Medical use of Oxygen (2024)

Different industries, including health systems, use oxygen in regular basis. Oxygen in the market is available for industrial and medical use. Medical-use oxygen is very different from industrial oxygen in purity and quality. Thus, industrial and medical use are not interchangeable.

"Industrial oxygen is not intended for human use. Solely medicinal oxygen that was tested to meet authorized specifications for its identity, purity and content and that was produced, stored and distributed following appropriate practices should reach the patient. Uncertainties regarding the purity and content of industrial oxygen, the possible occurrence of particulate and microbial contamination, and production, storage and distribution processes that may not be appropriately planned, performed and controlled can result in unacceptable risks for patients."

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Depending on the source and production method the medical oxygen has the following values:

1. For oxygen produced by the air-liquefaction process, theInternational Pharmacopoeia, defines the requirements of medical-use oxygen. Currently, oxygen must contains not less than 99.5% v/v of O2.
2. For Pressure Swing Adsorption (PSA) plants, the WHO interim guidance technical specifications for PSA plants, published in June 2020, specifies: "pressure swing adsorption technology to produce medical oxygen 93%±3 from ambient air"
3. For oxygen concentrators, the WHO-UNICEF technical specifications and guidance for oxygen therapy devices, published in 2019, as one of the sources of oxygen. “The concentrator should delivery of low-flow, continuous, clean and concentrated oxygen (> 82%) from room air (21%). “This same statement was published in WHO interim guidance of WHO list of Priority Medical devices for COVID-19 and its associated technical specifications, published November 2020.

Currently WHO has twoopen consultationsrelated to medical oxygen. For further detail, visit theHealth Products and policy Standards- Working documents in public consultation website. The consultations refer to:

1. WHO good manufacturing practices 5 for medicinal gases(QAS/21.875/Rev.1)- closing date31 August 2021
2. Medicinal Oxygen (QAS/20-867/Rev.2)- closing date10 September 2021
   

Many levels of the health systems need medical oxygen. The units in the health system that use oxygen include:

• Primary health care
  
• General wards
• Emergency transport
• Delivery rooms
• Operating theaters
• Intensive care units (ICU)
• Specialized hospitals
• Outpatient units
• Etc.

This diagram illustrates examples of medical units that use oxygen. All levels in the health system require oxygen and pulse oximeters (to monitor oxygen saturation in patients). These different levels and scenarios meet different needs of oxygen systems.

Due to their complexity, access to oxygen meets many challenges on:

• Availability
  
• Quality
• Affordability
• Management
• Supply
• Human resources capacity
• Safety

In face of these challenges, the WHO continuously develops resources to overcome them. WHO latest efforts include the development of technical specifications. The purpose of technical specifications is to increase access to quality products. It also aims to ensure the supply of oxygen, in low-resource settings. These efforts also aim to support ministries of health by:

1. ensuring oxygen supply is available
2. highlighting the importance of appropriate selection, procurement, maintenance and use of medical devices.