Fire Survivors Research Articles

Acute Neurobehavioral and Glial Responses to Explosion Gas Inhalation in Rats.

Military personnel, firefighters, and fire survivors exhibit a higher prevalence of mental health conditions such as depression and post-traumatic stress disorder (PTSD) compared to the general population. While numerous studies have examined the neurological impacts of physical trauma and psychological stress, research on acute neurobehavioral effects of gas inhalation from explosions or fires is limited. This study investigates the early-stage neurobehavioral and neuronal consequences of acute explosion gas inhalation in Sprague-Dawley rats. Rats were exposed to simulated explosive gas and subsequently assessed using behavioral tests and neurobiological analyses. The high-dose exposure group demonstrated significant depression-like behaviors, including reduced mobility and exploration. However, neuronal damage was not evident in histological analyses. Immunofluorescence revealed increased density of radial glia and oligodendrocytes in specific brain regions, suggesting hypoxia and axon damage induced by gas inhalation as a potential mechanism for the observed neurobehavioral changes. These findings underscore the acute impact of explosion gas inhalation on mental health, highlighting the habenula and dentate gyrus of hippocampus as the possible target regions. The findings are expected to support early diagnosis and treatment strategies for brain injuries caused by explosion gas, offering insights into early intervention for depression and PTSD in affected populations.

The tensions of crowdsourcing disaster response in disaster‐specific Facebook groups after the Camp Fire

AbstractDisaster‐specific Facebook groups (DSFGs) are Facebook groups devoted to a specific disaster or set of disasters. I argue DSFGs offer opportunities for disaster response and resilience organizing that can mitigate the limitations of institutionalized disaster response and illustrate the benefits and detriments of the use of DSFGs by survivors after California's 2018 Camp Fire. This study explores the helpfulness and unhelpfulness or hurtfulness of Camp Fire Facebook groups (CFFGs) for survivors' recoveries. I surveyed 232 Camp Fire survivors who used CFFGs. Sharing recovery processes and spreading information in CFFGs were both helpful and unhelpful to survivors' recoveries. CFFGs were also helpful for exchanging direct assistance, sustaining community, developing new relationships, lifting spirits, and championing survivors and unhelpful or hurtful due to scamming, facing negativity, and encountering the victim mentality. I contend that tensions exist for crowdsourcing disaster response in DSFGs, whereby what makes a DSFG helpful can also be unhelpful or hurtful, and I call for coordination between DSFGs and institutional disaster response to improve disaster response networks.

Exercise-induced myocardial ischemia presenting as exercise intolerance after carbon monoxide intoxication and smoke inhalation Injury: case report

BackgroundCarbon monoxide intoxication and smoke inhalation injury can lead to severe disorders, and the current literature has elaborated on the importance of major cardiopulmonary impairment. Exercise intolerance has seldom been discussed, particular in patient with low cardiovascular risk.Case presentationTwo young male fire survivors who presented with exercise intolerance after CO intoxication and smoke inhalation injury. Both received bronchodilator and glucocorticoid therapy, high-flow oxygen therapy, and hyperbaric oxygen therapy for airway edema and CO intoxication during acute care. Serum carboxyhemoglobin levels improved after treatment (8.2–3.9% in Case A and 14.8–0.8% in Case B). However, subjective exercise intolerance was noted after discharge. Cardiopulmonary exercise testing revealed exercise-induced myocardial ischemia during peak exercise (significant ST-segment depression on exercise electrocardiogram). They were instructed to exercise with precaution by setting the intensity threshold according to the ischemic threshold. Their symptoms improved, and no cardiopulmonary events were reported in the 6-month follow-up.ConclusionThe present case report raised the attention that exercise intolerance after carbon monoxide intoxication and smoke inhalation injury in low cardiovascular risk population may be underestimated. Cardiopulmonary exercise testing help physician to discover exercise-induced myocardial ischemia and set up the cardiac rehabilitation program accordingly.

