Dataset Information

The Impact of Reduced Fire Risk Cigarettes Regulation on Residential Fire Incidents, Mortality and Health Service Utilisation in New South Wales, Australia.

ABSTRACT: Smoking materials are a common ignition source for residential fires. In Australia, reduced fire risk (RFR) cigarettes regulation was implemented in 2010. However, the impact of this regulation on residential fires is unknown. This paper examines the impact of the RFR cigarettes regulation on the severity and health outcomes of fire incidents in New South Wales (NSW), Australia, from 2005 to 2014. Fire department data from 2005 to 2014 were linked with ambulance, emergency department, hospital, outpatient burns clinic and mortality datasets for NSW. Negative binomial regression analysis was performed to assess the changes to fire incidents' severity pre- and post-RFR cigarettes regulation. There was an 8% reduction in total fire incidents caused by smokers' materials post-RFR cigarettes regulation. Smokers' materials fire incidents that damaged both contents and structure of the building, where fire flames extended beyond the room of fire origin, with over AUD 1000 monetary damage loss, decreased by 18, 22 and 12%, respectively. RFR cigarettes regulation as a fire risk mitigation has positively impacted the residential fire incident outcomes. This provides support for regulation of fire risk protective measures and bestows some direction for other fire safety policies and regulations.

SUBMITTER: Ghassempour N

PROVIDER: S-EPMC9566670 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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The Impact of Reduced Fire Risk Cigarettes Regulation on Residential Fire Incidents, Mortality and Health Service Utilisation in New South Wales, Australia.

Ghassempour Nargess N Tannous Wadad Kathy WK Agho Kingsley Emwinyore KE Avsar Gulay G Harvey Lara Ann LA

International journal of environmental research and public health 20220930 19

Smoking materials are a common ignition source for residential fires. In Australia, reduced fire risk (RFR) cigarettes regulation was implemented in 2010. However, the impact of this regulation on residential fires is unknown. This paper examines the impact of the RFR cigarettes regulation on the severity and health outcomes of fire incidents in New South Wales (NSW), Australia, from 2005 to 2014. Fire department data from 2005 to 2014 were linked with ambulance, emergency department, hospital, ...[more]

PMID: 36231780

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Project description:BackgroundFire is a major contributor to global fatalities and disabilities and remains a prevalent threat to individuals in Australia. New South Wales (NSW) experiences over one-third of all structure fires, including residential ones, in the country and one-quarter of all associated deaths and hospital admissions. In an atmosphere of rising healthcare cost and heightened demand for its services, obtaining total cost data for residential fires is essential. The study aims to estimate the cost of health service utilisation, including ambulance, emergency, and hospital admission, resulting from residential fire incidents in NSW, Australia.MethodThis population-based cohort study uses response and health service administration data from 1 January 2005 to 31 December 2014. The data sources are Australian Computer Aided Dispatch system, Fire and Rescue NSW Australian Incident Reporting System, NSW Ambulance datasets, NSW Emergency Department Data Collections, and NSW Admitted Patient Data Collection which are administrative datasets that have been linked. Cost figures were expressed in constant 2023 Australian dollars.ResultsThe estimated annual average cost for ambulance use was AU$75 thousand, with the average cost per use of AU$945. The average annual cost for emergency department visits was AU$137 thousand, and the average cost per visit was AU$890. The average total length of stay in hospital was nine days. The average annual cost of episodes of care in hospital was estimated at AU$4 million, with the average cost per episode of care of AU$16,140. The study assessed the total cost for health service use relevant to residential fire incidents and associated injuries at AU$46 million over time, averaging approximately AU$5 million annually.ConclusionThis study provided, for the first time, total and average costs of health service utilisation per type for ambulance use, ED visits, and hospital admissions associated with residential fire incidents and related injuries using linked administrative data in NSW. Our study will assist the government and stakeholders in making informed decisions that prioritise funding for healthcare service and improve the quality of overall fire safety and public health outcomes.

