THE Malaysian Medical Association (MMA) is deeply concerned over the widespread advertising of oxygen supplementation canisters which supplies 99% pure oxygen for home use.
In one of the advertisements, the company even highlights that the product has been approved by the Health Ministry (MoH). In the advertisement, the company used a picture of a child to indicate that the oxygen supplementation is safe for children.
The MMA would like to stress that unregulated sales and purchase of oxygen supplementation should stop as the practice is not beneficial and may even be harmful to the patient. Aside from this, it is also a fire hazard. Oxygen supplementation should only be part of prescription from registered medical practitioners.
Dr Victor Hoe, occupational and public health professor, University of Malaya and life member of the Malaysian Medical Association Wilayah Branch explains:
Let us start by looking at the air we breathe.
The air we breathe contains 21% oxygen; this is the optimum amount of oxygen that our body is used to. Everywhere around the world people have been living on 21% oxygen. It does not matter if you are on the equator or on top of Mount Everest, the amount of oxygen is still 21%. Of course, the air on Mount Everest may be thinner, however, it still only contains 21% oxygen.
In the current Covid-19 pandemic, many people are trying to supplement the atmospheric oxygen that they breathe with either oxygen concentrators or canister oxygen. The reason for this behaviour is that there is information about people with Covid-19 who have decreased partial pressure of oxygen (PaO2) in their blood.
MoH is also advising people who have Covid-19 in Categories 1 and 2 under home isolation to monitor their PaO2. It is important for us to understand that all the patients with the virus under home isolation are monitored closely by healthcare workers. If there is any deterioration in their PaO2 the patients are admitted to the hospitals for further assessment and treatment.
This is because PaO2 deterioration indicates that the disease has worsened and is affecting the lungs or heart. When this happens, the patient needs to be assessed by a doctor in a clinic or hospital. It is not advisable for the patient to use supplemental oxygen. While using the supplemental oxygen, although the PaO2 may be normal, however, the lungs or heart continues to deteriorate.
Oxygen supplementation should only be given under strict medical advice and supervision. For home use oxygen is only prescribed to patients that have chronic low PaO2 due to chronic lung or heart conditions and should only be given in a controlled amount. This is because excessive oxygen is not beneficial and can be toxic to the patient. Paracelsus von Hohenheim, the Swiss physician and father of toxicology has said that
All things are poison, and nothing is without poison; the dosage alone makes it so a thing is not a poison.
This holds true for oxygen. There are many complications that arise from breathing 100% oxygen for a prolonged period of time.
The oxygen coming out from the canister is cold and dry and it needs to be conditioned before we can breathe it in. Breathing cold and dry air can damage the lungs and increase the risk for us to get lung infection including Covid-19.
The oxygen canister is also a fire hazard. When we are using high concentration of oxygen the risk of fire is there and we need to ensure that the surroundings are free from sparks, flammable liquid, and objects. – The Vibes, September 11, 2021
Prof Datuk Dr Subramaniam Muniandy is president of the Malaysian Medical Association