Fire ecology for the 21st century: Conserving biodiversity in the age of megafire

Fire ecology for the 21st century: Conserving biodiversity in the age of megafire

“A country boy can survive:” Rural culture and male-targeted suicide prevention messaging

The low rate of help-seeking and high rate of suicide completion among men has prompted public health officials to create suicide prevention campaigns that specifically target men. Drawing from data collected as part of a larger study of fire recovery in a rural county in Northern California, this paper utilizes 68 interviews with fire survivors (24 men and 44 women) and 40 interviews with mental health service providers to examine how rural residents interpret this type of campaign. To track patterns of help-seeking over time, I also draw upon 26 follow-up interviews – 20 with fire survivors (7 men and 13 women) and 6 with service providers – conducted one year after the first wave of interviews. In total, 134 in-depth interviews were conducted. This paper also draws on a secondary data source; I conducted content analysis of an internal Health and Human Services Agency focus group report used in the development of a local male-targeted suicide prevention campaign, Captain Awesome. As I show, male-targeted suicide prevention efforts have little salience in rural communities in which treatment resources are limited and stigma abounds. Perceptions about material conditions – i.e., treatment resources being few and far between – contribute to residents establishing a norm of not seeking help. Rural culture which emphasizes self-sufficiency and independence contributes to a pattern of both men and women repeating a narrative that frames men who seek help as weak. While research has identified women as key drivers for men's physical health maintenance, my research suggests that the same pattern might not hold around mental health maintenance in rural settings. In sum, I argue that male-targeted campaigns have limited resonance and efficacy in rural communities where material conditions and cultural narratives create physical and psychological barriers to accessing to treatment.

Texas wildfire survivors’ narratives and the meaning of everyday objects

This study suggests the importance of focusing on lost objects after disasters and gauging the emotional registers and impacts of object loss to best understand and assist in wildfire victims' recovery process. Because objects and materiality are a focus of research in the sociology of culture and the sociology of emotions, I assess these sub-field of interest in object and emotion, along with surveying the various fields dealing with disasters and their aftermaths. Participants were from a small, semi-rural community in the central hill country of Texas. A participant-observer design allowed for working alongside fire survivors. Grounded theory and situational analysis frameworks were used to analyze 54 survivors' narratives related to the importance of everyday household objects in their recovery– things resurrected from the wildfire. The findings suggest that it would be wise to ponder material objects in situated context—in a new manner and with new respect.

Origami paper analytical assay based on metal complex sensor for rapid determination of blood cyanide concentration in fire survivors

Cyanide-based blood poisoning can seriously damage fire victims and cause death if not detected quickly. Previous conventional methods require laboratory equipment, which are expensive and increase the duration of the analysis. Here, a simple origami based microfluidic device was introduced for point of need detection of blood cyanide concentration in people involved in fire. The device is made of four layers of paper. Each layer was in the size of 1 × 1 cm folded on each other. In this work, the blood sample was acidified by trichloroacetic acid to separate cyanide from methaemoglobin in the form of HCN gas. The produced gas released into borate buffer to recover free cyanide ions which interacted with the Pt complex ([Pt(p-MeC6H4)2(phen)]) used as a receptor in this study. Optimized conditions were applied to have a suitable interaction causing the color of the receptor to change from yellow to colorless. The color changes were recorded by a smartphone, and the sensor response was calculated by the routine image analysis software. The assay was capable of determining cyanide ions at different concentrations in the range of 1.0 to 100.0 µmol L−1. The detection limit of these determination was equal to 0.4 µmol L−1. The assay responses were not affected by the interfering species. As a practical analysis, the proposed sensor was applied to determine cyanide ions in the blood sample of 20 studied fire survivors and 10 controls with high accuracy.

