Residential Fire-related Injuries Research Articles

Using Linked Data to Estimate the True Number of Individuals Impacted by Residential Fire

IntroductionResidential fires remain a significant global public health problem. It is recognised that the reported number of residential fires, fire-related injuries and deaths significantly underestimate the true number. Australian population-based surveys show that around two-thirds of respondents who experience a residential fire are unwilling to call fire services, and studies from the US and New Zealand highlight that many individuals who access medical treatment for fire-related injuries do not have an associated fire incident report.
 Objectives and ApproachThis population-based study aimed to quantify the total number of residential fires, fire-related injuries and associated health service utilisation. The cohort included all persons residing at a residential address in New South Wales, Australia, which experienced a fire between 1 January 2005 - 31 December 2014. The cohort comprised linked person-level data from eight administrative datasets and includes information about nature of fire, first responder use (Fire and Rescue (FRNSW) and ambulance services), health service utilisation (emergency department, hospital and burns outpatient clinic) and health outcomes.
 ResultsOver the study period, FRNSW responded to 42,491 residential-fire incidents, involving 42,160 individuals with some individuals reporting multiple times. In total, 3,382 individuals used one or more health service and 154 individuals died. Of individuals who contacted FRNSW, 1,661 (3.9%) used health services;ambulance (n=1,101), emergency department (n=1,114), hospital admissions (n=168). There were 95 deaths. There were 1,721 (51%) additional individuals who used one or more health service as a result of a residential-fire that did not contact FRNSW and 59 additional deaths were identified.
 Conclusion / ImplicationsThis study found that more than half of individuals who used health services for residential fire-related injuries did not have an associated fire report, highlighting the importance of data linkage for accurate communication to policy makers and the public on the prevalence and impact of residential-fires.

Optimizing smoke alarm signals: Testing the effectiveness of children\u2019s smoke alarms for sleeping adults

BackgroundBeing asleep is an important risk factor for death during a residential fire; however, the high-frequency tone smoke alarms in many homes will not adequately awaken children who are old enough to self-rescue. In a series of previous studies, we identified smoke alarm signals that effectively awaken children 5–12 years old and prompt their escape. Because it is impractical to have separate alarms for children and adults in a household, the purpose of this study is to test whether alarms that are effective in awakening children and prompting their escape are also effective among adults.MethodsUsing a randomized, non-blinded, repeated measures design, 150 adults 20–49 years old were exposed during stage 4 sleep to four different smoke alarms. Statistical tests included the Kaplan-Meier estimator, generalized Wilcoxon test, and hazard ratios with Wald’s 95% confidence intervals.ResultsThe median age of study subjects was 30.0 years and 67.3% were female. Almost all (n = 149) subjects awakened and performed the escape procedure to all four alarms; one individual did not awaken or escape to the high-frequency tone alarm. The median time-to-awaken was 2.0 s for the high-frequency tone alarm and 1.0 s for the other three alarms. The median time-to-escape for the high-frequency tone alarm was 12.0 s, compared with 10.0 s for the low-frequency tone alarm and 9.0 s each for the female and male voice alarms. All pairwise comparisons between the high-frequency tone alarm and each of the other three alarms were statistically significant for the probability functions for time-to-awaken and time-to-escape. There were no significant differences in these outcome measures between the latter three alarms, except for female voice versus low-frequency tone alarms for time-to-escape.ConclusionsAll alarms performed well, demonstrating that smoke alarms developed for the unique developmental requirements of sleeping children are also effective among sleeping adults. Compared with a high-frequency tone alarm, use of these alarms may reduce residential fire-related injuries and deaths among children, while also successfully alerting adult members of the household.

Health impacts and economic costs of residential fires (RESFIRES study): protocol for a population-based cohort study using linked administrative data

IntroductionResidential fires remain a significant global public health problem. It is recognised that the reported number of residential fires, fire-related injuries and deaths significantly underestimate the true number. Australian surveys...

Association between neighbourhood socioeconomic features and residential fire incidence, related casualties and children: a cross-sectional population-based study in 4 Canadian provinces.

This study assessed whether socioeconomic factors affect the rates of residential fire incidence and fire-related injuries and deaths, and whether children are affected differently than the general population. We employed a cross-sectional study design using data for British Columbia, Alberta, Manitoba and Ontario from the National Fire Information Database, which includes fire incidents and losses reported by provincial fire marshals across Canada between 2005 and 2015. It also contains 2011 census subdivision social domain data from Statistics Canada based on fire location. Multivariable negative binomial regressions tested the significance of relations between census subdivision socioeconomic factors (average household size, educational attainment, median income and unemployment rate) and the rates of residential fires and casualties per person-year, and casualties per fire incident. Census subdivisions with higher educational attainment and unemployment rates had higher rates of residential fires (incidence rate ratio [IRR] 1.07, 95% confidence interval [CI] 1.05-1.10, and IRR 1.24, 95% CI 1.18-1.31, respectively) and of residential fire casualties per person-year (IRR 1.09, 95% CI 1.05-1.13, and IRR 1.29, 95% CI 1.20-1.40, respectively). Census subdivisions with smaller average households had higher rates of residential fire casualties per person-year (IRR 0.43, 95% CI 0.22-0.83) and per fire incident (IRR 0.75, 95% CI 0.58-0.97), and the association was even stronger for children (IRR 0.17, 95% CI 0.08-0.36, and IRR 0.41, 95% CI 0.20-0.86, respectively). The results suggest that efforts to prevent residential fires should be prioritized in neighbourhoods with higher educational attainment and unemployment, whereas house fire safety programs should be intensified in neighbourhoods with smaller households to prevent fire casualties, especially among children, once a fire does occur.

