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PubMed2001

Fires and burns during plastic surgery.

Many plastic surgery procedures are performed under local anethesia. When the procedure involves the head and neck, oxygen is perilously close to the surgical field. A thorough understanding of the fire triangle will allow the plastic surgeon to develop a routine that will avoid any risk of fire. The fire triangle consists of a heat source, a fuel, and an oxidizer. By removing one component of the fire triangle, the risk of fire is averted. An in-depth look at each component is needed because fire hazards involve some surprising sources.

Burns↗
PubMed2005

Fire in the operating room: principles and prevention.

Fire is a rare but potentially disastrous operating room misadventure. In this article, the authors describe the elements of operating room fires and present an illustrative case. The risk of fire can be minimized when the operating room team understands the interactions among the three sides of the classic fire triangle: oxidizers, fuels, and ignition sources. Lists of fire prevention techniques and steps to take in the event of an operating room fire are provided.

Adult↗
PubMed2002

Frogs flee from the sound of fire.

Fire has an important role in the sensory ecology of many animals. Using acoustic cues to detect approaching fires may give slow-moving animals a head start when fleeing from fires. We report that aestivating juvenile reed frogs (Hyperolius nitidulus) respond to playbacks of the sound of fire by fleeing in the direction of protective cover, where they are safe. This is a novel response to fire not known to occur in other animals. Moreover, we identify the rapid rise-time of the crackling sound of fire as the probable cue used. These results suggest that amphibian hearing not only has evolved through sexual selection, but also must be viewed in a broader context.

Animals↗
PubMed2005

Skin antiseptics and the risk of operating theatre fires.

BACKGROUND: Following press reports of patients catching fire or receiving chemical burns in the operating theatre, a review was conducted on the flammability of skin antiseptics. The purpose of the paper was to clarify confusion regarding povidine-iodine (Betadine), which had been reported as being flammable, and also to determine the use of alcohol-based solutions in the Hunter Area Health Service. A risk assessment was conducted and risk reduction strategies outlined. METHODS: Risk assessment was made following a literature review and an audit of 10 operating theatres in the Hunter Area Health Service. RESULTS: Risk for operating room fires from alcohol-based skin antiseptics was confirmed. Antiseptics in aqueous solutions only smoulder. The Hunter Health survey indicated that although alcohol-based solutions were not used in operating theatres, they were used in anaesthetic bays for insertion of epidural and central line catheters. Strategies to reduce the risk of fire include discontinuation of use of alcohol-based skin antiseptics in operating theatres; using fire retardant surgical drapes; installing over-current protection devices on electrical equipment; minimizing flammable conditions by avoiding nitrous oxide and using the lowest required concentration of inspired oxygen; use of non-flammable cuffed endotracheal tubes; education and training of operating theatre personnel in fire hazards. CONCLUSIONS: Operating theatre fires continue to be a major risk for patient safety. In order to reduce this risk, the strategies outlined here should be followed.

Alcohols↗
PubMed1999

House fire injury prevention update. Part II. A review of the effectiveness of preventive interventions.

OBJECTIVE: To evaluate and summarize the house fire injury prevention literature. METHODS: MEDLINE (1983 to March 1997) was searched by keyword: fire, burn, etiology, cause, prevention, epidemiology, and smoke detector/alarm. ERIC (1966 to March 1997) and PSYCLIT (1974 to June 1997) were searched by keyword: as above, and safety, skills, education, and training. Other sources included references of retrieved publications, review articles, and books; Injury Prevention hand search; government documents; and internet sources. Sources relevant to residential fire injury prevention were selected, evaluated, and summarized. RESULTS: Forty three publications were selected for review, including seven randomized controlled trials, nine quasiexperiments, two natural experiments, 21 prospective cohort studies, two cross sectional surveys, one case report, and one program evaluation. These studies examined the following types of interventions: school (9), preschool (1), and community based educational programs (5); fire response training programs for children (7), blind adolescents (2), and mentally retarded adults (5) and children (1); office based counseling (4); home inspection programs (3); smoke detector giveaway campaigns (5); and smoke detector legislation (1). CONCLUSIONS: This review of house fire prevention interventions underscores the importance of program evaluation. There is a need for more rigorous evaluation of educational programs, particularly those targeted at schools. An evidence based, coordinated approach to house fire injury prevention is critical, given current financial constraints and the potential for program overload for communities and schools.

Adolescent↗
PubMed2004

Smoky indoor cooking fires are associated with elevated hemoglobin concentration in iron-deficient women.

