Since the outbreak of the pandemic in March 2020, at least 38 (as of 11 June 2021) incidents of hospital fires associated with intense oxygen use have been found to have occurred in various countries around the world, causing the deaths of over 200 people and injuring many more.  The majority of the dead and injured were patients extremely ill with the novel Coronavirus and others were their health care providers. A review of past incidents reported in the global media indicates that the number of events in the last 12 months far exceeds the number of similar occurrences in any prior given year. 

The special issue of the Lessons Learned Bulletin (LLB) is intended to raise awareness of risks associated with oxygen-rich environments in hospitals due to intensified use of oxygen therapy. The pandemic has created a high reliance on providing supplemental oxygen to extremely ill patients to combat severe effects of the disease.  It is important for hospitals to be fully prepared for the elevated risk of fire associated with oxygen-rich environments, particularly in intensive care units where several oxygen ventilation units may be in operation. 

Most recently, on 25 April 2021, a fire in a Baghdad hospital treating Covid-19 patients purportedly started when an oxygen tank failed in storage, resulted in the deaths of at least 82 people (some from the fire and some from the lack of oxygen) and injury to over 100 others. According to a government spokesperson, there were no smoke detectors, sprinkler systems or fire hoses, and the fire spread even more quickly because of flammable material used in false ceilings in the intensive care ward. Only the day before, on 24 April 2021, 13 people died in a fire that started in the intensive care unit (ICU) of a Covid-19 hospital near Mumbai, India.

These events followed numerous other tragic and similar events. JRC research shows that there have been at least 20 incidents of fires caused by oxygen-rich environments in hospitals reported in the media in 2020, most of them in hospital intensive care units. Of these, 8 resulted in multiple fatalities. Although many hospitals successfully responded to such incidents and avoided injury, most events still required evacuation of staff and severely ill patients, while at the same time depriving oxygen ventilation to those in critical condition for the duration of the event.

The JRC is currently working on recommendations for applying  more rigorous risk management approaches. In particular, it will recommend borrowing strategies developed for chemical process safety to manage flammable and explosive atmospheres, so-called ATEX environments, so that there is no possibility of ignition when such hazards are present.