Association between spatial accessibility to fire protection services and unintentional residential fire injuries or deaths: a cross-sectional study in Dallas, Texas

ObjectivesIn addition to neighbourhood characteristics encompassing racial composition, socioeconomic status and housing environments, it was unclear if location characteristics relating to the accessibility of fire protection services were risk factors...

Exploring barriers and challenges in protecting residential fire-related injuries: a qualitative study.

:Background:Building fires can be a great threat to the safety of residents, and can lead to economic and social damage. Exploring the views of stakeholders is a great source for understanding the factors that affect fires. The purpose of this study was to explore stakeholders’ experiences of unintentional fire-related injuries in residential buildings in Iran.Methods:This qualitative study was carried out using grounded theory. The study was conducted in Iran, in 2017. The study participants consisted of 25 people including stakeholders who had practical experience/or were knowledgeable in the field of preventing and fighting building fires. Purposeful and theoretical sampling were used for data collection. Data were analyzed based on constant comparative analysis and according to recommendations by Strauss and Corbin.Results:"Lack of a comprehensive approach to prevention of fire-related injury" emerged as a core variable which impacted on residents' safety against fires. The findings were classified into four groups of challenges related to the structure of building, socio-economic challenge, residents of the building and rescue services.Conclusions:Based on participants` experiences, unintentional fire-related injuries in residential buildings are affected by cultural context and economic, social and geographical factors. Improving the safety against unintentional fire-related injuries in residential buildings requires multidisciplinary operations including both change and improvement of the building construction and change in the beliefs and practices of residents to increase safety against fires.

Do socio-economic determinants affect residential fire-related injuries and deaths among Canadian children?

Abstract BACKGROUND Fire is a leading cause of unintentional injuries among children in Canada. More specifically, residential fires are responsible for too many preventable deaths and injuries. Yet, there is no national database that reports on residential fire-related injuries and deaths among children. Although socio-economic determinants (SED) have been associated with increased risk of residential fire in the USA and UK, little is known about the significance of this impact on the Canadian child population. OBJECTIVES This study examined the role of SED (low education, median income and average number of persons per dwelling (ANPD)) in residential fire-related injuries and deaths, and assessed the relationship between age and the severity of residential fire-related injuries and deaths, among children and youth in Canada. DESIGN/METHODS A cross-sectional study design was used to examine data from the National Fire Information Database (NFID), which includes 10-years (2005–2015) of microdata information on fire incidents and losses reported by provincial/territorial Fire Marshals and Fire Commissioners Offices across Canada. Census 2011 data at the CSD level, from Statistics Canada, provided the SED variables. Our outcome of interest was the odds of death and major injury over minor injury. A logistic regression model was applied to test the relationship between age and SED with our outcome of interest, while adjusting for province. RESULTS For every 1 person increase in the average ANPD at the CSD level, there is a 31% decrease in the odds of dying or being severely injured in a residential fire (p=0.0003). For every 1% increase in CSD’s low education proportion, there is a 2.5% increase in the odds of dying or being severely injured in a residential fire (p=0.0002). Median income was not significantly associated with the odds of death and major injury over minor injury. The odds of death and major injury were not significantly different for youths and adults, compared to children, controlling for ANDP, low education and median income. CONCLUSION The National Fire Information Database is one of the first to amass reliable fire incident and loss information across Canada into one database. Using this novel dataset, we determined that increased ANPD strongly decreased the odds of death and major injury over minor injury. Thus, the number of persons living in a household should be considered when targeting vulnerable children and youth for residential fire prevention and safety promotion programs.

Carbon Monoxide Alarm and Smoke Alarm Use Among Parents Recruited From a Pediatric Emergency Department.

