Fire Safety When Someone Uses Oxygen Therapy

Oxygen therapy keeps people out of hospital and at home, but it changes how fire behaves in that home. Oxygen itself is not flammable, yet it creates an oxygen-enriched environment in which fires start more easily and burn much faster and hotter¹. Even at low flows it can saturate clothing, furniture and carpets, so a small flame that would normally smoulder can spread rapidly².

The practical rules are simple. Never smoke or allow anyone else to smoke near the equipment, and never smoke in bed³. Keep oxygen equipment away from fires, heaters and naked flames, and keep tubing clear of gas fires, cookers and candles⁴. Turn the supply off when you have finished using it⁶. After you switch off, oxygen can remain in clothing for up to 20 minutes, so ventilate clothing in the open air for at least 20 minutes before going near a flame or ignition source⁵.

A free home fire safety visit from your local fire and rescue service can check your home, give advice and fit smoke alarms where needed⁷. Each floor of your home should have a working smoke alarm, tested at least once a month⁶. If a fire starts, get out, stay out and call 999⁸.

Oxygen is not flammable, but it makes fires start more easily and burn faster

This is the fact that makes every other rule on this page make sense. Oxygen is not itself a fuel, but it can create an oxygen-enriched environment, which means fires can start more easily and burn much faster and hotter¹. Fire services put it more strongly: oxygen significantly increases flammability, making materials that would not typically catch fire easily much more combustible³. It supports combustion and can accelerate fire incidents¹⁰.

The reason is that extra oxygen in the air makes a fire burn more quickly¹¹. Oxygen, even at low flows, can saturate everyday items such as clothing, furniture and carpets, creating an environment where fires can ignite and spread rapidly². The oxygen-rich atmosphere stays within clothing and furnishings, which creates an increased risk of rapid fire spread and is a particular risk for smokers⁶.

That last point matters because of who uses home oxygen. It is prescribed for conditions such as COPD, emphysema, cystic fibrosis, chronic asthma, lung cancer and other lung disorders⁵. Many of those conditions are smoking-related, and fire services note that users often continue to smoke, even though oxygen is a gas that helps things burn and can react explosively when dirt, grease or naked flames are exposed to it¹².

The window of danger is wider than the time the machine is running. A fire can start and spread extremely quickly if a heat or ignition source, such as a cigarette, heater, candle or even static electricity, is present while oxygen is in use or within 30 minutes after it is switched off¹. Treat the room as an oxygen-rich space for half an hour after the equipment stops.

No smoking near oxygen, and 30 minutes before you use it again

Smoking is the single biggest danger in a home with oxygen. Never smoke or let anyone else smoke while you are using oxygen¹³. Never smoke, or let anyone else smoke near you, while using your oxygen equipment, and never smoke in bed³. Never smoke while using oxygen or emollients¹⁴.

The 30-minute rule runs in both directions. Do not use your oxygen supply for at least 30 minutes after you have finished smoking, to reduce your risk⁶. And allow at least 30 minutes after you have removed your oxygen before cooking¹⁵. If you are a carer, talk to the person you care for about the fire risk of introducing an ignition source close to their oxygen or in an oxygen-enriched environment, especially staying away from smoking materials, naked flames and open fires¹⁶.

Northern Ireland Fire and Rescue Service sets out the smoking rules in full, and they are worth reading even if you live elsewhere:

Smoking materials are a leading cause of house fires¹⁷. In an oxygen-rich room they are far more dangerous, because bedding, clothing and upholstery that have absorbed oxygen will catch and spread fire much faster than usual².

Oxygen stays in clothing for up to 20 minutes after you turn it off

Turning the equipment off does not make the room safe straight away. Oxygen can remain in clothing for up to 20 minutes after the oxygen equipment has been turned off, and fire services advise ventilating your clothing in the open air for at least 20 minutes before smoking or going near an open flame or source of ignition³. Greater Manchester Fire and Rescue Service gives the same figure: oxygen will remain in clothing for up to 20 minutes after the home oxygen equipment has been turned off, so always ventilate clothing in the open air for at least 20 minutes before smoking or going near an open flame or ignition source⁵.

