Fire fatalities in long term oxygen therapy users due to smoking: A description and analysis of 11 deaths
Bibliographic record
Abstract
RATIONALE: Many patients suffering hypoxemia due to chronic lung or cardiac disease can benefit from long term oxygen therapy (LTOT) in the out-of-hospital setting. A primary indication for LTOT is chronic obstructive pulmonary disease (COPD), and COPD is most commonly due to chronic smoking. As such, many patients for whom LTOT is indicated are active smokers, despite recommendations to quit. Smoking near a purified oxygen source increases the risk of fire and possible death.OBJECTIVES The objectives of this study were to determine the incidence of LTOT-associated fire deaths within Ontario, Canada.METHODS Data regarding LTOT-associated fire deaths in Ontario over a 15-year period (2004–2018) was compiled using provincial Coroner and Forensic Pathology records and compared with client user data from the Home Oxygen Reimbursement Program (Ontario Ministry of Health: Assistive Devices Program).MAIN RESULTS: Herein, we present the circumstances and pathological findings of 11 deaths. We identified 7 males and 4 females with an average age of 69 that all died in their homes from fire complications resulting from smoking while using LTOT. Nearly all decedents were alone when the fire started, and most were pronounced dead within 2 hours of the fire starting. Death was most often a complication of smoke/hot gas inhalation in the setting of chronic lung and/or heart disease. Only 2 cases showed evidence of carbon monoxide poisoning (carboxyhemoglobinemia) contributing to death.CONCLUSION We advocate increased vigilance in the selection, support and monitoring of patients using LTOT that continue to smoke due to the risk for harm, including death.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".