Project description:BackgroundAustralians born in countries where hepatitis B infection is endemic are 6-12 times more likely to develop hepatocellular cancer (HCC) than Australian-born individuals. However, a program of screening, surveillance and treatment of chronic hepatitis B (CHB) in high risk populations could significantly reduce disease progression and death related to end-stage liver disease and HCC. Consequently we are implementing the B Positive pilot project, aiming to optimise the management of CHB in at-risk populations in south-west Sydney. Program participants receive routine care, enhanced disease surveillance or specialist referral, according to their stage of CHB infection, level of viral load and extent of liver injury. In this paper we examine the program's potential impact on health services utilisation in the study area.MethodsEstimated numbers of CHB infections were derived from Australian Bureau of Statistics data and applying estimates of HBV prevalence rates from migrants' countries of birth. These figures were entered into a Markov model of disease progression, constructing a hypothetical cohort of Asian-born adults with CHB infection. We calculated the number of participants in different CHB disease states and estimated the numbers of GP and specialist consultations and liver ultrasound examinations the cohort would require annually over the life of the program.ResultsAssuming a 25% participation rate among the 5,800 local residents estimated to have chronic hepatitis B infection, approximately 750 people would require routine follow up, 260 enhanced disease surveillance and 210 specialist care during the first year after recruitment is completed. This translates into 5 additional appointments per year for each local GP, 25 for each specialist and 420 additional liver ultrasound examinations.ConclusionsWhile the program will not greatly affect the volume of local GP consultations, it will lead to a significant increase in demand for specialist services. New models of CHB care may be required to aid program implementation and up scaling the program will need to factor in additional demands on health care utilisation in areas of high hepatitis B sero-prevalence.

Project description:BackgroundNSW has a multicultural population with increasing migration from South East Asia, the Western Pacific and Eastern Mediterranean.ObjectiveTo compare cancer stage, treatment (first 12 months) and survival for 12 country of birth (COB) categories recorded on the population-based NSW Cancer Registry.DesignHistoric cohort study of invasive breast cancers diagnosed in 2003-2016.PatientsData for 48,909 women (18+ ages) analysed using linked cancer registry, hospital inpatient and Medicare and pharmaceutical benefits claims data.MeasurementComparisons by COB using multivariate logistic regression and proportional hazards regression with follow-up of vital status to April 30th, 2020.ResultsCompared with the Australia-born, women born in China, the Philippines, Vietnam and Lebanon were younger at diagnosis, whereas those from the United Kingdom, Germany, Italy and Greece were older. Women born in China, the Philippines, Vietnam, Greece and Italy lived in less advantaged areas. Adjusted analyses indicated that: (1) stage at diagnosis was less localised for women born in Germany, Greece, Italy and Lebanon; (2) a lower proportion reported comorbidity for those born in China, the Philippines and Vietnam; (3) surgery type varied, with mastectomy more likely for women born in China, the Philippines and Vietnam, and less likely for women born in Italy, Greece and Lebanon; (4) radiotherapy was more likely where breast conserving surgery was more common (Greece, Italy, and Lebanon) and the United Kingdom; and (5) systemic drug therapy was less common for women born in China and Germany. Five-year survival in NSW was high by international standards and increasing. Adjusted analyses indicate that, compared with the Australian born, survival from death from cancer at 5 years from diagnosis was higher for women born in China, the Philippines, Vietnam, Italy, the United Kingdom and Greece.ConclusionsThere is diversity by COB of stage, treatment and survival. Reasons for survival differences may include cultural factors and healthier migrant populations with lower comorbidity, and potentially, less complete death recording in Australia if some women return to their birth countries for treatment and end-of-life care. More research is needed to explore the cultural and clinical factors that health services need to accommodate.

Project description:PurposePeople with intellectual disability are a minority group who experience poorer physical and mental health than the general population and have difficulty accessing healthcare services. There is lack of knowledge about healthcare service needs and gaps experienced by people with intellectual disability. This study aims to interrogate a large linked administrative data set containing hospital admissions, presentations to emergency departments (ED) and mortality data to provide evidence to inform the development of improved health and mental health services for this population.ParticipantsA retrospective cohort of people with intellectual disability (n=51 452) from New South Wales (NSW), Australia, to explore health and mental health profiles, mortality, pattern of health service use and associated costs between 2005 and 2013. The cohort is drawn from: the Disability Services Minimum Data Set; Admitted Patients Data Collection; Emergency Department Data Collection, Australian Bureau of Statistics Death Registry and Registry of Births, Deaths and Marriages. Mental health service usage among those with intellectual disability will be compared to a cohort of people who used mental health services (n=1 073 139) and service usage other than for mental health will be compared with published data from the general population.Findings to dateThe median age of the cohort was 24 at the time of the last hospital admission and 21 at the last ED presentation. The cohort has a higher proportion of men than women and accounts for 0.6% of the NSW population in 2011. Over 70% had up to 5 ED presentations and hospitalisations between 2005 and 2012. A high proportion of people with intellectual disability live in the most disadvantaged neighbourhoods.Future plansResults will be used to inform the development of more responsive healthcare, including improved interactions between health, social and disability supports. More generally, the results will assist the development of more inclusive policy frameworks for people with intellectual disability.

Dataset Information

The Impact of Reduced Fire Risk Cigarettes Regulation on Residential Fire Incidents, Mortality and Health Service Utilisation in New South Wales, Australia.

Publications

The Impact of Reduced Fire Risk Cigarettes Regulation on Residential Fire Incidents, Mortality and Health Service Utilisation in New South Wales, Australia.

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