Quarterly Digest
Volume 9 - Number 3 March 2000

• Preface
  
  
• Map: B.C. Local Health Areas

• British Columbia: Local Health Areas (LHA) within Health Regions

• Vital Event Statistics - July 1, 1999 - September 30, 1999 and Year-to-date Totals
  (Population, Livebirth, Death, Marriage, Stillbirth, Infant Deaths)

• Selected Birth Statistics - July 1, 1999 - September 30, 1999 and Year-to-date Totals
  (Low Birthweight, Preterm, Teenage Mother, Elderly Gravida, Cesarean Section)

• External Causes of Death - July 1, 1999 - September 30, 1999 and Year-to-date Totals
  (Accidents - [Motor Vehicle Accidents, Poisoning, Falls, Burns/Fire, Drowning, Other], Suicide, Homicide, Other External Causes)

• Neoplasm Deaths - July 1, 1999 - September 30, 1999 and Year-to-date Totals
  (Lung, Female Breast, Colorectal, Other G.I., Female Reproductive, Prostate, Blood/Lymph, Other Malignancy, Nonmalignant and Unspecified)

• Heart Disease Deaths - July 1, 1999 - September 30, 1999 and Year-to-date Totals
  (Rheumatic/Valvular, Hypertension, Ischemic, Conductive & Dysrhythmic, Heart Failure, Congenital, Other)

• Respiratory Disease Death Statistics - July 1, 1999 - September 30, 1999 and Year-to-date Totals
  (Emphysema, COPD, Pneumonia, Influenza, Asthma, Lung Disease from External Agents, Pulmonary Fibrosis, Other Respiratory)

• Other Selected Death Statistics - July 1, 1999 - September 30, 1999 and Year-to-date Totals
  (Diabetes, Alcohol-Related, AIDS, Other Infectious Disease, Cerebral and Other Vascular, Liver Disease, Amyotrophic Lateral Sclerosis and Multiple Sclerosis, Alzheimer's Disease, Parkinson's Disease)

• Summary Article:
  Fire Deaths in British Columbia, 1986 to 1998
  by Z. Kashaninia

• Glossary

• Contributors' Note

• Readers' Note

Preface

Due to the fact that Vital Statistics Agency files are continually being updated, totals compiled by addition of the annual quarters will not correspond exactly to year-to-date and year-end figures. For the same reason, depending on the date the data are extracted, there will be differences in numbers presented in Volume 9 of this publication and those eventually reported in the 1999 Annual Report. Therefore, the numbers provided in this report should be considered provisional. Finally, the usual cautions regarding random fluctuations in values, particularly those involving small numbers, must be noted.

In BC, over the 13 years from 1986 to 1998, 618 people died due to fire and over 5,000 have been injured. This issue's feature article examines fire and conflagration mortality (accident, suicide, and homicide) for age, gender, types of fire deaths, and regional patterns. Comparative differences in age standardized rates from accidental fires between Status Aboriginal and the rest of the BC population is also provided. In addition, information boxes within the article provide a brief summary concerning, for example, suicide by fire, multiple victim events or the involvement of alcohol/smoking/drugs. Although there appears to be a declining trend in the numbers of deaths due to fires, information in this article may be useful for identifying and targeting areas of concern.

As always, requests for changes and suggestions or contributions for articles continue to be welcome. Your support and input into this publication is greatly appreciated.

R.J. Danderfer	Soo-Hong Uh
Director	Manager
British Columbia	Information and Resource
Vital Statistics Agency	Management Branch
	Vital Statistics Agency

[Return to Table of Contents]

British Columbia
Local Health Areas

British Columbia:
Local Health Areas (LHA)
within Health Regions

Fire Deaths in British Columbia,
1986 to 1998

Introduction

This report will provide an analysis of all fire deaths in British Columbia from 1986 to 1998. A regional analysis based on age, gender and regional differences as well as Age Specific Death Rates, Age Standardized Mortality Rates (ASMRs) and Standardized Mortality Ratios (SMRs) will be provided. In addition, comparison of ASMRs between aboriginal population and the rest of the BC population will also be provided. For detailed analysis, all original death records from 1994 to 1998 were retrieved and examined. Based on this close examination, information boxes on fire related homicides, suicides, alcohol, drug and smoking related deaths as well as multiple fire victims will be provided. All data for injuries due to fires were obtained from, Fire Losses in British Columbia, published yearly by the Office of the Fire Commissioner, British Columbia Ministry of Municipal Affairs.

Methodology

Age Standardized Mortality Rates (ASMRs) are a summary of age adjusted death rates by gender that are standardized to a specific population to compare different time periods or geographical locations. The Vital Statistics data that are used in this report are standardized to 1991 Canada Census population.

Standardized Mortality Ratios (SMRs) are the ratio of the actual number of deaths in a Local Health Area (LHA) to the expected number of deaths in that area, based on provincial age-specific mortality rates. SMRs are used for comparing each LHA's observed fire deaths to the Province as a whole and are displayed through mapping.

Status aboriginal death events were identified using probabilistic record linkage using data from the British Columbia Vital Statistics Agency, BC Medical Services Plan, and the Indian Status Verification file from the Medical Services Branch, Health Canada.

