Identifying sociodemographic risk factors associated with residential fire fatalities: a matched case control study.

OBJECTIVES: This study aimed to investigate the association between sociodemographic factors and residential fire fatalities in Sweden. A majority of fatal fires occur in housing. An understanding of risk factors and risk groups is a must for well-founded decisions regarding targeted prevention efforts. There is a lack of consideration of the interrelation between sociodemographic factors and fire fatalities and there is a lack of high quality large-scale studies. METHODS: In this matched case-control study, residential fire fatalities (cases, n=850) (age above 19 years old) were identified in the national register on fatal fires. Four controls per case were randomly matched by gender and age. ORs were calculated to assess the association between different sociodemographic factors with residential fire fatalities using conditional logistic regression. RESULTS: Having low income, receiving social allowance and receiving health-related early retirement pension were associated with an increased risk of dying in residential fires. The results also show clearly that adults dying in residential fires to a significantly lower extent were living together with a partner, were in work, were highly educated and lived in urban areas. However, contrary to previous research, living in rented apartments appeared not to influence the risk of death. CONCLUSIONS: In this study, we show that fatalities due to residential fires in Sweden are associated with some but not all of previously published sociodemographic risk factors. The results provide valuable information that can improve the guiding and targeting of fire mortality prevention strategies in Sweden.

Do home fire and safety checks by on-duty firefighters decrease the number of fires? Quasi-experimental evidence from Southern Sweden.

INTRODUCTION: Fire and rescue services Syd, in the south of Sweden, started to conduct home fire and safety checks on a large scale in 2010. The goal was to reduce the damages from residential fires. METHOD: We estimate the effects of the intervention on the incidence of residential fires and evaluate its economic effect. We use a difference-in-kinks design to analyze time-varying intervention effects and conduct a cost-benefit analysis for the economic evaluation. RESULTS: The results demonstrate that fires and developed fires decrease by a maximum of approximately 6% and 8% per year (assuming 100% causality) and that the intervention has positive economic effects, with the benefits estimated to be maximum 8-11 times higher than the costs. Practical applications: The results should be valuable as input when deciding whether to implement home fire and safety checks elsewhere.

Are national injury prevention and research efforts matching the distribution of injuries across sectors?

In 2011, 88% of all unintentional injury fatalities occurred in home and leisure environments in Sweden, while transportation fatalities accounted for 10% and work/school injuries for 2%. The corresponding proportions among non-fatal injuries were 75, 12 and 13%, respectively. However, 83% of the national governmental expenditure on unintentional injury prevention in 2011 was allocated to transportation safety, 7% to home and leisure, and 10% to the work sector including schools. Likewise, around 85% of the governmental research budget aimed for unintentional injury research was allocated to the transportation sector, 9% to home and leisure environments, and 6% to the work and school sector. Our results reveal a striking lack of correspondence between problem profile and governmental countermeasures.

Time is money, but how much? The monetary value of response time for Thai ambulance emergency services.

OBJECTIVE: To calculate the monetary value of the time factor per minute and per year for emergency services. METHODS: The monetary values for ambulance emergency services were calculated for two different time factors, response time, which is the time from when a call is received by the emergency medical service call-taking center until the response team arrives at the emergency scene, and operational time, which includes the time to the hospital. The study was performed in two steps. First, marginal effects of reduced fatalities and injuries for a 1-minute change in the time factors were calculated. Second, the marginal effects and the monetary values were put together to find a value per minute. RESULTS: The values were found to be 5.5 million Thai bath/min for fatality and 326,000 baht/min for severe injury. The total monetary value for a 1-minute improvement for each dispatch, summarized over 1 year, was 1.6 billion Thai baht using response time. CONCLUSIONS: The calculated values could be used in a cost-benefit analysis of an investment reducing the response time. The results from similar studies could for example be compared to the cost of moving an ambulance station or investing in a new alarm system.

Preferences for lives, injuries, and age: a stated preference survey.

One of the more difficult ethical questions from a public decision-making perspective is whether the estimation of benefits from risk reducing projects should be influenced by factors such as age groups and risk domains. For example, should a project that saves the lives of elderly people be assigned a more different benefit value in cost-benefit analyses than one that saves the same number of children's lives? This paper examines the preferences of the general public in Sweden on these issues. We design a choice experiment in which subjects are required to make six pair-wise choices where the characteristics of each choice are accident type (fire and traffic), number of fatalities and serious injuries avoided, and age of those saved (5-15-, 35-45- and 65-75-year-olds). We find that avoiding the fatality of one 5-15-year-old is equivalent to avoiding 1.4 fatalities of 35-45-year-olds. Likewise, avoiding the fatality of one 5-15-year-old is equivalent to avoiding 3.3 fatalities of 65-75-year-olds. We find no significant differences between the causes of accident. One avoided fatality is found to be equivalent to around 3.5 avoided severe injuries, which is lower than the official value of 6 used by the Swedish Road Administration.

Value of statistical life and cause of accident: a choice experiment.

The purpose of this study is to compare the value of statistical life (VSL) estimates for traffic, drowning, and fire accidents. Using a choice experiment in a mail survey of 5,000 Swedish respondents we estimated the willingness to pay for risk reductions in the three accidents. In the experiment respondents were asked a series of questions, whether they would choose risk reducing investments where type of accident, cost of the investment, the risk reduction acquired, and the baseline risk varied between questions. The VSLs for fire and drowning accidents were found to be about 1/3 lower than that for traffic accidents. Although respondents worry more about traffic accidents, this alone cannot explain the difference in VSL estimates. The difference between fire and drowning accidents was not found to be statistically significant.