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  • 1.
    Bonander, Carl
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Jonsson, Anders
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Investigating the effect of banning non-reduced ignition propensity cigarettes on fatal residential fires in Sweden 2016In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 26, no 2, p. 334-338Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:Annually, 100 people die as a result of residential fires in Sweden and almost a third of the fatal fires are known to be caused by smoking. In an attempt to reduce the occurrence of these events, reduced ignition propensity (RIP) cigarettes have been developed. They are designed to reduce the risk of fire by preventing the cigarette from burning through the full length when left unattended. In November 2011, a ban was introduced, forbidding the production and sale of all non-RIP cigarettes in all member states of the European Union, including Sweden.

    METHODS:Monthly data on all recorded residential fires and associated fatalities in Sweden from January 2000 to December 2013 were analyzed using an interrupted time series design. The effect of the intervention [in relative risk (RR)] was quantified using generalised additive models for location, shape and scale.

    RESULTS:There were no statistically significant intervention effects on residential fires (RR 0.95 [95% CI: 0.89-1.01]), fatal residential fires (RR 0.99 [95% CI: 0.80-1.23]), residential fires where smoking was a known cause (RR 1.10 [95% CI: 0.95-1.28]) or fatal residential fires where smoking was a known cause (RR 0.92 [95% CI: 0.63-1.35]).

    CONCLUSION:No evidence of an effect of the ban on all non-RIP cigarettes on the risk of residential fires in Sweden was found. The results may not be generalisable to other countries.

  • 2.
    Jonsson, Anders
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Dödsbränder i Sverige: En analys av datakvalitet, orsaker och riskmönster2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In Sweden, more than 100 people die in fires every year and there is a societal goal of decreasing the risk of fire-related deaths. A goal-orientated prevention approach needs to be credibly underpinned with an understanding of the extent of the problem, its causes and risk factors, aspects that have largely been missing in Sweden. Therefore, the purpose of this thesis was to analyze fatal fires and fatalities in Sweden from an epidemiological perspective. The historical trends show that the risk of dying due to fire has decreased by more than 50% over the last 60 years in Sweden, with the largest decline being seen amongst children. In Sweden today, the risk of young children dying in a fire is very low. However, the risk of dying in fires has not declined to the same extent among elderly. In light of the aging Swedish population, older people must therefore be a priority in future fire protection. To investigate fire fatalities, data from three different national registers were combined. By combining the three sources, it was clear that the present routine statistics systematically underestimate the true situation. In-depth analysis regarding residential fires show that men and elderly are particularly at risk, as well as people living alone, as well as those on low income, social security benefits and health-related early-retirement benefits. The most common cause of fire was smoking and the presence of alcohol among the victims was very common. When combined, the extensive material can be simplified and described by well-defined clusters that each can be meet with relevant preventive efforts. Crucially, however, it is clear that mortality in residential fires is essentially a social problem and improving the protection of the most vulnerable people in society needs to be ascertained through sustained and holistic strategies, consisting of both social and technical measures. To establish and facilitate this, a cross-sectoral approach within municipalities and central government is needed.

  • 3.
    Jonsson, Anders
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Dödsfall i Sverige till följd av brand: Omfattning och historiska trender2016Licentiate thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Ingen ska omkomma eller skadas svårt till följd av brand. Så lyder den nollvision som Myndigheten för Samhällsskydd och Beredskap har formulerat för brandskyddsområdet. Visionen ingår i en nationell strategi för att stärka brandskyddet för den enskilde och innehåller förutom vision tydliga mål. Ett målstyrt arbete måste vägledas av kunskap om problemets omfattning, orsaker och riskfaktorer. Likaså är det av stor vikt att ha kunskap om den historiska utvecklingen och rådande trend. Syftet med denna licentiatuppsats är att undersöka förekomst och historisk utveckling av brandrelaterade dödsfall Sverige. Data från tre olika nationella register har använts: Dödsbrandsdatabasen, Dödsorsaksregistret, och Registret över rättsmedicinska undersökningar. Vi har härigenom kunnat visa att den rutinmässigt framtagna statistiken från enskilda register systematiskt underskattar den verkliga situationen med 20-25%. Den historiska analysen visar att risken att omkomma genom brand har mer än halverats under de senaste 60 åren i Sverige. Den största minskningen gäller små barn och det är idag mycket ovanligt att små barn omkommer i brand. Risken har inte minskat i samma utsträckning bland äldre och en åldrande befolkning innebär att denna grupp måste prioriteras i framtida brandskyddsarbete.

