Doctors stress smoking, oxygen therapy don’t mix

More than 35 patients, mostly seniors, treated for burns over past 10 years

EDMONTON – Alberta Health Services (AHS) and physicians and staff at the University of Alberta Hospital (UAH) are concerned about the ongoing incidence of burn injuries sustained by patients who smoke while using oxygen therapy.

The use of long-term home oxygen therapy has become increasingly common for the treatment of chronic pulmonary diseases, such as chronic obstructive pulmonary disease (COPD) and terminal lung cancer.

Over the past 10 years, the Firefighters Burn Treatment Unit at the UAH has treated more than 35 patients, predominantly seniors, with mild to severe burns on their face, hands and body as a result of smoking while on oxygen therapy.

“Smoking while using oxygen can cause very serious, permanent painful injuries that can require mechanical ventilation, skin graft surgeries and extensive hospital stays,” say Dr. Edward Tredget, Director of the Firefighters Burn Treatment Unit. “In some cases, we have seen patients die as a result of burns from an absolutely preventable injury.”

Normal air contains 21 per cent oxygen, while supplemental oxygen can contain up to 100 per cent oxygen, creating an environment in which fires can easily ignite and burn quickly. Once ignited, fires burn hotter and more rapidly in oxygen-rich surroundings. This increases the danger of serious burns on the head and face if smoking materials are brought toward the mouth, and burns on the remainder of the body if clothing ignites.

“These patients differ from standard burn patients because they are older in age and have pre-existing lung problems,” says Dr. Tredget. “Although they often have burns to a smaller total body surface area, burns as a result of smoking while on oxygen cause higher rates of inhalation injury and require much longer lengths of hospitalization for patients.”

Patients who receive home oxygen therapy are instructed not to smoke, be near a smoker, or allow smoking inside a home where the supplemental oxygen is in use.

Al Pombert, 70, sustained burns to his face and head as the result of smoking a cigarette while on oxygen therapy in his long-term care facility last November.

“I heard the warning but I thought it would never happen to me,” says Pombert, who has COPD and emphysema. Although he was told he could not smoke while on oxygen therapy, he continued to light up.

“You can see the wounds of my mistake all over my face. I am the living example of what smoking on oxygen can look like.”

Pombert is sharing his story in the hope others don’t make the same mistake he did.

Smoking while on home oxygen therapy also put those who worked and lived in his long-term-care facility at risk.

“I haven’t had a cigarette since the day I ended up in the burn unit,” says Pombert, who started smoking when he was nine years old.

“I’m still on the mend, but I got the message. I would never smoke with oxygen again, nor would I ever be around someone who did. I still have a few reasons to live for.”

Burn Awareness Week in Alberta runs until Feb. 6.

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

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