Surveillance and Prevention of Residential-Fire Injuries

Injury Prevention, 2002

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 dataset for the city of Dallas, Texas. Methods: Data for all residential fires were linked with fire related injury data, using fire department records, ambulance transports, hospital admissions, and medical examiner records, for children 0-19 years of age. Causes of fires, including fireplay (children playing with fire or combustibles), arson and other causes, were determined by fire department investigation. Results: From 1991-98, 76 children were injured in residential fires (39 deaths, 37 non-fatal). The highest rates occurred in the youngest children (<5 years) and in census tracts with lowest income. Fireplay accounted for 42% (32/76) of all injuries, 62% (15/24) of deaths in children 0-4 years, and 94% (13/14) of deaths from apartment and mobile home fires. Most of the fireplay related injuries (27/32, 84%) were from children playing with matches or lighters. Most started in a bedroom. Smoke alarms showed no protective efficacy in preventing deaths or injuries in fires started by fireplay or arson, but there was significant protective efficacy for a functional smoke alarm in fires started from all other causes (p<0.01). Conclusions: Residential fire related injuries among children in Dallas occurred predominantly in the youngest ages (<5 years) and in poor neighborhoods. Most of the deaths, especially those in apartments and mobile homes, resulted from fireplay. Smoke alarms appeared to offer no protection against death or injury in fireplay associated fires, possibly from the nature of the child's behavior in these fires, or from the placement of the smoke alarm. Prevention of childhood residential fire related deaths may require interventions to prevent fireplay in order to be successful.

Journal of Burn Care & Research, 2023

S9 (23.1% vs 5.3%; p = 0.083). Therapy data were available for 88 patients totaling 656 occupational and 462 physical therapy sessions, including acute care, inpatient rehabilitation unit, and outpatient. Unfortunately, there were 8 (6%) unnecessary deaths from their injuries with an average 77.3 ± 10.4 years of age and 42.4 ± 21.7% TBSA with 35.1 ± 23.7% being full-thickness. Total hospital charges exceeded $32.6 million with a median $32,952.26 ($8,790.48, $103,113.95) per patient. Payer source at day of discharge was mixed (private 37%, self-pay 26%, Medicare 20%, and Medicaid 17%). Conclusions: Injuries from waste burning are completely unnecessary and subsequent mortality, morbidity, and health care burden avoidable. Focusing future outreach efforts on education and resource availability may prevent future debris and trash related injuries. Applicability of Research to Practice: This is the first study to utilize repository data to analyze waste burning injuries from a regional perspective.

Public Health Reports, 2007

Objectives. This study was conducted to estimate (1) the proportion of U.S. homes with installed smoke alarms and fire escape plans, and (2) the frequency of testing home smoke alarms and of practicing the fire escape plans. Methods. The authors analyzed data on smoke alarms and fire escape plans from a national cross-sectional random-digit dialed telephone survey of 9,684 households. Results. Ninety-five percent of surveyed households reported at least one installed smoke alarm and 52% had a fire escape plan. The prevalence of alarms varied by educational level, income, and the presence of a child in the home. Only 15% tested their alarms once a month and only 16% of homes with an escape plan reported practicing it every six months. While smoke alarm prevalence in U.S. homes is high, only half of homes have a fire escape plan. Additional emphasis is needed on testing of installed smoke alarms and on preparedness for fire escape plans.

Journal of Burn Care &amp; Research, 2015

The treatment of burn injuries requires high-cost services for healthcare and society. Automatic fire sprinklers are a preventive measure that can decrease fire injuries, deaths, property damage and environmental toxins. This study's aim was to conduct a cost-analysis of patients with burn or inhalation injuries due to residential fires, and to compare this to the cost of implementing residential automatic fire sprinklers. We conducted a cohort analysis of adult burn patients admitted to our provincial burn center (1995-2012). Patient demographics and injury characteristics were collected from medical records, and clinical and coroner databases. Resource costs included average cost per day at our intensive care and rehabilitation program, transportation, and property loss. During the study period there were 1,557 residential fire-related deaths province-wide and 1,139 patients were admitted to our provincial burn center due to a flame injury occurring at home.