  • 4.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Bergqvist, Anders
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Assessing the number of fire fatalities in a defined population2015In: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, Vol. 55, p. 99-103Article in journal (Refereed)
    Abstract [en]

    Introduction: Fire-related fatalities and injuries have become a growing governmental concern in Sweden, and a national vision zero strategy has been adopted stating that nobody should get killed or seriously injured from fires. There is considerable uncertainty, however, regarding the numbers of both deaths and injuries due to fires. Different national sources present different numbers, even on deaths, which obstructs reliable surveillance of the problem over time. We assume the situation is similar in other countries. This study seeks to assess the true number of fire-related deaths in Sweden by combining sources, and to verify the coverage of each individual source. By doing so, we also wish to demonstrate the possibilities of improved surveillance practices. Method: Data from three national sources were collected and matched; a special database on fatal fires held by The Swedish Contingencies Agency (nationally responsible for fire prevention), a database on forensic medical examinations held by the National Board of Forensic Medicine, and the cause of death register held by the Swedish National Board of Health and Welfare. Results: The results disclose considerable underreporting in the single sources. The national database on fatal fires, serving as the principal source for policymaking on fireprevention matters, underestimates the true situation by 20 %. Its coverage of residential fires appears to be better than other fires. Conclusions: Systematic safety work and informed policy-making presuppose access to correct and reliable numbers. By combining several different sources, as suggested in this study, the national database on fatal fires is now considerably improved and includes regular matching with complementary sources.

  • 5.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Bergqvist, Anders
    Swedish Fire Protect Assoc, Stockholm, Sweden..
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Assessing the number of fire fatalities in a defined population2016In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 22, p. A41-A41Article in journal (Other academic)
  • 6.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Huss, Fredrik
    Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
    The state of the residential fire fatality problem in Sweden: Epidemiology, risk factors, and event typologies2017In: Journal of Safety Research, ISSN 0022-4375, E-ISSN 1879-1247, Vol. 62, p. 89-100Article in journal (Refereed)
    Abstract [en]

    Introduction

    Residential fires represent the largest category of fatal fires in Sweden. The purpose of this study was to describe the epidemiology of fatal residential fires in Sweden and to identify clusters of events.

    Method

    Data was collected from a database that combines information on fatal fires with data from forensic examinations and the Swedish Cause of Death-register. Mortality rates were calculated for different strata using population statistics and rescue service turnout reports. Cluster analysis was performed using multiple correspondence analysis with agglomerative hierarchical clustering.

    Results

    Male sex, old age, smoking, and alcohol were identified as risk factors, and the most common primary injury diagnosis was exposure to toxic gases. Compared to non-fatal fires, fatal residential fires more often originated in the bedroom, were more often caused by smoking, and were more likely to occur at night. Six clusters were identified. The first two clusters were both smoking-related, but were separated into (1) fatalities that often involved elderly people, usually female, whose clothes were ignited (17% of the sample), (2) middle-aged (45–64 years old), (often) intoxicated men, where the fire usually originated in furniture (30%). Other clusters that were identified in the analysis were related to (3) fires caused by technical fault, started in electrical installations in single houses (13%), (4) cooking appliances left on (8%), (5) events with unknown cause, room and object of origin (25%), and (6) deliberately set fires (7%).

    Conclusions

    Fatal residential fires were unevenly distributed in the Swedish population. To further reduce the incidence of fire mortality, specialized prevention efforts that focus on the different needs of each cluster are required.

    Practical applications

    Cooperation between various societal functions, e.g. rescue services, elderly care, psychiatric clinics and other social services, with an application of both human and technological interventions, should reduce residential fire mortality in Sweden.

  • 7.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Climate and Safety (from 2013). Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Jaldell, Henrik
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Karlstad Business School (from 2013).
    Identifying sociodemographic risk factors associated with residential fire-related fatalities: A matched case control study2019In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785Article in journal (Refereed)
    Abstract [en]

    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.