Fire threatens the diversity and structure of tropical gallery forests

AbstractGallery forests are widespread in most tropical savanna landscapes creating a mosaic of grass‐dominated systems with tree components and forest patches. Interactions among water, nutrient availability, and wildfires have influenced the structure, patterns, and processes of these landscape systems and have shaped today’s biodiversity in the savanna–forest transitions of the Orinoco basin in Colombia and Venezuela. However, savanna fires have become larger and more frequent in these areas. In order to investigate the impacts of fire on gallery forests, we established 18 forest plots of 0.1 ha within three different fire exposures: (1) fire affected forests along the edge (<100 m) from open savanna to gallery forest (burned edge), (2) fire affected closed forests (burned interior; >100 m from the edge), and (3) no evidence of fire (unburned). We identified responses of the vegetation to fire (through natural regeneration) by analyzing the compositional and structural changes and quantifying fire‐related functional traits for the most abundant tree species. We surveyed 128 species, corresponding to 77 genera and 35 families. Tree height is over 10.70 m (± 2.72) in unburnt forests. Dead tree presence in burnt edges (21.76% ± 24.3) almost doubles that of burnt interior (13.08% ± 15.73). The aboveground biomass (AGB) of unburnt forests (176.9 Mg/ha) was more than double that of the interior burnt forests (74.4 Mg/ha) and four times higher that AGB in the edge burnt sites (41.3 Mg/ha). Of the most abundant species, 62% were classified as fire‐sensitive species, 14% were fire survivors and 24% were resistant to fires and mostly present in communities with lower diversity. Although fire‐tolerant species in general presented thicker barks, higher wood densities, and higher leaf dry matter content, no clear pattern of fire response was associated only with functional traits. Thus, overall fire is resulting in strong compositional changes, with more fire‐resistant species, which are species that establish in disturbed areas and encouraging grasses, resulting in savanna encroachment into gallery forests. Consequences on the long‐term should be monitored.

Empirical methods in pedestrian, crowd and evacuation dynamics: Part II. Field methods and controversial topics

Following the review of the experimental methods and top emerging topics, here, studies using the field data collection methods of pedestrian dynamics (April 2017-July 2019) are reviewed. This includes studies based on post-disaster analysis of real emergencies and past crowd incidents, field pedestrian observations in natural settings, and qualitative interviews with survivors of fire and other emergency incidents. The method of collecting field observations in natural settings is identified to be gaining increasing traction among other field methods (compared to the years preceding 2017) which in part reflects the recent growing attention to the calibration and validation of simulation models. Also, by assembling and analysing the entire body of empirical crowd literature from 1995 to 2019, this review identifies a list of controversial topics and puts a spotlight on recent experiments that have revisited and, in cases, challenged/modified certain long-held assumptions in crowd dynamics. Nine major controversial topics of crowd dynamics are identified for which mixed or contradictory empirical evidence exist. This includes questions related to the flow of pedestrians through bottlenecks (i.e. the faster-is-slower effect, partial obstruction effect, exit location effect, the nature of exit width-capacity relationship), as well as the decision-making aspects of pedestrian evacuations (i.e. the symmetry breaking phenomenon, and the effect of urgency level on various aspects of decision-making) and other topics such as the effect of social groups on evacuation efficiency or the effect of additional exits on blind evacuation efficiency. It is hoped that the discussions on these topics pave the way for further investigating and explaining these inconsistencies and settling the questions surrounding them.

Post-Traumatic Stress Disorder Symptoms and Their Predictors in Earthquake or Fire Survivors

