@article {bnh-5807, title = {Preventable residential fire fatalities in Australia July 2003 to June 2017}, number = {506}, year = {2019}, month = {08/2019}, institution = {Bushfire and Natural Hazards CRC}, address = {Melbourne}, abstract = {

Introduction

On average, more than one fire-related death occurs in a residential context every week in Australia. That equates to approximately the same number of deaths as occurred during the Black Saturday bushfires (173) every three years. These deaths are overwhelmingly preventable. Deaths from residential fires have significant social, economic and emotional impacts on individuals, families, communities and also on the firefighters and other emergency service workers who attend these tragic incidents. The last published national study into residential fire fatalities in Australia was released in 2005 (Australasian Fire Authorities Council (AFAC), 2005). The current study follows on from that report but looks in greater depth at who is most at risk. It provides fire services and other stakeholders with an analysis of preventable residential fire fatalities to inform evidence-based policy and practice to reduce the number of future deaths.

Aims

The aims of this study were to:

Methods

The methodology of this study is based primarily on the collection and analysis of coronial records from the National Coronial Information System (NCIS) database, supported by the analysis of publicly available Coronial reports. The NCIS database is an online facility storing coronial cases from all jurisdictions in Australia from 2000 onwards. To access the NCIS database ethics approvals were obtained from the Human Research Ethics Committees of Macquarie University and the Victorian Department of Justice and Regulation, from the Coroners Court of Victoria Research Committee and from the Western Australian Coronial Ethics Committee.\ 

Australian records from 1 July 2003 to 30 June 2017 were accessed in the NCIS by a\ variety of searches. After refinement of the applicable dataset, relevant structured\ and non-structured data from the NCIS (comprising the summary page, police,\ autopsy and toxicology reports and coroner{\textquoteright}s findings) were coded for 41 fields and\ entered into a specially constructed Microsoft (MS) Access database {\textendash} the\ Preventable Residential Fire Fatalities Database. Once complete, the data were\ exported to MS Excel tables and statistically analysed.\ \ 

Results/Discussion

Mortaility statistics

This study found that at least 900 people have died in preventable residential fires in\ Australia from July 2003 to June 2017, averaging approximately 64 deaths per year\ or more than one preventable residential fire death every week. This is a national\ death rate of approximately 0.29 per 100,000 population. The majority of deaths\ occur in single fatality incidents. Between 2003 and 2017 there was no clear\ declining trend in fire fatalities.

The results from this study highlight that the conceptualisation of fire fatality risk is\ complex. The presence of a single risk factor on its own is unlikely to significantly\ increase a person{\textquoteright}s risk of dying in a residential fire. It is the co-occurrence of a\ range of factors surrounding the person, their behaviours, their residential\ environment and other external factors that is likely to impact their overall level of
risk of having a fire that results in their death.

Fire services, individuals and other stakeholders can and should do more to reduce the rate of residential fire fatalities further, with an aim of reducing preventable residential fire deaths towards zero. Interventions to reduce the risk of residential fire for those most at risk of dying need to encompass both technological and human-centred approaches.

The residence and location

Free-standing houses/ villas were the housing type where the majority of fatal fires occurred (67.1\%). However, stand-alone houses comprise 78.4\% of housing stock in Australia, so other housing types may be over-represented in the fatality data. Similarly, owner occupiers were the most commonly identified property tenure (53\%), but owner occupiers account for approximately 67\% of all property tenures in
Australia (ABS, 2017). This indicates that other tenure types, such as private and public rentals, may be over-represented in fire fatalities.\ 

Geographically, most fatal residential fires occurred in major cities, but with regard to the death rate per 100,000 population, there was over-representation of deaths in regional and remote areas. The analysis of the fatality data in relation to areas of relative socio-economic advantage and disadvantage (IRSAD) (refer to pp.31-32 and Appendix 3) shows that most fatalities occurred in locations where there is relatively greater socio-economic disadvantage.\ Fatal preventable residential fires start most commonly in the living room/ lounge or\ bedroom. They are not necessarily large or severe fires, with approximately half of\ fatal fires burning one room or less of the structure.

Seasonality

The most common characteristics of residential fires that are fatal include that they\ occur mostly during the Australian winter months. They occur most commonly\ between hours of 8pm-8am and particularly from midnight-4am.

Smoke alarms

Smoke alarms are the most important residential fire safety device. They are required\ by law in residential properties in all Australian jurisdictions. For this study, data on\ smoke alarms was collected from the narrative parts of the NCIS database. In a\ large majority of cases (65.9\%), this information was not known. The extent that the\ presence of a smoke alarm was noted is low considering their importance, and
considering that the absence of a smoke alarm may have had an impact on the\ fatality outcome (e.g., by providing an earlier warning to the fire victim.)