The icd codes for this fire study are:

E8900-E8999		Conflagration in residential homes or public places
E9680		Assualt by fire or burning liquids (homicidal burns)
E9581		Suicide by fire
E9230-E9239 with injury codes 9400-9494 & 9870-9879		Accidents caused by explosive material resulting in a burn or smoke/gas inhalation

• The annual number of fire deaths in BC dropped by nearly half from 1986 to 1998.

• With 64 deaths, 1988 was the year with highest number of fire deaths. 1994 showed the lowest number of fire deaths with 32 deaths.

• From 1988 to 1998, the number of fire deaths declined continuously with the exception of 1992, 1995 and 1997.

Suicide deaths by fire Between 1986 and 1998, a total of 39 individuals (27 males, 12 females) died as a result of committing suicide by setting themselves on fire in their homes or vehicles. Sixty nine percent of those who died were 49 years of age or younger with the majority being males (18 males, 9 females). In fact, over the 13 years of study, more individuals in their 40s committed suicide by fire than any other age groups. Males had a higher number of suicide deaths than females in every age group. There were no suicide deaths from fire for those under 20 years of age and only one death was reported for those 70 years of age and over.

Note: Includes 10 non BC residents.

• Between 1986 and 1998, a total of 618 individuals (402 males and 216 females) died as a result of fires in British Columbia.

• Overall, a fire fatality was almost twice as likely to be male.

• Male deaths outnumbered female deaths in every year from 1986 to 1998.

• 1986 marked the highest number of deaths for males at 44. The highest number of deaths for females was 25 for both years of 1988 and 1990.

• There was an overall decline in fire deaths from 1986 to 1998 mostly due to the more marked decline in male deaths.

• More than 83 percent of fire deaths were due to accidental fires in private homes in British Columbia from 1986 to 1998.

• Six percent of fire deaths during the same period were caused by suicides when individuals intentionally set themselves on fire in their homes or vehicles.

• Homicides, explosive fire accidents, fire accidents in public places and outdoor accidental fires, each comprised approximately two to three percent of all fire deaths between 1986 and 1998.

Homicide deaths by fire During the period of 1986 to 1998, a total of 17 individuals (7 males, 10 females) were victims of homicides by fire. (No homicidal fire deaths were reported for 1989, 1993, 1994, 1996, 1997 and 1998). The majority of those who died (88 percent) were individuals 45 years of age or younger. Females, particularly those 40 years of age or younger, were more likely to die from homicidal fire deaths than males. Six children 8 years of age or younger were also victims of homicidal fires.

Note: Includes non BC residents.
Source: Injury data from Fire Losses in BC. Office of the Fire Commissioner, BC Ministry of Municipal Affairs, 1997.

• Between 1986 and 1997, there were 4,923 injuries and 582 deaths due to fires in British Columbia.

• With 479 injuries, 1992 was the year with the highest number of injuries. The highest number of deaths occurred in 1986 with 61 deaths.

• Over the period of 1986 to 1997, there was an overall decline in both injuries and deaths resulting from fires in British Columbia.

Alcohol abuse and fire deaths An examination of original death records from 1994 to 1998 revealed a relationship between alcohol abuse and fire deaths. During this five-year period, 28 percent of all those who died as a result of fire were intoxicated or had a history of alcohol abuse. Over half of all those who died of an alcohol related fire death were under 50 years of age. Males were more likely to die of an alcohol related fire death than females. In fact, of all 52 alcohol related fire deaths, 41 were males and 11 were females.

Note: Rate per 100,000 population. Non residents excluded.

• The rate of death due to fire was highest for those aged 85 and over (4.81). The lowest rate was 0.67 for those aged 10-14.

• Males had a much higher rate than females in every age group over the period of 1986-1998.

• The chances of dying as a result of a fire increased markedly for both males and females aged 65 and over.

• Males aged 10-14 and females aged 30-34 had the lowest age specific death rates.

• Relatively high rates were also experienced by infants less than one year of age and children aged 1-4 years.

Smoking and fire deaths Each year, smoking is responsible for the cause of at least 20 percent of all residential fires in British Columbia. From 1994 to 1998, 18 deaths (10 percent of all fire deaths) were caused directly by cigarette smoking. In addition, another 26 fire death records showed tobacco abuse during the same period. The majority of these deaths (10 out of 18 deaths) were for those 65 years of age and over. Except for one person aged 19 years, no one under the age of 25 died as a result of fire caused by smoking.

Note: ASMR per 10,000 age and gender specific standard population (1991 Canada Census). Non BC residents excluded.

• The Age Standardized Mortality Rates (ASMRs) for fire deaths showed a relatively steady decline for both males and females (from 2.8 to 1.1 for males and from 1.1 to 0.6 for females) over the period of 1986 to 1998.

• The highest male ASMR occurred in 1986 (2.8) and for females, the highest rate was in 1988 (1.6).

• The lowest ASMR for males was 1.1 for both years of 1996 and 1998. 1994 showed the lowest ASMRs for females at 0.4.