  • 8.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Climate and Safety.
    Lundqvist, Marie
    Gell, Thomas
    MSB.
    Andersson, Ragnar
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Identifying schools at risk of fire-setting2017In: Security Journal, ISSN 0955-1662, E-ISSN 1743-4645, Vol. 30, no 1, p. 153-161Article in journal (Refereed)
  • 9.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Huss, Fredrik
    Uppsala University .
    Seriously injured due to residential fires in sweden2018In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 24, p. A16-A16, article id PA 07-5-25Article in journal (Refereed)
  • 10.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety.
    Runefors, Marcus
    Särdqvist, Stefan
    Fire-related mortality in Sweden: Temporal trends 1952 to 20132015In: Fire technology, ISSN 0015-2684, E-ISSN 1572-8099, Vol. 52, no 6, p. 1697-1707Article in journal (Refereed)
    Abstract [en]

    This study examines temporal trends in deaths due to fire-related accidents in Sweden from 1952 to 2013 based on statistics in the Cause of Death register held by the Swedish National Board of Health and Welfare. Fatalities coded with underlying cause of death associated with fire-related accidents are included and absolute numbers and age-adjusted mortality rates are calculated and statistically analysed for trends using Poisson regression. The results show a significant reduction in both absolute numbers and in the age-adjusted mortality rate with a decline in absolute number of deaths of 34% over the period. However, the elderly population (80+ years) showed a significant increase in absolute numbers. Regarding the age-adjusted mortality rate, a significant reduction of 63% was observed and children aged 0 to 4 years showed the largest decrease (91%). A reduction was seen both in terms of fatalities due to burns and carbon monoxide poisoning, although the reduction was more pronounced with regards to burns (69% compared to 46%). Although an overall decrease was observed in both absolute numbers and in the age-adjusted mortality rate, with an aging population, the absolute numbers of fire-related deaths for the elderly population will most likely increase in the future. Therefore, whilst previously a child-injury issue, fire-related deaths in Sweden is now predominantly an issue of safety for the elderly. In combination with more deaths now being attributed to carbon monoxide poisoning, new preventative strategies may be required

  • 11.
    Jonsson, Anders
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Runefors, Marcus
    Lund Univ, Lund, Sweden..
    Sardqvist, Stefan
    Swedish Civil Contingencies Agcy, Lund, Sweden..
    Nilson, Finn
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Fire-related mortality in sweden-temporal trends 1952-20132016In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 22, p. A151-A152Article in journal (Other academic)
  • 12.
    Nilson, Finn
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Jonsson, Anders
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences.
    Differences in determinants amongst individuals reporting residential fires in Sweden – results from a cross-sectional study 2015In: Fire technology, ISSN 0015-2684, E-ISSN 1572-8099, Fire Technology, Vol. 51, no 3, p. 615-626Article in journal (Refereed)
  • 13.
    Nilson, Finn
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Bonander, Carl
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Jonsson, Anders
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Environmental and Life Sciences (from 2013).
    Differences in determinants amongst individuals reporting residential fires in sweden-: results from a cross-sectional study2016In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 22, p. A40-A40Article in journal (Other academic)
  • 14.
    Nilson, Finn
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Jonsson, Anders
    Myndigheten för samhällsskydd och beredskap.
    Elolyckor i Sverige2019Report (Other academic)
  • 15.
    Svee, A
    et al.
    Uppsala universitetssjukhus.
    Jonsson, Anders
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Centre for Public Safety (from 2013).
    Sjöberg, F
    Linköping University.
    Huss, F
    Uppsala Universitet.
    Burns in Sweden: temporal trends from 1987 to 2010.2016In: Annals of Burns and Fire Disasters, ISSN 1121-1539, E-ISSN 1592-9558, Annals of burns and fire disasters, ISSN 1592-9558, Vol. 29, no 2, p. 85-89Article in journal (Refereed)
    Abstract [en]

    Our aim was to investigate the epidemiology of burned patients admitted to hospitals in Sweden, and to examine temporal trends during the last three decades. Our hypothesis was that there has been an appreciable decline in the number of patients admitted. Retrospective data about burned patients treated at Swedish hospitals 1987 - 2010 were obtained from the Swedish National Board of Health and Welfare. Patients with primary or secondary ICD diagnoses of burns were included, reviewed and statistically interpreted in terms of sex, age, incidence, mortality in hospital and duration of stay. A total of 30,478 patients were admitted to hospitals with burns. The absolute number of admissions declined by 42% (95% CI 39 to 44). There was a highly significant reduction of 45% (95% CI: 38 to 51) in the ageadjusted incidence (admissions/million population) over the years, and the reduction was significant for both sexes. Children aged 0-4 years (n=8308) were most likely to be admitted to hospital (27%). The median duration of stay shortened over time (p < 0.0001). There was an overall significant reduction in deaths at hospital/100 admissions over time (p <0.0001). We think that the improvements are the result of a combination of preventive measures, improved treatments and greater use of outpatient facilities. If we understand these trends and the relations between age-adjusted incidence and actual number of admissions, we can gain insight into what is needed for future provision of emergency health care.

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