Journal of Community Health, 2006

The purpose of the study was to assess the state of fire prevention research, provide an updated synthesis of evaluated fire prevention programs, and discuss the role of fire fighters and data systems in prevention efforts. The review included all evaluations of U.S. based fire prevention interventions published between January 1998 and September 2004 and any earlier articles about U.S. fire prevention interventions not included in two prior review articles. We retrieved information from each identified study including evaluation findings, involvement of fire service personnel and use of existing data systems. We identified twelve articles: seven reported on smoke alarm interventions, three on multi-faceted programs, and two other programs. Five programs involved fire service personnel in the design, implementation, and/or evaluation, and three used existing data systems. Studies reviewed suggest that canvassing and smoke alarm installations are the most effective means of distributing alarms and increasing the functional status of distributed alarms. The functionality of smoke alarms, an issue noted in earlier reviews, remains a problem. Programs involving partnerships with fire departments have indicated success in preventing fires and deaths, improving smoke alarm ownership and functional status, and improving children's fire safety knowledge. Using existing data systems to target and to evaluate interventions was effective. In the years since prior reviews, some improvements in the rigor of evaluation designs have been made, but there is still a need for high quality evaluations that will inform fire injury prevention efforts.

Journal of Safety Research, 2012

This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright Author's personal copy Reduced frequency and severity of residential fires following delivery of fire prevention education by on-duty fire fighters: Cluster randomized controlled study

Applied Geography , 2023

BMJ, 2002

Objective To measure the effect of giving out free smoke alarms on rates of fires and rates of fire related injury in a deprived multiethnic urban population. Design Cluster randomised controlled trial. Setting Forty electoral wards in two boroughs of inner London, United Kingdom. Participants Primarily households including elderly people or children and households that are in housing rented from the borough council. Intervention 20 050 smoke alarms, fittings, and educational brochures distributed free and installed on request. Main outcome measures Rates of fires and related injuries during two years after the distribution; alarm ownership, installation, and function. Results Giving out free smoke alarms did not reduce injuries related to fire (rate ratio 1.3; 95% confidence interval 0.9 to 1.9), admissions to hospital and deaths (1.3; 0.7 to 2.3), or fires attended by the fire brigade (1.1; 0.96 to 1.3). Similar proportions of intervention and control households had installed alarms (36/119 (30%) v 35/109 (32%); odds ratio 0.9; 95% confidence interval 0.5 to 1.7) and working alarms (19/118 (16%) v 18/108 (17%); 0.9; 0.4 to 1.8).

Accident Analysis & Prevention, 1980

Accidental home fires usually start in areas of the dwelling where people spend most of their time. The most frequent causes of fires are related to the activities of the residents, smoking being the most common. Persons who have home fires are, on average, younger than their controls, have more children, smoke in bed more and stay at home less often during the day. Typically, they live in apartment buildings where there has already been a fire, have less space available, but enjoy more fire protection than the controls. Home fires have characteristic seasonal, weekly and hourly distributions, as well as preponderance for older areas of the city. They are usually discovered by residents, smoke leading to detection in most cases, and most often occupants use their own telephones to alert firemen. This happens "immediately" after the discovery and the firemen are at the scene within 10 minutes in 90% of all instances. Extent of damage seems to be dependant on the time that elapses between the onset and the discovery of fires. No single variable can explain the occurences of accidental home fires. Yet, there appears to exist a person-building susceptible profile in which personal characteristics take precedence. Smoke detectors should become mandatory. Anti-smoking efforts should be enhanced. More care is needed when designing electrical power supplies in dwellings. THE PROBLEM Canada reports twice as many deaths due to fires as any other industrialized nation, with the exception of the U.S. [Harlow, 1975]. According to the Reports of the Dominion Fire Commissioner [Fire Losses in Canada, 1968-75], about two thirds of all fires occur on residential premises (which represents about 40,000 such accidents~), resulting in 500-600 deaths and as many as 30,000 injuries each year. The Commissioner estimated damages to property in 1974 at $430,000,000, but pointed out that they probably ran several times as high due to production loss and unemployment. The Montreal Fire Department [Rapports Annuels, 1968-75] recorded a slight increase in the absolute numbers of fires. The annual incidence, however, in 1971 and in the decade preceding the survey was about 5 per 1000 occupied dwellings. On average, the number of deaths was about 30/yr, with approximately ten times as many injuries.

Prehospital and disaster medicine

All events that result in disasters are unique, and it is impossible to become fully prepared. However, through thorough planning and preparedness, it is possible to gain a better understanding of the typical injury patterns and problems that arise from a variety of hazards. Such events have the potential to claim many lives and overwhelm local medical resources. Burn disasters vary in scope of injury and procedures required, and are much more labor and resource intensive than non-burn disasters. This review of the literature should help determine whether, despite each event having its own unique features, there still are common problems disaster responders face in the prehospital and hospital phases, what recommendations were made from these disasters, and whether these recommendations have been implemented into practice and the current disaster planning processes. The objective of this review was to assess: (1) prehospital and hospital responses used during past burn disasters; (2...