In this study, we aimed to investigate the relationship between post-traumatic stress disorder and previous knowledge of emergency management, sense of control over the stressor, perceived threat, and somatic symptoms in earthquake and fire survivors.. The data were obtained from the 2009-database of the Izmir Province Fire Department to include the people who had experienced domestic fire (n=92), from the people who had applied to the Health Group Directory after the 2005 earthquake in Seferihisar (n=38) and from the staff of a third step hospital who experienced a fire in public building in 2010 (n=34). The Impact of Events Scale-revised version (IES-R) was used to determine the traumatic stress levels of the participants; and the Behavior, Security, and Culture - Survivor (BeSeCu- S) questionnaire was used to acquire information on factors before and after the traumatic events. Compared to the fire survivors, the earthquake survivors perceived higher levels of threat and lower levels of control during the event gender, perceived threat, somatic symptoms experienced during the event and perceived control over the event were found to predict the post-traumatic stress disorder. Results of the research suggested that control-focused treatment METHODS could be effective in treatment of people who had experienced earthquake and fire. It is observed that informing the public about emergency management would be protective for mental health by increasing the sense of control of the individuals at the time of the incident. On the other hand, the positive relationship between PTSD and previous knowledge on emergency suggests that the ringing alarms and practice errors during the fire and earthquake drills could traumatize people. Future research is recommended on the relationship between information processing, somatic symptoms and emotional processes in individuals during earthquake, fire and their drills.

The representation and experience of English urban fire disasters,c.1580-1640

Fire disasters were a perennial threat to urban life in early modern England, but are yet to receive sustained attention from historians. By analysing popular literature, charitable collections and relief distribution this article reveals how urban fires were interpreted and what effect they had on individuals and specific communities in England between 1580 and 1640. Some aspects of the experience of fire disasters in early modern England are illuminated through detailed contextual readings of contemporary news reports, quantitative analyses of the collection and distribution of charitable funds, and attention to the fortunes of individual survivors of fires.

Comparative investigation of ‘survival’ and fatality factors in accidental residential fires

ObjectiveThis study compares the odds ratio (OR) values of factors associated with accidental residential fires where an individual has died versus fires where all occupants have survived (with no serious injury that required extended hospitalisation). MethodsAnalyses were based on 177 single fatalities (from coronial files) and 183 survivors (from interviews) of accidental residential fires. Results/discussionThe top seven risk factors (OR>10) that were significantly more associated with fatal than survived fires were, in descending order, psychotropic and sedative drug intake, discarded cigarettes, living alone, being aged over 70, being asleep, location in the room of fire origin (RFO) at ignition, and alcohol intake. The five risk factors (OR>10) that were more significantly associated with survived fires were, in descending order, cooking fires, electrical fires, kitchen being RFO, stove being an appliance involved in ignition, and fire in a one or two family dwelling. People who survived were more likely to wake up to non-smoke alarm fire cues (e.g. glass breaking, smoke) than a smoke alarm cue. ConclusionsThis comparative study provides new insights into statistically significant differences in risk factors between fatal fires and those fires where all occupants survived. The implications for fire engineering are complex as most fatal residential fires were associated with cognitive and physical impairment.

Chronic pain following physical and emotional trauma: the station nightclub fire.

Objective: The purpose of this study was to evaluate factors associated with chronic pain in survivors of a large fire, including those with and without burn injury.Methods: This study employed a survey-based cross-sectional design to evaluate data from survivors of The Station nightclub fire. The primary outcome measure was the presence and severity of pain. Multiple linear regressions with a stepwise approach were used to examine relationships among variables. Variables considered included age, gender, marital status, burn injury, total body surface area, skin graft, pre-morbid employment, time off work, return to same employment, depression (Beck depression inventory, BDI), and post-traumatic stress (impact of event scale – revised).Results: Of 104 fire survivors, 27% reported pain at least 28 months after the event. Multiple factors associated with pain were assessed in the univariate analysis but only age (p = 0.012), graft (p = 0.009), and BDI score (p < 0.001) were significantly associated with pain in the multiple regression model.Discussion: A significant number of fire survivors with and without burn injuries experienced chronic pain. Depth of burn and depression were significantly associated with pain outcome. Pain management should address both physical and emotional risk factors in this population.

