On 24 April 2021, a disastrous fire in an Iraqi hospital took the lives of 82 people. Since the outbreak of the pandemic in March 2020, incidents of oxygen-related hospital fires in various countries around the world have caused over 200 deaths, the majority of whom were patients extremely ill with the novel Coronavirus. Fires involving medical oxygen are not a new phenomenon but are more common in the operating theatre where oxygen is routinely administered. In these settings, strict safety protocols are normally enforced and surgical staff are well trained in dealing with oxygen hazards. It appears that some hospitals may not have been fully prepared for the elevated risk of oxygen-related fire in intensive care units due to the high demand for oxygen therapy in severely ill Covid-19 patients. Indeed, gas producers and public health authorities were also slow to recognize and alert hospitals to the potential dangers. Oxygen is essential to life and generally makes up about 21 % of the gases in the air we breathe. Pure oxygen reacts with common materials such as oil and grease to cause fires, and even explosions, when released at high pressures. A leaking valve or hose, and openings at interfaces of masks and tubes, when in a confined space or where air circulation is low, can quickly increase the oxygen concentration to a dangerous level. Even a small increase in the oxygen level in the air to 24 % can create a fire hazard. In an oxygen-enriched environment, materials become easier to ignite and fires will burn hotter and more fiercely than in normal air. There is also a potentially heightened risk of using ethanol-based and organic solvents as cleaning agents in an oxygen rich atmospheres. This paper will provide an overview of oxygen accident scenarios that may be relevant for hospital intensive care units, with particular reference to recent events and similar accidents that have occurred in the past. The paper will recommend that hospitals recognize their chemical risks as part of their risk governance responsibility and assign chemical risk management a prominent role in their overall management. Investigation of dangerous events to extract causes and lessons learned should be utilized to highlight opportunities for prevention as well as emergency response. The industrial gas industry also needs to actively support hospitals in adoption of more rigorous risk management approaches, building on lessons learned in chemical process safety for managing flammable and explosive atmospheres.

2021 年 4 月 24 日，伊拉克一家医院发生灾难性火灾，夺走了 82 人的生命。自2020年3月疫情暴发以来，全球多个国家发生的与氧气有关的医院火灾事故已造成200多人死亡，其中大部分为新型冠状病毒重症患者。涉及医用氧气的火灾并不是一种新现象，但在常规使用氧气的手术室中更为常见。在这些环境中，通常会执行严格的安全规程，并且外科手术人员在处理氧气危害方面受过良好培训。由于重症 Covid-19 患者对氧气治疗的高需求，一些医院似乎还没有做好充分准备，以应对重症监护病房中与氧气相关的火灾风险升高。的确，天然气生产商和公共卫生当局在识别和提醒医院注意潜在危险方面也很缓慢。氧气对生命至关重要，通常占我们呼吸的空气中气体的 21% 左右。纯氧在高压下释放时会与油和油脂等常见材料发生反应，从而引起火灾，甚至爆炸。泄漏的阀门或软管，以及面罩和管道接口处的开口，在密闭空间或空气流通低的地方，会迅速将氧气浓度增加到危险水平。即使空气中的氧气含量稍微增加到 24%，也会造成火灾危险。在富氧环境中，材料变得更容易点燃，火会比在正常空气中燃烧得更热、更猛烈。在富氧环境中使用乙醇和有机溶剂作为清洁剂也可能增加风险。本文将概述可能与医院重症监护病房相关的氧气事故场景，特别是最近发生的事件和过去发生的类似事故。该文件将建议医院将其化学品风险视为其风险治理责任的一部分，并将化学品风险管理置于其整体管理中的突出作用。应利用对危险事件的调查来提取原因和吸取的教训，以突出预防和应急响应的机会。工业气体行业还需要积极支持医院采用更严格的风险管理方法，