OBJECTIVE: Indoor air pollution from the burning of such biomass fuels as wood and agricultural waste is associated with a higher risk of a number of respiratory problems. The effect on other health outcomes, such as fetal growth, has not yet been adequately documented. The objective of this study was to determine whether, among women who burn biomass fuels for cooking indoors, the use of "smoky" fires is associated with elevated hemoglobin concentration in comparison to women using "smokeless" stoves, that is, stoves that are designed to reduce indoor air pollution. This research was conducted as part of a series of preliminary studies to determine the feasibility and potential health benefits of a randomized stove intervention to reduce indoor air pollution from the burning of biomass fuels for cooking. METHODS: A cross-sectional observational study was conducted in rural highland communities of Guatemala from March to August 1994. Venous blood samples were collected and analyzed for hemoglobin and ferritin. All the women studied burned biomass fuels and cooked indoors, and none of the women was pregnant. Eighty-nine indigenous women using smokeless stoves (designated as the not-exposed group) and 185 indigenous women from the same communities using smoky fires (the exposed group) were studied. Multiple linear regression analyses were used to investigate the relationship between exposure (smokeless stove or smoky fire) and hemoglobin concentration, with adjusting for potential confounding factors. RESULTS: No effect of exposure (smokeless stove or smoky fire) on hemoglobin concentration was found in univariate or multivariate analyses. In routine post hoc analysis to determine whether hemoglobin elevation is observed in some particular subgroup, we found that the use of a smoky fire was associated with a 5.2 g/L elevation in hemoglobin concentration among women with low ferritin stores (P < 0.10). CONCLUSIONS: The elevation of hemoglobin concentration through exposure to indoor air pollution resulting from the burning of biomass fuels in smoky fires for cooking could have important implications for the diagnosis of anemia. However, considering the observational nature of this study, further research using more rigorous measures of exposure to carbon monoxide as well as additional measures of iron status are needed to confirm the relationships among iron status, exposure to smoke from the burning of biomass fuels indoors, and hemoglobin concentration of women living at moderately high altitude. Further study of this matter could help to assure that appropriate adjustments to anemia cutoffs are made, if warranted, and could assist in clarifying potentially negative outcomes of exposure to smoke from biomass fuels burned indoors.

Adolescent↗
PubMed1977

Lung function in fire fighters, I: a three year follow-up of active subjects.

From a cohort of 1,768 Boston fire fighters studied initially in 1970, pulmonary function measurements were repeated on 1, 146 active subjects in 1974. The mean time between examinations was 3.4 years. The data on 1,430 subjects after one year of follow-up had indicated excessive decrements in levels of forced vital capacity and one-second forced expiratory bolume which were related to the frequency of fire exposure. The annual decline over three years was less than that observed over one year and could not be related to the number of fires fought or to other indices of acute fire exposure. Selection factors within the fire department appear to be important in protecting fire fighter from continued loss ventilatory capacity.

Adult↗
PubMed1991

Aging and the fitness of fire fighters: the complex issues involved in abolishing mandatory retirement ages.

This study presents an assessment of the cardiorespiratory health and physical fitness of fire fighters of different ages with the aim of addressing several questions currently being debated on a national level. These include how fire fighters differ across age groups in their health and physical fitness, and what would be the impact on the existing work force of implementing minimum fitness standards as an alternative to mandatory retirement ages. Fire fighters aged 20-65 years were found to be similar in their cardiorespiratory health and physical fitness to the sedentary segment of the general population of the same age. Particularly worrisome, however, is the low maximal aerobic capacity (31, 28, 26 ml/kg/min), high percent body fat (26, 29, 30), and high resting blood pressure (136/86, 140/90, 143/93 mm Hg) observed in the 40-45-, 50-55-, and 60-65-year-old fire fighters, respectively. In fact, 66%, 83%, and 93% of the fire fighters in these three age groups, respectively, fall below the lowest published recommendations for maximal aerobic capacity in this profession. These data underscore the need to establish minimum health and physical performance standards for fire fighters and demonstrate the profound impact such minimum standards will have on the existing work force.

Adult↗
PubMed1994

The respiratory health impact of a large urban fire.