“Burn Catatonia”

Thermal injuries have been recognized to cause significant neuropsychiatric symptoms and disability in their sufferers since the middle of the 20th century, when Drs. Stanley Cobb and Erich Lindemann of the Massachusetts General Hospital (Boston, MA) studied survivors of the Cocoanut Grove nightclub fire in Boston. Although "burn encephalopathy" or burn-induced delirium is a common occurrence in the acute phase, catatonia in burn patients is not often reported. This report describes a case of malignant catatonia occurring in a 51-year-old male patient acutely suffering from burns acquired in a chemical explosion, effectively treated with reinstitution of a selective serotonin reuptake inhibitor. The literature on burn encephalopathy and catatonia in burns is reviewed. Few examples of burn catatonia exist. Burn encephalopathy is common, and may occur in patients with low TBSA burns such as described in the case above. Descriptions of burn encephalopathy are numerous, but have not included catatonia as a possible etiology. Catatonia in burn patients as an etiology of burn encephalopathy is likely underrecognized. Clinicians should be aware of the possibility of catatonia when a patient's confusional state after a burn does not respond to usual care.

Changes in forest structure and composition after fire in tropical montane cloud forests near the Andean treeline

Background: In tropical montane cloud forests (TMCFs) fires can be a frequent source of disturbance near the treeline. Aims: To identify how forest structure and tree species composition change in response to fire and to identify fire-tolerant species, and determine which traits or characteristics are associated with fire tolerance. Methods: Shifts in forest structure and diversity were assessed on 15 paired plots in burnt and unburnt (control) forests, along a fire chronosequence. Species were classified as fire-sensitive, fire survivors or fire thrivers, using a fire tolerance index. Regression and tree analyses were used to determine which traits contributed to the fire tolerance of species. Results: There were more small- and medium-sized trees in the burnt plots independent of time since the last fire. There were shifts in family importance value and in species diversity among the plots. Of the 73 species analysed there were 39 fire-sensitive species, 19 fire survivors and 14 fire thrivers. Sprouting ability and biomass showed a positive relationship with the fire tolerance of species. Conclusions: There were immediate as well as long-term (up to 15 years) effects of fire on forest structure and species composition, suggesting that TMCFs take more than 15 years to regenerate from a fire. Long-term studies are needed to fully understand regeneration patterns of TMCFs after fires.

Posttraumatic Stress Symptoms and Posttraumatic Growth Among Italian Survivors of Emergency Situations

We investigated the relation between posttraumatic growth and posttraumatic stress symptoms among survivors of fires, earthquakes, and floods. Furthermore, we explored the contribution of several predictors to these outcomes. Participants were 173 survivors of several events that have occurred in Italy in the last decade. Posttraumatic growth was positively related to posttraumatic avoidance and intrusion-hyperarousal symptoms. Multiple regression analyses revealed that peritraumatic panic was a predictor of posttraumatic intrusion-hyperarousal symptoms and posttraumatic growth. Moreover, posttraumatic intrusion-hyperarousal symptoms mediate the relationship between peritraumatic panic symptoms and posttraumatic growth. These results contribute to a better understanding of the role of intrusive thoughts in promoting posttraumatic growth.

Predicting Protective Factors of Physical and Mental Health for Survivors of Residential Fire

Symptoms of posttraumatic stress disorder (PTSD), depression, and physical health outcomes are three of the most common health outcomes evaluated for trauma survivors and several lines of empirical and meta-analytic research have demonstrated many risk factors for PTSD. Further, examining trauma survivors’ responses through a resilience orientation has grown increasingly popular over the past decade. However, the resilience orientation has little support among adult trauma survivor populations and none when evaluating physical health as part of an integrated health index (combining PTSD, depression, and physical health outcomes). Through examination of residential fire survivors, the current project evaluates the predictive validity of protective factors of PTSD as they relate to this integrated health index. Participants were assessed via self-report and semi-structured interviews approximately 4 months post-fire. Through evaluation of the integrated health index, peritraumatic emotionality and resource loss were found to significantly predict a resilient group of residential fire survivors 4 months post-fire. The present study suggests lower sustained resource loss and lower peritraumatic emotionality are significant protective factors for resiliency from residential fire.

