Mitigating fire casualties in cities around the world

Ms Elise Kempler1, Professor Peter Maitz2, Professor Palmer Bessey3

1Sydney Medical School, The University of Sydney, , Australia, 2Burns Research Group, ANZAC Research Institute, Burns and Reconstructive Surgery Unit, Concord Repatriation General Hospital, Sydney Medical School, The University of Sydney, , Australia, 3The William Randolph Hearst Burn Center, New York Presbyterian Weill Cornell Medical Center, , United States


Introduction Prevention of deaths and injuries from fires in buildings is a public health responsibility of municipal governments. The purpose of this study was to understand how high-density cities across the globe carry out this mission.
Methods: Publically available city-specific data sources were surveyed for New York (NYC), Sydney (SYD), London (LON), Tokyo (TOK), Singapore (SIN), Hong Kong (HK), Barcelona (BAR), Berlin (BER) and Paris. Data on building codes, firefighting resources, use of warning systems and education were recorded.
Results: NYC averages 270 structural fires per M population annually and 8.5 fire deaths per M. SIN averages 520 and 0.7, LON 670 and 4.3, and BAR 780 and 18. LON and TOK promote smoke detector installation in almost every room. NYC installs devices in public housing. SYD requires them in caravans. Paris had no requirement until 2016. BER will require them from 2020. SIN and HK have no requirement. HK requires rescue floors in “supertall” buildings. Education is commonly provided to schoolchildren and other groups. Home visits are conducted for the aged. LON uses software to estimate areas of high fire risk and educational need. NYC and TOK have the largest firefighting departments.
Summary and conclusion: There has been a remarkable global shift in fire prevention. The use of smoke detectors is a common strategy to reduce fire deaths and burns for most high-density cities, but requirements vary widely. Lack of standardised data makes it difficult to evaluate the efficacy of these and other measures.


Elise Kempler is a final-year medical student at the University of Sydney who has been based at both Royal Prince Alfred Hospital and Dubbo Base Hospital. Elise recently completed an 8-week Elective clerkship at Weill Cornell Medical College in New York City. This included a placement in Surgery at the William Randolph Hearst Burn Center where she shadowed burns surgeon Professor Palmer Bessey and witnessed the consequences of structural fires. As a first time visitor to the city, Elise was intrigued by the fire escapes – the zig-zag metal stairs that iconically hug the exteriors of many apartment buildings. She contemplated their utility. Today Elise will be presenting the findings of the epidemiological question of how major population centres such as New York City address fire safety and prevent burns casualties.


ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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