2019-v5.1.pdf
Centers for Disease Control and Prevention. (2023, June 29). International classification of diseases, tenth revision, clinical modification (ICD-10-CM). National Center for Health Statistics. https://www.cdc.gov/nchs/icd/icd-10-cm.htm
Fire Safety Research Institute. (2021). Close your door. Close Before You Doze. https://closeyourdoor.org/#make-a-900-difference
Hall, S. (2023). Fires and burns involving home medical oxygen [Research Report]. National Fire Protection Association. https://www.nfpa.org/education-and-research/research/nfpa-research/fire-statistical-reports/fires-and-burns-involving-home-medical-oxygen
Jacobs, S. S., Krishnan, J. A., Lederer, D. J., Ghazipura, M., Hossain, T., Tan, A.-Y. M., Carlin, B., Drummond, M., Ekström, M., Garvey, C., Graney, B. A., Jackson, B., Kallstrom, T., Knight, S. L., Lindell, K., Prieto-Centurion, V., Renzoni, E. A., Ryerson, C. J., Schneidman, A.,...Holland, A. E. (2020). Home oxygen therapy for adults with chronic lung disease: An official American Thoracic Society clinical practice guideline. American Journal of Respiratory and Critical Care Medicine, 202(10), e121–e141. https://doi.org/10.1164/rccm.202009-3608st
Simkovich, S. M., Goodman, D., Roa, C., Crocker, M. E., Gianella, G. E., Kirenga, B. J., Wise, R. A., & Checkley, W. (2019). The health and social implications of household air pollution and respiratory diseases. NPJ Primary Care Respiratory Medicine, 29(1). https://doi.org/10.1038/s41533-019-0126-x
Singer, K. E., Harvey, J. A., Heh, V., & Dale, E. L. (2020). Mortality from burns sustained on home oxygen therapy exceeds predicted mortality. Journal of Burn Care & Research, 41(5), 976–980. https://doi.org/10.1093/jbcr/iraa097
Sigma Membership
Upsilon Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Equity or Social Determinants of Health, Acute Care, Policy and Advocacy, Home Oxygen Fires, Home Oxygen Therapy
Recommended Citation
Auber, Mary; Anderson, Sue; and Klas, Karla S., "Home Oxygen Fires: A Statewide Retrospective Review of Injuries and Fatalities" (2025). International Nursing Research Congress (INRC). 132.
https://www.sigmarepository.org/inrc/2025/presentations_2025/132
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Home Oxygen Fires: A Statewide Retrospective Review of Injuries and Fatalities
Seattle, Washington, USA
Purpose: Determine statewide home oxygen fire incidence and reduce risk.
Introduction: Patients using home oxygen therapy (HOT) face a high risk of burns and death. Smoking is the primary cause, and the number of HOT users who smoke is rising. HOT fires are a growing problem, threatening the lives of patients, family, friends, neighbors, home health workers, and first responders. Unfortunately, there is no way to accurately track HOT fires and outcomes. This project aimed to analyze statewide burn center, fire, and EMS data of HOT fire-related burns to better understand the scope of the problem, address fire prevalence, and reduce risk.
Methods: State fire marshal and inspectors, epidemiologists, injury prevention at 5 burn hospitals, and EMS were contacted about HOT fires and injuries from 2020-2023. Manual text query search of HOT-related terms was performed for deidentified admissions data and EMS data where HOT listed as a med.
Results: There are no ICD-10-CM codes for HOT-related injuries, creating a variance in data availability and making a complete estimate of statewide incidence impossible. Alternative injury codes and narrative free text fields showed: National Fire Incidence Reporting System (NFIRS) mean of 3.5 HOT fires/year (range 0-6) with 10 injuries, and 2 deaths; Fire inspectors mean of 10.3 HOT deaths/year (range 5-15) representing 10% of fatal residential fires; Death certificates mean of 10.3 HOT deaths/year (range 7-13), 93.3% attributed to smoking; Four burn centers mean of 17.9 HOT admissions/year each (range 13-31) with combined 4-year total 285 HOT admissions (range 51-124). One hospital could not identify HOT data due to no specific coding. Trauma epidemiology has no HOT data, as mandatory state reporting excludes burns. EMS data reported mean of 15.5 HOT burn calls/year. EMS data is currently being analyzed.
Conclusion: HOT fire-related deaths are occurring 20x more than reported in state data. Comparison to national data suggests 33% of HOT patients nationwide were treated by 4 hospitals in one state. This implausible finding can be explained by the lack of specific ICD-10-CM codes and substantial gaps in data tracking.
Applicability: Validates the need for HOT-specific ICD-10-CM codes addressing HOT fire injuries. These codes would allow for more accurate diagnosing and future data collection, inform statewide risk-reduction measures, and represent a benchmark from which other states can explore their own data and incidence rates.
Description
Home oxygen therapy (HOT) users face high risk of burns and death. Currently, there is no way to track HOT fires and outcomes. This project explored 2020-2023 statewide hospital, fire, and EMS data to establish incidence and inform risk-reduction. Findings show HOT deaths are 20x more than state reports. Comparison to national data suggests 33% of all HOT patients were treated by 4 burn hospitals in 1 state. This implausible finding could be explained by the lack of HOT-specific ICD-10-CM codes.