OBJECTIVES: In July 1988, a fire destroyed a huge supermarket warehouse in Richmond, Calif, sending smoke into residential neighborhoods for nearly a week. There was no organized public health response. To evaluate the respiratory health impact on the general population, a survey of emergency room visits and hospital admissions to the two acute-care hospitals serving the population downwind was conducted. METHODS: Medical records of 489 patients meeting specified diagnostic criteria during the week of the fire and several reference periods were abstracted. Ratios of proportions for respiratory diagnoses (i.e., emergency room visits for a given diagnosis/total emergency room visits) were calculated, comparing the fire week with the reference periods, and 1988 mortality data for the area were reviewed. RESULTS: Ratios of proportions for emergency room visits for asthma and all lower respiratory conditions increased significantly during the fire. Respiratory-related hospitalizations also increased. However, there was no observable increase in respiratory mortality. CONCLUSIONS: This fire was found to have had a moderate impact on the respiratory health of local residents. Public health intervention is indicated to prevent respiratory morbidity when extended exposure to structural fire smoke is predictable.

Asthma↗
PubMed1995

Single-strand breaks in deoxyribonucleic acid in fire fighters accidentally exposed to o-nitroanisole and other chemicals.

OBJECTIVES: The aim of the study was to detect single-strand breaks in deoxyribonucleic acid (DNA) in mononuclear blood cells of fire fighters exposed to o-nitroanisole and other substances released into the environment during an accident in a chemical plant. METHODS: The level of DNA single-strand breaks in mononuclear blood cells was detected by alkaline elution. The results were compared for 16 fire fighters who worked in a contaminated area for about 8 h and two reference groups (one of fire fighters who had not worked in the contaminated area, group I, and one of persons without any apparent occupational exposure to genotoxic substances, group II). RESULTS: The mean normalized elution rate (nER) 19 d after the accident was slightly but statistically significantly (P < 0.05) higher for the exposed fire fighters [mean 1.48 +/- 95% confidence interval (95% CI) 0.21] than for reference group I (mean 1.21 +/- 95% CI 0.21) or reference group II (mean 1.17 +/- 95% CI 0.18). No statistically significant difference was found between reference groups I and II. Another analysis was performed three months after the first. The level of DNA single-strand breaks (mean nER 1.12 +/- 95% CI 0.11) was no longer increased in comparison with the levels of the reference groups. CONCLUSIONS: DNA single-strand breaks were increased in fire fighters exposed to o-nitroanisole and other substances. In comparison with the extent of DNA strand breaks found in other occupational groups the increase was only moderate. The observed decrease in DNA single-strand breaks to the reference level in exposed fire fighters three months later suggests a DNA repair mechanism for DNA single-strand breaks caused by o-nitroanisole.

Accidents↗
PubMed1997

[Analysis of severe fire disaster in five years (1989-1993) in China].

UNLABELLED: The aim of this study was to analyze epidemiological characteristics of burn caused by severe fire disaster. The results of this study showed that a total 21,228 people were burned, 10,428 cases died and RMB 3320 millions yuan were lost in those fire disasters occurring in five years (from 1989 to 1993) in this country. The principal causes of the fire disaster were faults in administration and operations against regulations. CONCLUSION: In order to prevent fire disaster propaganda should be carried out, jurisdiction should be enforced, active "law of fire control" and the program of constructive administration should be implemented. Those who are working in burn care should also participate in work of fire control and devote much attention to the investigation of burn epidemiology.

Burns↗
PubMed2001

Evaluating fire safety in older persons through home visits.

The evaluate elders' risk factors for fire injury, we performed in-home assessments on our Geriatric Clinic clients. Nearly two-thirds of the subjects had physical impairments that could compromise escaping a fire. Fire safety equipment often was suboptimal. Nearly three-fourths of our subjects were not worried about fire injury, yet all had at least one fire injury risk factor. Fire safety knowledge was poor. Apathy was common, with fewer than one-third of our subjects complying with our recommendations.

Aged↗
PubMed2004

The evaluation of the extent of transporting or "tracking" an identifiable ignitable liquid (gasoline) throughout fire scenes during the investigative process.

Tests have determined that boots or shoes of individuals at a fire scene do not transport sufficient contaminants ("tracking") through the fire scene to produce a positive laboratory result for the presence of gasoline in a fire scene that was not present at the time of the fire. Questions about the validity of forensic laboratory results have been raised on the basis that low-level gasoline residues detected in the laboratory samples could have been the result of transporting the residue by footwear contaminated from the fire scene ("tracking"). The data collected in this study establish that "tracking" does not lead to false-positive laboratory results. Canines trained and experienced in the detection of trace ignitable liquid residues were also utilized in this study. The canine results confirmed that properly trained canines show a higher sensitivity than do standard ASTM laboratory techniques for fire debris analysis. In a few cases, canines responded to contamination, but laboratory testing (which is the definitive indicator) did not produce positive results.

