Effectiveness of home fire safety interventions. A systematic review and meta-analysis

Interventions for Preventing Residential Fires in Vulnerable Neighbourhoods and Indigenous Communities: A Systematic Review of the Literature

Globally, residential fires constitute a substantial public health problem, causing major fire-related injury morbidity and mortality. This review examined the literature on residential fire prevention interventions relevant to Indigenous communities and assessed their effectiveness on mitigating fire incidents and their associated human and economic burden. Electronic databases including MEDLINE, EMBASE, CENTRAL, and Web of Science Core Collection were reviewed for studies on fire prevention interventions published after 1990 and based on the 4E’s of injury prevention approaches (Education, Enforcement, Engineering, and Engagement). The grey literature and sources including indigenous organizational websites were also searched for eligible studies. Two authors independently screened, selected, and extracted data, in consultation with experts in the field. Outcomes measured included enhanced safety knowledge and practices, decreased residential fires incidents, reduced fire-related injuries and deaths, and lowered costs for healthcare needs. After removing duplicates, screening titles and abstracts, and assessing full texts, 81 articles were included in this review. Of the included studies, 29.1% implemented educational interventions within a variety of settings, including schools, community centres and homes, and included healthcare professionals and firefighters to raise awareness and the acquisition of fire safety skills. Engineering and environmental modifications were adopted in 20.2% of the studies with increased smoke alarm installations being the leading effective intervention followed by sprinkler inspections. Moreover, engagement of household members in hands-on safety training proved to be effective in enhancing household knowledge, fire safety decisions and practices. More importantly, effective outcomes were obtained when multi-faceted fire safety interventions were adopted, e.g., environmental modification and educational interventions, which together markedly reduced fire incidents and associated injuries. This review reveals the dearth of fire prevention evidence gathered directly within Indigenous communities. Nonetheless, relevant fire prevention recommendations can be made, calling for the adoption of combined and context-sensitive fire prevention interventions tailored to targeted Indigenous and vulnerable communities through multiple approaches and measures. Follow-ups and longitudinal studies are critical for accurate evaluation of the long-term outcomes and impacts on preventing residential fires.

A multi-scalar perspective on health and urban housing: an umbrella review

With more than half the world's population living in cities, understanding how the built environment impacts human health at different urban scales is crucial. To be able to shape cities for health, an understanding is needed of planetary health impacts, which encompass the human health impacts of human-caused disruptions on the Earth's natural ecosystems. This umbrella review maps health evidence across the spatial scales of the built environment (building; neighbourhood; and wider system, including city, regional and planetary levels), with a specific focus on urban housing. Systematic reviews published in English between January 2011 and December 2020 were searched across 20 databases, with 1176 articles identified and 124 articles screened for inclusion. Findings suggests that most evidence reports on health determinants at the neighbourhood level, such as greenspace, physical and socio-economic conditions, transport infrastructure and access to local services. Physical health outcomes are also primarily reported, with an emerging interest in mental health outcomes. There is little evidence on planetary health outcomes and significant gaps in the research literature are identified. Based on these findings, three potential directions are identified for future research.

Prevalence of musculoskeletal disorders among Canadian firefighters: A systematic review and meta-analysis

Introduction: Firefighters are set to respond to a number of dynamic demands within their roles that extend well beyond fire suppression. These tasks (i.e., heavy lifting, awkward postures) and their unpredictable nature are likely contributing factors to musculoskeletal disorders (MSDs). Several individual studies have assessed the prevalence of MSDs among Canadian firefighters. Therefore, a systematic review and meta-analysis was conducted to critically appraise the quality of the body of available literature and to provide pooled point- and period-prevalence estimates of anatomical regions of MSDs among Canadian firefighters. Methods: The MEDLINE, Embase, PubMed and Web of Science databases were searched from inception to November 2018. Cross-sectional cohort studies with musculoskeletal prevalence estimates (point- and period-) of career/professional firefighters in Canada were identified and critically appraised. MSDs were defined as sprains/strains, fractures/dislocations and self-reported bodily pain (chronic or acute). Period- and point-prevalence estimates were calculated, and study-specific estimates were pooled using a random-effects model. Results: Five eligible cohort studies (3 prospective, 2 retrospective) were included, with a total of 4,143 firefighters. The participants had a mean age range of 34 (SD = 8.5) to 42.6 (SD = 9.7) years. The reported types of MSDs included sprain or strain, fractures, head, neck, shoulder, elbow, arm, hand, back, upper thigh, knee, and foot pain. The point-prevalence estimate of shoulder pain was 23.00% (3 studies, 312 of 1,491 firefighters, 95% CI, 15.00–33.00), back pain was 27.0% (3 studies, 367 of 1,491 firefighters, 95% CI, 18.00–38.00), and knee pain was 27.00% (2 studies, 180 of 684 firefighters, 95% CI, 11.00–48.00). The one-year period-prevalence estimate of all sprain/strain injuries (all body parts) was 10.0% (2 studies, 278 of 2,652 firefighters, 95% CI, 7.00–14.00). Discussion: High point-prevalence estimates (1 in 4 firefighters) of shoulder-, back-, and knee-related MSDs were identified among Canadian firefighters. This emphasizes the need for early assessment, intervention, and injury prevention strategies that reflect how units work together to maximize ergonomic efficiency and injury prevention.