Safety Articles

Disclaimer: The ideas and opinions expressed in these documents are those of the authors. Inclusion on this list does not necessarily constitute endorsement by the Undersea and Hyperbaric Medical Society.

The articles listed below have been reproduced with the permission of the publisher. The downloadable files are in PDF format.

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REVIEWED BY: UHMS Hyperbaric Oxygen Safety Committee

DDC Chamber View-port Catastrophic Failure

Author(s): Association of Diving Contractors International
Publisher: ADCI
Description: This view-port was in a deck chamber where someone had placed droplight too close to the port. The resulting radiant heat from the lamp exceeded the design temperature of the view-port.

Decompression Sickness in Inside Attendants

Author(s): PJ Sheffield, C Pirone
Appeared in: Hyperbaric Facility Safety: A Practical Guide (1999)
Publisher: Best Publishing Company, Flagstaff, AZ
Description: This chapter discusses the risk of decompression sickness in hyperbaric chamber inside attendants. A review of the literature reveals that attendant oxygen breathing, more conservative decompression profiles, and attention to variables that affect attendant fitness were effective actions taken to reduce decompression sickness incidence.

Hyperbaric and Hypobaric Chamber Fires: A 73-year Analysis

Author(s): PJ Sheffield, DA Desautels
Appeared in: Undersea Hyper Med, 1997; 24(3): 153-164
Publisher: Undersea and Hyperbaric Medical Society, Dunkirk, MD
Abstract: Fire can be catastrophic in the confined space of a hyperbaric chamber. From 1923 to 1996, 77 human fatalities occurred in 35 hyperbaric chamber fires, three human fatalities in a pressurized Apollo Command Module, and two human fatalities in three hypobaric chamber fires reported in Asia, Europe, and North America. Two fires occurred in diving bells, eight occurred in recompression (or decompression) chambers, and 25 occurred in clinical hyperbaric chambers. No fire fatalities were reported in the clinical hyperbaric chambers of North America. Chamber fires before 1980 were principally caused by electrical ignition. Since 1980, chamber fires have been primarily caused by prohibited sources of ignition that an occupant carried inside the chamber. Each fatal chamber fire has occurred in an enriched oxygen atmosphere (>28% oxygen) and in the presence of abundant burnable material. Chambers pressurized with air (<23.5% oxygen) had the only survivors. Information in this report was obtained from the literature and from the Undersea and Hyperbaric Medical Society's Chamber Experience and Mishap Database. This epidemiologic review focuses on information learned from critical analyses of chamber fires and how it can be applied to safe operation of hypobaric and hyperbaric chambers.

UHMS Chamber Experience and Mishap Database Report (1923 - 1998)

Author(s): DA Desautels
Appeared in: Undersea Hyper Med, 1997; 24(3): 153-164
Description: This article summarizes hyperbaric mishap data collected by the UHMS Hyperbaric Oxygen Safety Committee up to 1998. This database is no longer active.

Titanium in a Hyperbaric Oxygen Environment May Pose a Fire Risk

Author(s): J Hink, E Jansen
Appeared in: Aviat Space Environ Med 2003; 74(12): 1301-1302
Publisher: Aerospace Medical Association, Alexandria, VA
Description: The use of titanium during hyperbaric oxygen therapy may pose a risk of fire. A fresh titanium surface in a high oxygen atmosphere can be a source of ignition. The clinical scenario may be a patient who accidentally breaks his titanium-framed glasses during a hyperbaric oxygen treatment in a monoplace chamber or using an oxygen hood. We recommend some safety precautions to be exercised until consensus standards have been established by the hyperbaric medicine community.

Air-Activated Chemical Warming Devices: Effects of Oxygen and Pressure

Author(s): G Raleigh, R Rivard, S Fabus

Appeared in: Undersea Hyper Med 2005; 32(6)

Publisher: Undersea and Hyperbaric Medical Society

Description: Air-activated chemical warming devices use an exothermic chemical reaction of rapidly oxidizing iron to generate heat for therapeutic purposes. Placing these products in a hyperbaric oxygen environment greatly increases the supply of oxidant and thus increases the rate of reaction and maximum temperature. Testing for auto-ignition and maximum temperatures attained by ThermaCare™ Heat Wraps, Playtex™ Heat Therapy, and Heat Factory® disposable warm packs under ambient conditions and under conditions similar to those encountered during hyperbaric oxygen treatments in monoplace and multiplace hyperbaric chambers (3 atm abs and >95% oxygen) revealed a maximum temperature of 269°F (132°C) with no spontaneous ignition. The risk of thermal burn injury to adjacent skin may be significantly increased if these devices are used under conditions of hyperbaric oxygen.


Author(s): Bill Gearhart, CHT, DMT, EMT, CFPS

Appeared in: UHMS Pressure Membership Newsletter

Description: I wrote an article explaining the storage details of small, "E” sized oxygen cylinders in the Health Care Environment. I received one question regarding the article and it asked if there could be more cylinders if the area was larger. The determining factor in this situation is the smoke compartment size requirement in a Health Care Occupancy, which is limited to 22,500 square feet, (2,100 meters square) and the travel distance to an exit can be no longer than 200 linear feet. These requirements are stated in NFPA 101, 18.3.7 & 19.3.7, (Subdivision of Building Spaces), New and Existing Health Care Occupancies, respectively.


Author(s): Lindell Weaver, MD & Michael Strauss, MD
Report of the Hyperbaric Chamber Safety Committee of the Undersea & Hyperbaric Medical Society
Appeared in: September 1991 (Revised 1997)
Publisher: Undersea & Hyperbaric Medical Society
Description: The guidelines are designed to provide basic information regarding safety and set-up of the monoplace hyperbaric chamber facility, and patient management. The guidelines are dynamic and subject to change as developments in the field occur. Consequently, the format is such that chapters and sections can be easily amended and revised while the basic organization of the guidelines remains intact.


Author(s): UHMS Hyperbaric Safety Committee: David Desautels, Wilbur T Workman, Erick Kindwall, Keith Van Meter & James McCarthy
Report of the Hyperbaric Chamber Safety Committee of the Undersea & Hyperbaric Medical Society
Appeared in: June 1994
Publisher: Undersea & Hyperbaric Medical Society
Description: There are two basic types of clinical hyperbaric chambers: monoplace and multiplace. The monoplace chamber allows for the treatment of only one patient at a time in a 100% oxygen environment. The multiplace chamber allows more than one patient to be exposed to an air environment under increased atmospheric pressure while breathing oxygen through a mask, a hood, or endotracheal tube. The purpose of this document is to provide operations of clinical multiplace hyperbaric systems basic guidelines by which to operate such facilities.