In this market, the cylinders mostly supply gas to consumer owned barbecues and patio heaters.
[2] POL valves are legal and quite common in the United States, especially on larger containers, although certain uses (smaller portable containers) require a modified version of the POL valve that includes some safety features.
The hexagon nut required a spanner to achieve sufficient pressure to obtain a gas tight seal.
Following international convention, the standard changed to allow the use of an integrated hand wheel, with leak tightness being provided by an o-ring or rubber bull nose.
[2] POL is the common name for the standard CGA 510 (US Compressed Gas Association connection number).