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Lore & Background

Oxygen is not flammable, but when it is present in increased concentrations it will enable fires to start much more easily. Once a fire has started, if supplemental oxygen is present it will burn more fiercely, based on the principle of the fire triangle. Materials that do not burn in ambient air may burn when there is a greater concentration of oxygen present than there is in air. Most home oxygen fires are caused by patients smoking whilst using medical oxygen. Other sources of naked flames, such as gas flames and birthday candles, can also pose a risk. Despite the inherent dangers, researchers estimate that between 10 and 50 per cent of home oxygen patients continue to smoke. Once a fire has started in the patient's nasal cannula it will track back towards the oxygen source and if not stopped may lead to a 'whole house' fire. Whole house fires are directly correlated with single or even multiple deaths. According to the US National Fire Protection Association (NFPA), 25% of oxygen fires get beyond the immediate surrounding area to become 'whole house' fires. While an oxygen firebreak / thermal fuse cannot stop the initial ignition, it can limit the potential for whole house fires, more serious injury and death. Firebreaks / thermal fuses can also buy more time for a patient and other individuals in the building to escape, and limit the material cost of fire damage.

In Their Own Story

In July 2025, a major fire in the Gabriel House assisted living facility in Fall River, Massachusetts, killed 10 residents and injured more than 30 people, including six firefighters. Preliminary findings trace the point of origin to a single second-floor studio where either a malfunctioning oxygen concentrator or discarded smoking materials ignited in an oxygen-enriched atmosphere. Bristol County District Attorney Thomas M. Quinn III, described the incident as "the greatest loss of life to fire in Massachusetts in more than 40 years". On July 31, 2025, in North El Paso, Texas, three people were hurt and one seriously injured when a house fire erupted. An investigation determined the cause to be "the unintentional ignition of common combustibles due to careless smoking, with a contributing factor being an oxygen-enriched environment from a medical oxygen tank." On May 6, 2025, over 250 occupants of the Wyndham Crossing apartment complex in North East Edmonton, Alberta, Canada were left homeless after a fire ignited as a result of a person smoking while on oxygen inside one of the suites. Due to wind conditions, the fire turned into an immense blaze, with almost all units expected to have sustained either fire or water damage from the firefighting effort.

Reader's Guide

A study published in September 2019 analyzed media reports of home oxygen fire incidents between December 2017 and August 2019, finding 311 incidents resulting in 164 deaths, equivalent to one patient death every four days. It also found that a third of reported incidents referenced exploding cylinders, posing a significant risk to third parties, including emergency services. The study estimates that there are between 100 and 150 deaths every year from home oxygen fires in the US. Further research published in November 2021 examined media reports between August 2019 and July 2021, recording 256 incidents and 152 deaths in this 23-month period, equating to a death every four days. Over the total study period of 3.5 years, there were 567 fires involving home oxygen and 316 deaths, including two firefighters who lost their lives. The new report also draws on a study by Wake Forest Baptist Medical Center in 2020 which found home oxygen fires cause at least 1,000 burn injuries per year. In 2008 the NFPA published a report suggesting that there are 46 deaths each year in the US from 182 fires, and that US hospital emergency rooms deal with an average 1,190 cases of burns each year as a result of home oxygen fires. However, the NFPA describes these statistics as "likely underestimates". In England and Wales, after firebreaks became mandatory in 2006, the average number of deaths by fire was 0.36 per thousand patients per year. In the US, where firebreaks were not required, almost twice as many patients (0.62 patients per thousand) died. A Freedom of Information request in 2018 revealed that only one fatality relating to home oxygen fires was recorded in the five-year period between 2013 and 2017.

Did You Know?

• Oxygen is not flammable, but when present in increased concentrations it will enable fires to start much more easily.
• Researchers estimate that between 10 and 50 per cent of home oxygen patients continue to smoke despite the dangers.
• According to the NFPA, 25% of oxygen fires get beyond the immediate surrounding area to become 'whole house' fires.
• A study found that between December 2017 and August 2019, there were 311 home oxygen fire incidents resulting in 164 deaths in the US.
• In England and Wales, after firebreaks became mandatory in 2006, the average number of deaths by fire was 0.36 per thousand patients per year, compared to 0.62 in the US where firebreaks were not required.