Preventing deaths and injuries from house fires: a cost–benefit analysis of a community-based smoke alarm installation programme

Yellman, Merissa A.; Peterson, Cora; McCoy, Mary A; Stephens-Stidham, Shelli; Caton, Emily; Barnard, Jeffrey J.; Padgett, Ted O; Florence, Curtis S.; Istre, Gregory R.

doi:10.1136/injuryprev-2016-042247

Cited by 17 publications

(22 citation statements)

References 18 publications

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“…A simple and commonly administered approach to home fire safety programs centers on the distribution and installation of smoke alarms. This approach has effectively reduced fire-related deaths and injuries in many types of populations (Istre et al, 2014; Yellman et al, 2018). Such programs are most effective when combined with fire safety education, low-cost or free equipment installations, and lithium battery alarms (Cooper et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Community/Public Health Nurses’ Awareness of Residential High-Rise Fire Safety issues

Glauberman

Qureshi

2021

SAGE Open Nursing

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High-rise (HR) building fires remain a tragic cause of preventable injury and death in the United States. Recent incidences of HR building fires have served as high-profile reminders of the persistent threat that HR fires pose to public health. Fire safety is an important aspect of household emergency preparedness addressed by community/public health nurses (C/PHNs). This study aimed to address a gap in the literature regarding C/PHNs’ awareness of fire safety for people and families who reside in HR buildings. A descriptive qualitative study using key-informant and focus group interviews was conducted involving C/PHNs ( n = 19) in Honolulu, Hawaii. Qualitative data analysis revealed three main themes related to this issue: (1) C/PHN awareness of HR fire safety issues, (2) C/PHN perceived barriers for HR building occupant fire safety, and (3) C/PHN suggested strategies to address HR fire safety for occupants. Findings highlight how more needs to be done to assure that C/PHNs are adequately prepared to work with occupants of residential HR buildings on matters related to fire safety.

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Section: Discussionmentioning

confidence: 99%

Community/Public Health Nurses’ Awareness of Residential High-Rise Fire Safety issues

Glauberman

Qureshi

2021

SAGE Open Nursing

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“…Previous interventions to reduce unintentional injuries have tended to focus on one type of injury e.g. burns associated with fire (11)(12)(13)(14)(15)37), scalds (16,38), and poisonings. (17) All but one of these interventions were found to be cost-effective.…”

Section: In Context With the Literaturementioning

confidence: 99%

Cost-effectiveness of England’s national ‘Safe At Home’ scheme for reducing hospital admissions for unintentional injury in children aged under 5

et al. 2022

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BackgroundInjuries in children aged under 5 years most commonly occur in the home and disproportionately affect those living in the most disadvantaged communities. The ‘Safe at Home’ (SAH) national home safety equipment scheme, which ran in England between 2009 and 2011, has been shown to reduce injury-related hospital admissions, but there is little evidence of cost-effectiveness.Materials and methodsCost-effectiveness analysis from a health and local government perspective. Measures were the incremental cost-effectiveness ratio per hospital admission averted (ICER) and cost-offset ratio (COR), comparing SAH expenditure to savings in admission expenditure. The study period was split into three periods: T1 (years 0–2, implementation); T2 (years 3–4) and T3 (years 5–6). Analyses were conducted for T2 versus T1 and T3 versus T1.ResultsTotal cost of SAH was £9 518 066. 202 223 hospital admissions in the children occurred during T1-3, costing £3 320 000. Comparing T3 to T1 SAH reduced admission expenditure by £924 per month per local authority and monthly admission rates by 0.5 per local authority per month compared with control areas. ICER per admission averted was £4209 for T3 versus T1, with a COR of £0.29, suggesting that 29p was returned in savings on admission expenditure for every pound spent on SAH.ConclusionSAH was effective at reducing hospital admissions due to injury and did result in some cost recovery when taking into admissions only. Further analysis of its cost-effectiveness, including emergency healthcare, primary care attendances and wider societal costs, is likely to improve the return on investment further.

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“…A smoke-alarm give-away program in Oklahoma City, OK in the late 80's found an 80 % decrease in injuries in the treatment area over the course of the study [21]. Yelman et al [55] evaluated the cost effectiveness of the Dallas program and found that, after accounting for lost productivity among victims, and not accounting for fire-prevention effects, the cost per injury prevented of the program was negative. That suggests that smoke-alarm give-away programs are highly cost-effective.…”

Section: Mitigation Measuresmentioning

confidence: 99%

Human behavior in home fires

Gilbert¹

2021

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Casualties in fires--and in particular, deaths--are tail events. The average fire does not cause deaths or injuries. There is increasing evidence that the people susceptible to dying in fires are a specific subset of the people in homes. It seems likely that the same holds true of the fire and the environment as well. That is, that it is a suite of circumstances that produce deaths (and to a lesser extent injuries) in fires. While there has been a lot of valuable work aimed at identifying characteristics associated with deaths in fire, there has been little aimed at identifying those suites of conditions that produce fire deaths. One that can be readily identified is a cigarette fire ignited on or in the immediate vicinity of a person who is frail. Other suites of circumstances are less clear. There are a number of observations that can be made based on the research regarding fire in domestic environments. The large majority of fires are not reported to the fire department, and evidence suggests that the majority of those fires are put out by the people on site. This occurs in spite of the frequent admonition to Get out, Stay out.... \cite{thompson_2015}. It is a reminder that people do not necessarily always act in accordance with fire-safety messaging. The typical engineering approach to fire design--ASET/RSET--does not explicitly capture all observed behaviors in domestic fires. The basic assumption of the approach is that people react to a fire by evacuating, and that the time to evacuate is mostly independent of the fire. But these assumptions break down for domestic fires. A different approach is warranted for fire design for domestic spaces.

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Preventing deaths and injuries from house fires: a cost–benefit analysis of a community-based smoke alarm installation programme

Cited by 17 publications

References 18 publications

Community/Public Health Nurses’ Awareness of Residential High-Rise Fire Safety issues

Community/Public Health Nurses’ Awareness of Residential High-Rise Fire Safety issues

Cost-effectiveness of England’s national ‘Safe At Home’ scheme for reducing hospital admissions for unintentional injury in children aged under 5

Human behavior in home fires

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