T Th he e p pu ub bl li ic ca at ti io on n o of f t th he e R Re ep po or rt t w wa as s s sp po on ns so or re ed d b by y t th he e S St ta at te e F Fi ir re e A Ac ca ad de em my y o of f E Em me er rc co om m o of f R Ru us ss si ia a О От тч че ет т и из зд да ан н п пр ри и с со од де ей йс ст тв ви ии и и и п по од дд де ер рж жк ке е А Ак ка ад де ем ми ии и Г Го ос су уд да ар рс ст тв ве ен нн но ой й п пр ро от ти ив во оп по ож жа ар рн но ой й с сл лу уж жб бы ы М МЧ ЧС С Р Ро ос сс си ии и All statistical data in the report for any year are based on official data from every country that provided data for that year. No attempt has been made to limit the calculations to countries that provided data for all or most years or to compensate statistically for changes in the participating countries (or cities). Therefore, readers should use caution in interpreting these results. An apparent trend up or down may reflect not so much a real change in fire experience or fire risk but rather the movement in and out of the database of a very large country or a shift in the fraction of included populations residing in high-rate versus low-rate countries.

Fire and Materials, 2016

Objective: Research to date has focused on causal descriptions of residential fire fatalities and injuries, with an emphasis on ignition factor. This paper examines if, how and why human actions or inactions lead to accidental residential fires and identifies risk factors most closely associated with those fires caused by human unsafe behaviours. Methods: Interviews of 182 people who had survived accidental residential fires without serious injury were conducted. Each fire was classified as either 1) directly caused by human unsafe behaviours; 2) human long term inactions; or 3) involved NO human actions. Frequencies and odds ratio values were presented. Results/Discussion: Slightly less than half (46%) of the non-injury fires were directly caused by human unsafe behaviours, 40% involved no human actions, and 14% were associated with long-term human inactions. Examination of the fires caused by human unsafe behaviours compared to no human involvement using Odds Ratios showed that individuals in the former group were significantly more likely to be mentally ill, physically disabled, asleep, not in full-time paid employment and more intimate with ignition. Conclusions: Many non-injury fires do not directly arise from unsafe activity and most of them were caused by electrical or ignition system failure. New design innovations and/or improvements in appliances may reduce those fires due to appliance maintenance negligence or electrical faults. Identification of the most high risk individuals for unsafe behaviours can help inform fire safety educational programs.

Fire Safety Journal, 2015

Objective: This 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). Methods: Analyses were based on 177 single fatalities (from coronial files) and 183 survivors (from interviews) of accidental residential fires. Results/discussion: The top seven risk factors (OR4 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 410) 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. Conclusions: This 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.

American Journal of Public Health, 2019

Objectives. To evaluate the risk of death and injury in residential fires started on upholstered furniture, with a focus on open flame and cigarette-related heat sources. Methods. We used civilian death and injury data from 34 081 residential fires in the Massachusetts Fire Incident Reporting System from 2003 to 2016. We compared outcomes associated with fires that started on upholstered furniture ignited by smoking materials versus open flames. Results. Although fires starting on upholstered furniture were not common (2.2% of total fires), odds of death and injury were significantly higher in these fires than in fires started on other substrates. Among furniture fires, odds of death were 3 times greater when those fires were ignited by smoking materials than when ignited by open flames (odds ratio = 3.4; 95% confidence interval = 1.3, 10.9). Conclusions. Furniture fires started by smoking materials were associated with more deaths than were furniture fires started by open flames. P...

Fire and Materials, 2016

Research on fatal fires and evacuation exercises yield little or no information about how fire victims respond to a real house fire incident where occupants' mental stress levels differ greatly. Drawing upon daily records of fire incidents from the Victorian Metropolitan Fire Brigade and Country Fire Authority, Australia, 182 individuals who had survived accidental residential fires without serious injuries were interviewed. Similar to most literature, this paper found that electrical failure and cooking-related activities were the main causes of noninjury house fires. The smell of smoke was the top listed cue that first alerted an individual ('host' or person in the vicinity). The majority of hosts took proactive actions when facing the threat of a fire, while in only one third of survived fires no attempt to extinguish the fire was made at the time of ignition. This study did not reveal any significant relationships between main activities during a fire and occupant characteristics, however, people with no or only basic fire safety knowledge were more likely to engage in activities such as attempting to extinguish a fire/ collect personal belongings/ rescue pets/ disconnect power source than those who had some level of fire training.