Some fire service guidance says to stay away from smoking for at least 30 minutes after the equipment is switched off, while other guidance gives 20 minutes for clothing. Where the two figures differ, follow the longer one: keep away from flames and cigarettes for at least 30 minutes after switching off, and air clothing outside for at least 20 minutes.

The same logic applies to soft furnishings. Because oxygen saturates furniture and carpets as well as clothing², a cushion or blanket that has been in an oxygen-rich room should be treated with the same caution. Keep bedding and upholstery away from ignition sources, and never smoke in bed³.

Storing and using oxygen equipment away from heat and flames

Store oxygen equipment in a well-ventilated area, kept clean, dry and away from heat sources and naked flames, including gas or electric fires and cookers⁵. Store cylinders away from flammable materials such as oils, greases and aerosol cans, ignition sources, electrical devices, and locations prone to high temperatures¹⁰. Keep oxygen equipment away from fires, heaters and naked flames⁴.

Distance matters. One fire and rescue service recommends that oxygen should be kept a minimum of 3 metres away from any open flame, including gas and electric cookers⁹. Another advises keeping oxygen at least six feet (two metres) away from flames or heat sources such as gas cookers, paraffin or gas heaters, candles, cigarettes, cigars and fireplaces¹³. The two figures differ; the 3 metre figure is the more cautious, and it is the one to work to where space allows.

Tubing is easy to overlook. Do not allow the home oxygen tubing to pass close to naked flames including gas fires, gas cookers and candles, or hot items such as electric cookers or electric heaters⁵. A tube draped across a hob or trailing past a fire is a direct route for a flame to reach the supply.

Keep the equipment clean and dry, and dry it properly before using it again¹⁹. Never attempt to repair or modify the equipment yourself; contact your oxygen supplier for further information or advice about your equipment³.

Keeping air moving: open internal doors and ventilate rooms

Oxygen can build up and concentrate in a closed room or confined space, but disperses easily in a well-ventilated room. Fire services advise keeping internal doors open when using oxygen⁶. That runs against the usual fire safety advice to close doors, so it needs care: keep the area around internal doors clear so they can be closed, because closing doors in rooms limits the spread of fire and smoke²⁰. The balance is to ventilate while you are using oxygen, and to be able to close doors quickly if a fire starts.

At night, close internal doors. It will help keep your rooms warm and reduce fire and smoke spread if a fire starts²¹. Closed internal doors can help slow the spread of fire and smoke, and if a fire starts, get out, stay out and call 999²².

When you ventilate, do not compromise other aspects of safety and security, for example by propping open fire doors²³. Open a window or an internal door rather than wedging open a door that is there to hold back fire.

Smoke alarms, fire service home visits and who to contact

Each floor of your home should have a working smoke alarm, and they should be tested at least once a month⁶. If you need alarms or advice, your local fire and rescue service can help. In Wales, a home safety visit includes free home safety advice and equipment, and if needed smoke alarms and carbon monoxide alarms will be provided⁷. In Dorset, you can call 0800 05 02 999 or complete an online referral form to request a home fire safety visit²⁴. In Cornwall, you can register online for a Free Home Fire Safety Check or by calling 0800 3581 999²⁵. Greater Manchester runs a Home Fire Safety Assessment: complete the online home fire safety check and, if eligible, you will be asked to submit contact details and the service will telephone to arrange the visit²⁶. Warwickshire offers a Safe and Well visit to check the safety of your home¹⁰.

You may not need to register at all. One fire and rescue service states that you no longer need to inform the fire service if you use oxygen, unless you wish to request a home visit⁶. Arrangements vary between services, so check with your local one.

The National Fire Chiefs Council online home fire safety check can be completed by the home occupant directly, by a third party such as a police officer, social worker or paramedic who has concerns about someone's welfare or safety, or by the fire and rescue service itself²⁷. If you care for someone who uses oxygen, include and record fire safety in your assessments and care planning¹⁸, and involve the person in decisions about their fire safety and talk to them about what to do if a fire starts or their alarm activates¹⁶.

For advice about the oxygen equipment itself, contact your supplier³. For a fire, get out, stay out and call 999⁸.

If you are building a wider plan for the household, our guide to what to do if a fire starts in your house and our fire safety checklist cover the rest of the home, and Extra Help in an Emergency explains support for medically dependent households.