Although the proper installation and maintenance of carbon monoxide (CO) and smoke alarms can protect individuals from residential CO-related and fire-related injuries, these devices are underutilized. We describe characteristics associated with self-reported CO and smoke alarm use of parents recruited from a pediatric emergency department to improve CO alarm use. Parents of children≤18years (N=299) reported socio-demographic characteristics and CO and smoke alarm ownership and practices. We assigned participants to a behavioral profile and a Precaution Adoption Process Model stage based on their self-reported CO and smoke alarm use. Most participants (71%) did not have CO alarms in their homes, but reported owning at least one working smoke alarm (98%). Participants who reported "perfect" CO alarm behavior (defined as having a working CO alarm, onenear a sleeping area, with batteries replaced every 6months; 9%) were more likely to earn a higher income, own their home, and have lived at their current residence for at least 2 years. Participants who reported "perfect" smoke alarm behavior (defined as having a working smoke alarm on every level, with batteries replaced every 6months; 49%) were more likely to rent their home, receive federal assistance, and have lived at their current residence for at least 2 years. Interventions to increase correct CO alarm use are necessary.

Examining fire department injury data as a tool for epidemiological investigation.

Residential fires, while constituting a small fraction of fire incidents, are responsible for the majority of civilian fire-related injuries. This study investigates census tract neighborhood socioeconomic factors as correlates of civilian injuries occurring during residential fires in Baltimore, Maryland, between 2004 and 2007. Civilian residential fire related injuries were geocoded and linked to the American Community Survey 2005-2009 data. Negative binomial regression was used to analyze the relationship between fire-injury rates and neighborhood socioeconomic indicators including household income and percentages of households below the poverty line, persons aged 25 years or older with at least a bachelor's degree, homes built in 1939 or earlier, vacant properties, and owner-occupied homes. Between January 2004 and July 2007, there were 482 civilian fire-related injuries that occurred during 309 fires. At the census tract level, a 10% increase in the number of vacant homes was associated with an increase in injury rates by a factor of 1.28 (95% confidence interval 1.05-1.55). A 10% increase in persons aged more than 25 years with at least a bachelor's degree was associated with a decrease in injury rates by a factor of 0.86 (95% confidence interval 0.77-0.96). Neighborhood measures of education and housing age proved good indicators for identifying areas with a higher burden of fire-related injuries. Such analyses can be useful for fire department planning.

Years of safe community activities in Dallas, TX, USA: has it made a 15 difference?

BackgroundThe Injury Prevention Center of Greater Dallas, Texas (IPC) was established in 1994, and Dallas became the first WHO designated Safe Community in the U.S. in 1996. The IPC has...

Residential fire related deaths and injuries among children: fireplay, smoke alarms, and prevention

Background: The aim of the study was to describe the epidemiology of residential fire related deaths and injuries among children, and identify risk factors for these injuries through a linked...

Smoke Alarm Giveaway Program Is Cost Effective in Preventing Fire-Related Injuries and Death

Smoke Alarm Giveaway Program Is Cost Effective in Preventing Fire-Related Injuries and Death

Cost effectiveness analysis of a smoke alarm giveaway program in Oklahoma City, Oklahoma

Objective—To estimate the cost effectiveness of the Lifesavers Residential Fire and Injury Prevention Program (LRFIPP), a smoke alarm giveaway program. Setting—In 1990, the LRFIPP distributed over 10 000 smoke alarms...

Evaluating Injury Prevention Programs: The Oklahoma City Smoke Alarm Project

Evaluation of injury prevention programs is critical for measuring program effects on reducing injury-related morbidity and mortality or on increasing the adoption of safety practices. During the planning and implementation of injury prevention programs, evaluation data also can be used to test program strategies and to measure the program's penetration among the target population. The availability of this early data enables program managers to refine a program, increasing the likelihood of successful outcomes. The Oklahoma City Smoke Alarm Project illustrates how an evaluation was designed to inform program decisions by providing methodologically sound data on program processes and outcomes. This community intervention trial was instituted to reduce residential fire-related injuries and deaths in a geographic area of Oklahoma City that was disproportionately affected by this problem. The distribution of free smoke alarms in targeted neighborhoods was accompanied by written educational pamphlets and home-based follow-up to test whether the alarms were functioning correctly. Early evaluation during the planning and implementation phases of the program allowed for midcourse corrections that increased the program's impact on desired outcomes. During the six years following the project, the residential fire-related injury rate decreased 81% in the target population but only 7% in the rest of Oklahoma City. This dramatic decline in fire-related injuries in the target area is largely attributed to the free smoke alarm distribution as well as to educational efforts promoting awareness about residential fires and their prevention.

National estimates of U.S. residential fire-related injuries: An improved procedure

This study compared fire-related injuries from two ongoing data systems to determine how to combine them to provide improved estimates of U.S. residential fire-related injuries. National estimates and characteristics of patients treated in hospital emergency rooms for fire-related injuries were compared with injuries in a database of fires attended by the fire service. National estimates, age, and diagnosis distributions of injuries seen by both a hospital and the fire service were very similar in the two systems, indicating that the systems overlapped for this segment of injuries. Each system also contained a segment of fire-related injuries that was not included in the other. Combining the overlapping segment of injuries with segments that did not overlap resulted in an estimate of 45,000–47,000 U.S. fire-related injuries, the most com-prehensive estimate of U.S. residential fire-related injuries available to date.