Perievent distress during fires – The impact of perceived emergency knowledge

Emotional distress during fire situations and other emergencies has been found to be an important factor in predicting posttraumatic stress symptoms. Little research has been done concerning the predictors of peri-event emotional distress itself and its related factors. The present study investigated the predictive power of pre- and peri-event factors on peri-event emotional distress in a European convenience sample of 574 domestic fire survivors. In addition to peri-event emotional distress, the increase in distress due to the fire (i.e. fire-induced emotional distress) was investigated. It was found that fire-induced emotional distress could be predicted by the amount of prior perceived emergency knowledge, perceived time pressure, perceived threat, panic attack symptoms and education. Results of a path analysis revealed perceived emergency knowledge as the most important factor in reducing stress caused by the fire. Possible differences between perceived and actual emergency knowledge and their implications for training are discussed.

The Long-Term Impact of Physical and Emotional Trauma: The Station Nightclub Fire

BackgroundSurvivors of physical and emotional trauma experience enduring occupational, psychological and quality of life impairments. Examining survivors from a large fire provides a unique opportunity to distinguish the impact of physical and emotional trauma on long-term outcomes. The objective is to detail the multi-dimensional long-term effects of a large fire on its survivor population and assess differences in outcomes between survivors with and without physical injury.Methods and FindingsThis is a survey-based cross-sectional study of survivors of The Station fire on February 20, 2003. The relationships between functional outcomes and physical injury were evaluated with multivariate regression models adjusted for pre-injury characteristics and post-injury outcomes. Outcome measures include quality of life (Burn Specific Health Scale–Brief), employment (time off work), post-traumatic stress symptoms (Impact of Event Scale–Revised) and depression symptoms (Beck Depression Inventory). 104 fire survivors completed the survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. Although depression and quality of life were associated with burn injury in univariate analyses (p<0.05), adjusted analyses showed no significant relationship between burn injury and these outcomes (p = 0.91; p = .51). Post-traumatic stress symptoms were not associated with burn injury in the univariate (p = 0.13) or adjusted analyses (p = 0.79). Time off work was the only outcome in which physical injury remained significant in the multivariate analysis (p = 0.03).ConclusionsSurvivors of this large fire experienced significant life disruption, including occupational, psychological and quality of life sequelae. The findings suggest that quality of life, depression and post-traumatic stress outcomes are related to emotional trauma, not physical injury. However, physical injury is correlated with employment outcomes. The long-term impact of this traumatic event underscores the importance of longitudinal and mental health care for trauma survivors, with attention to those with and without physical injuries.

Prevalence of hydrogen cyanide and carboxyhaemoglobin in victims of smoke inhalation during enclosed-space fires: a combined toxicological risk

Background. Hydrogen cyanide (HCN) is one of the most toxic components of fire smoke, but insufficient attention is paid to its potential role as a cause of injury or death in victims (alive or dead) of enclosed-space fires. Objective. To analyse the prevalence of toxic HCN exposure in fire victims and factors that may influence its toxicity, particularly the co-presence of carbon monoxide (CO) and ethanol. Materials and methods. Blood samples from fire victims and persons rescued from fires were analysed. Results. A positive result for HCN (mean concentration 16.83 mg/l) was detected in blood samples from 169 of 285 fire-related deaths (59%). Ethanol was present in 91 (65%) of 139 samples with coincident presence of HCN and carboxyhaemoglobin (COHb). HCN (mean 4.0 mg/l) was also detected in 20 of 40 (50%) fire survivors. Discussion. The high prevalence of coincident CO and HCN in enclosed-space, fire-related deaths should alert clinicians to suspect toxic HCN exposure in all persons rescued from fire with signs and symptoms of respiratory distress. Conclusions. Medical procedures in persons rescued from enclosed-space fires, especially in the pre-hospital setting, should be augmented to cover the possibility of toxic HCN exposure, particularly in individuals who do not respond to standard supportive therapy. Likewise, post-mortem investigations should routinely include assays for HCN when determining probable cause of death.