The people

Single variable analysis from the current research found that those most at risk of\ dying in a preventable residential fire included:

By age cohort, people aged >=65 are the group most at risk of dying in a residential fire. In the >=65 cohort, the fatality rate increases with age; older age groups are more at risk. The data indicates that the other factors that increase risk in older people include smoking, having a disability, the presence in their blood of alcohol and/ or medications, living alone and requiring support to live at home. Where these
factors are present in combination, an older person{\textquoteright}s risk may increase significantly.\ 

The presence of a working smoke alarm may not provide early enough warning to enable older people to escape from a fire. This is an area that needs more research, but it indicates that there may be life-saving benefits if fire services and other stakeholders focus on increasing the uptake of specialist smoke alarms appropriate to the needs of older people.

The future fire fatality risk for older people is likely to be on an increasing trajectory due to a range of demographic and policy factors. These include an ageing population and this growing population of older people\ {\textquotedblleft}ageing in place{\textquotedblright} within their own home for longer.

Children aged 0-4 had the largest number of deaths of any 5 year age range. The cause of fire was more often lighters or matches (n=31), which may indicate that a significant number of fires were lit by children during fire-play. The link to social and financial disadvantage was particularly significant in this cohort, with almost half (48.6\%, n=34) of deaths in the 0-4 age bracket occurring in locations in the top 10\% of greatest socio-economic disadvantage, and 87.2\% of fatalities occurred in the top 40\% of locations of greatest disadvantage.

Fire safety interventions for this cohort need to be focused on increasing the basic home fire safety of families with young children, particularly in areas of social and financial disadvantage. Fire services and other stakeholders may consider interventions that partner with other services, such as maternal and child health services, to identify and reach those most at risk.

Within the fire fatality data, 46.7\% (n=420) of decedents were identified as having at least one disability present. Physical disabilities comprised 46.2\% of disabilities identified, while mental health and neurological disorders made up 27.8\% and 9.7\% of disabilities identified. People with a disability are likely to be over-represented in the fire fatality data. Mental health and neurological disorders are an identified risk factor for residential fire fatality. Similar to older people, there may be a lifesaving benefit in fire services and other stakeholders focusing on increasing the uptake of specialist smoke alarms appropriate to the needs of people with a disability.\ 

Some 8.2\% (n=57) of decedents were identified as Aboriginal, Torres Strait Islander\ (TSI) or both. Approximately 3.3\% of the Australian population identify as Aboriginal\ or TSI (ABS, 2019a), meaning that this cohort are over-represented in the data by a\ factor of 2.5. Aboriginal/ TSI people comprised 12\% of fatalities under 65 years of age and 3\% of people over 65 years, likely reflecting the younger age structure of the\ Aboriginal and TSI population.

Smokers are over-represented to a large extent in residential fire fatalities. Of cases\ where the smoking status of the decedent was known (n=428), 65.4\% of people\ were smokers. During the study period, smoking rates in Australia decreased\ significantly, and reduced-fire-risk cigarettes were mandated in Australia in 2010. In\ the 2004/5 financial year 23.3\% of Australians were smokers. By 2014/15 this had
decreased to 15.5\%. The fatality data does not reflect any decline in the number of\ smokers who died over the course of the study period. It is unclear why this is the\ case.

Smoking materials are a major cause of ignition of fatal residential fires. For those cases where the fire cause was known, over a quarter (26.7\%, n=161) were caused by smoking materials (i.e., cigarettes, pipes etc), with just over a third of those (n=56) relating to smoking in bed. There was a strong link between smoking materials as the cause of fire and the residence being located in a relatively disadvantaged area,\ with 49\% of fires caused by smoking materials occurring in the top 25\% of most\ disadvantaged locations.

Recommendations

Fire services and other stakeholders may consider the following recommendations to reduce the incidence of preventable residential fire fatalities in Australia:

Conclusion

Preventable residential fire fatalities in Australia remain a significant public health problem, with an average of 64 fatalities each year. Deaths from residential fires have significant social, economic and emotional impacts on individuals, families, communities and also on the firefighters and other emergency service workers who attend these tragic incidents.

For the first time in over 14 years, this study provides an update on the evidence around the extent of preventable residential fire fatalities in Australia, those people most at risk and the details of fire incidents and residences where fatal fires have occurred. It provides a set of data that fire services and other stakeholders can use to develop evidence-based policy and practice to reduce the occurrence of fatal residential fires.

}, keywords = {Australia, Emergency management, Fatalities, Fire, metropolitan fire, MFB}, isbn = {978-0-6482756-3-3}, issn = {506}, author = {Coates, Lucinda and Geoff Kaandorp and Julie Harris and Jonathan Van Leeuwen and Ashley Avci and Jacob Evans and Steve George and Andrew Gissing and Robin van den Honert and Katharine Haynes} }