Using Linked Data to Estimate the True Number of Individuals Impacted by Residential Fire

IntroductionResidential fires remain a significant global public health problem. It is recognised that the reported number of residential fires, fire-related injuries and deaths significantly underestimate the true number. Australian population-based surveys show that around two-thirds of respondents who experience a residential fire are unwilling to call fire services, and studies from the US and New Zealand highlight that many individuals who access medical treatment for fire-related injuries do not have an associated fire incident report. Objectives and ApproachThis population-based study aimed to quantify the total number of residential fires, fire-related injuries and associated health service utilisation. The cohort included all persons residing at a residential address in New South Wales, Australia, which experienced a fire between 1 January 2005 - 31 December 2014. The cohort comprised linked person-level data from eight administrative datasets and includes information about nature of fire, first responder use (Fire and Rescue (FRNSW) and ambulance services), health service utilisation (emergency department, hospital and burns outpatient clinic) and health outcomes. ResultsOver the study period, FRNSW responded to 42,491 residential-fire incidents, involving 42,160 individuals with some individuals reporting multiple times. In total, 3,382 individuals used one or more health service and 154 individuals died. Of individuals who contacted FRNSW, 1,661 (3.9%) used health services;ambulance (n=1,101), emergency department (n=1,114), hospital admissions (n=168). There were 95 deaths. There were 1,721 (51%) additional individuals who used one or more health service as a result of a residential-fire that did not contact FRNSW and 59 additional deaths were identified. Conclusion / ImplicationsThis study found that more than half of individuals who used health services for residential fire-related injuries did not have an associated fire report, highlighting the importance of data linkage for accurate communication to policy makers and the public on the prevalence and impact of residential-fires.