Animals↗
PubMed2005

Tracheostomal fire during an elective tracheostomy.

Some surgeries, a tracheostomy and oral surgeries in particular, have a higher risk of fire. Often it can occur when leaking flammable gas contacts an ignition heat source. Fire during a tracheostomy can sometimes be seen to produce different degrees of insult to the patient. The essential components of a fire, i.e., the fuel source, ignition, and an oxidizer, can be avoided or blocked in order to prevent fires from occurring. Herein, we discuss a fire during a tracheotomy, and ways to avoid its occurrence, and how to stop once it gets started. This case demonstrates 2 important points regarding tracheostomies. First, extreme caution should be exercised when cautery is used in an approximately 100% oxygen gaseous condition, and second, immediate extubation is not absolutely necessary if a fire breaks out during a tracheostomy. The procedures which can be taken when facing this type of emergency are also considered and discussed.

Female↗
PubMed2006

Fire-fighters' perspectives of the accuracy of the Physical Aptitude Test (P.A.T) as a pre-employment assessment.

Pre-employment assessments must accurately simulate job tasks and demands and select appropriate personnel to be considered effective. This study focussed on the perception of NSW fire-fighters in relation to the validity of the NSW Fire Brigade's pre-employment assessment, the Physical Aptitude Test. A qualitative method was used to gain a precise understanding of fire fighters' opinions of the accuracy of the Physical Aptitude Test. Information letters and consent forms were sent to an urban fire station with interested participants replying via the university. Six participants, who met the inclusion criteria were randomly selected for the study and in-depth, ethnographic, semi-structured interviews were conducted. The fire fighters believed in order for the Physical Aptitude Test to accurately simulate job demands and select the most capable fire fighters', it needed to be more physically demanding. However, participants believed that the "work-simulating" nature of the Physical Aptitude Test provided an accurate indication of the job tasks.

Adult↗
PubMed1989

Fire deaths in aircraft without the crashworthy fuel system.

Cases reported to the Armed Forces Institute of Pathology were examined for occupants of helicopters without the crashworthy fuel system (CWFS) who survived crashes but died as a result of postcrash fires. There were 16 fire deaths in the 9 such accidents which occurred between January 1976 and April 1984. All of these victims would have survived if there had been no postcrash fire. Partial body destruction by fire probably prevented inclusion of many other cases. The dramatic reduction in fire deaths and injuries due to installation of the CWFS in Army helicopters is discussed. The author concludes that fire deaths and injuries in aircraft accidents could almost be eliminated by fitting current and future aircraft with the CWFS.

Accidents, Aviation↗
PubMed1986

Energy costs of simulated stair climbing as a job-related task in fire fighting.

The purpose of this investigation was to determine the energy requirement of simulated stair climbing. Metabolic costs of climbing stairs in getting to the scene of a fire can be very demanding for fire personnel. Heart rate and oxygen consumption were measured on 17 fire fighters during each of three conditions: (1) stair climbing without fire-fighting uniform or equipment, (2) stair climbing with fire-fighting uniform and equipment, and (3) pedaling a bicycle ergometer in a graded maximal exercise test. These three conditions were designed to determine (1) baseline reference values, (2) actual work task measures, and (3) maximum reference values. Results showed that climbing stairs with an 8-inch rise at 60 steps per minute with fire fighter's uniform and equipment (86.5 pounds) for five minutes required heart rates to reach 95% (84 to 100) of maximum effort, and oxygen consumption measures were found to be 80% (63 to 97) of maximum. It was concluded for the personnel studied that the rate of energy cost of climbing a simulated staircase with uniform and equipment required an ability to consume at least 2.7 L of oxygen per minute and 39 mL/kg/min.

Adult↗
PubMed1987

Coronary artery disease deaths in the Toronto Fire Department.

The occupation of fire fighting is alleged to be associated with an increased risk of death from circulatory disease, but not all mortality studies confirm this finding. An historical prospective study was done in the Toronto Fire Department to examine the relationship between fire fighting and mortality from coronary artery disease. Using adjusted city of Toronto rates for comparison, the overall standardized mortality ratio (SMR) for fire fighters aged 45 to 54 was 1.73 (P less than .005). Stratification by age and year of death produced the highest SMR of 2.47 (P less than .10) in fire fighters aged 45 to 49 during the period 1975 to 1979. A relative index of fire fighting activity was created and tested but proved difficult to use in an historic study. Explanations are offered and recommendations for further studies are made.

Coronary Disease↗