• Males had a much higher ASMR than females in every year during the period of 1986 to 1998.

Multiple Victim Fires A study of original death records from 1994 to 1998 showed a number of multiple victim fires. All except one of the fires that resulted in two or more deaths, occurred in private residences. In 1994, three fires in the areas of Prince George, Maple Ridge and Richmond claimed the lives of six individuals (2 people in each fire). 1995 also showed six deaths in the areas of Fruitvale, Alexis Creek and Kelowna (2 people in each fire). Four people died as a result of an explosion in Quesnel in 1997 while another two died in a fire in Chilliwack in the same year. A total of seven individuals lost their lives due to three fires in 1998, which included three deaths in Sicamous , and two deaths each in the areas of Victoria and Langley.

Note: Includes only E8900-E8999 - conflagration in residential homes or public places. Non BC residents excluded.
Source: Analysis of Status Indians in British Columbia, 1991-1998, British Columbia Vital Statistics Agency (to be released June, 2000).

• There was an overwhelming decline in the Age Standardized Mortality Rates (ASMRs) for fire deaths for the Status Aboriginal population in British Columbia from 1991 to 1998 (1.9 to 0.7). In fact this decline was responsible for the overall decline of fire deaths in the Province since the rate for the rest of the BC population remained at 0.1 for every year during the same period.

• The lowest ASMR for the Aboriginal population was 1.0 for both years of 1992 and 1995. The highest ASMR occurred in 1991(1.9).

Note: *SMR - standardized mortality ratio (Observed/Expected). (see glossary)
Cells that are shaded BLUE indicate a statistically significantly high difference between the observed and expected deaths and cells that are shaded GREY indicate a statistically significantly low difference between the observed and expected deaths (p<0.05, two tailed).
⁺ Based on less than 5 deaths.
Excludes non BC residents.

• Based on Standardized Mortality Ratios (SMRs), 14 Local Health Areas (LHAs) showed statistically significantly more fire deaths than were expected. These were: Central Coast (11.01)⁺, Snow Country (10.31)⁺, Kitimat (6.29), Arrow Lakes (5.56), Upper Skeena (4.96)⁺, Gulf Islands (3.90), Merrit (3.87), Prince Rupert (3.53), Nechako (3.31), Powell River (3.12), Creston (3.07), Quesnel (2.93), Cariboo-Chilcotin (2.27), and Prince George (1.69).

• The areas that showed statistically significantly fewer deaths than were expected were: West Vancouver-Bowen Island (0.23)⁺, Delta (0.26)⁺, Vancouver City Centre (0.45), North Vancouver (0.49), Coquitlam (0.53), and Surrey (0.62).

Summary and Conclusion

A close study of the death records between 1994 and 1998 (184 deaths) showed that alcohol and cigarette smoking were important factors in relation to fire deaths in British Columbia. Twenty eight percent of all fire death records showed intoxication or a history of alcohol abuse. As for cigarette smoking, 10 percent of all fire death records showed smoking as a direct cause of the fire and the death while an additional 26 death records indicated that the victim was a smoker.

The probability of dying as a result of a fire increased for both males and females aged 60 and over with those aged 85 and over having the highest death rate during the period of the study. Almost all of these individuals died as a result of an accidental fire in their private residence. With much emphasis on fire safety, the number of fire deaths has been reduced dramatically in the last decade and it is possible that this downward trend will continue, as more people become aware of fire safety steps to avoid this most preventable cause of death.

Glossary

Age Standardized Mortality Rate (ASMR):
A summary of age adjusted death rates by gender which have been standardized to a specific population for the purpose of rate comparisons of different time periods or different geographical locations. ASMRs in this report are per 100,000 standard population (1991 Canada Census).

Alcohol-Related:
This category includes all deaths stated as being directly or indirectly related to alcohol. It should be noted that where alcohol is an indirect cause of death (i.e. not primary) and the direct underlying cause of death falls within one of our selected causes (e.g. motor vehicle accidents), then this death may be counted in both columns. That is, not all of "alcohol related" are exclusive. This category includes ICD-9 codes - 291, 303, 305.0, 357.5, 425.5, 535.3, 571.0-571.3, 571.5, 577.1, 648.4, 760.7, E860, 790.3.

Assignment of Health Region:
Cases are assigned to Health Regions by the aggregation of appropriate LHAs.

Assignment of Local Health Area (LHA):
Allocation of LHA, in the case of births and deaths is based upon the usual residence (by postal code) of the mother and deceased respectively. Marriages are assigned to LHAs according to the place of event. Community name, is used in the absence of postal code.

Elderly Gravida:
Any mother who was 35 years of age or older at the time of delivery of a live born infant.

External Causes of Death:
Deaths due to environmental events, circumstances and conditions as the cause of injury, poisoning, and other adverse effects. Broad categories include accidents, suicide, medical or abnormal reactions, homicide, legal intervention, misadventures and injury from war operations. Standard tables under this heading include deaths due to accidents, suicide, homicide and other. Accidents are subdivided by the following categories; motor vehicle accidents (MVA) (ICD-9 E810-E825, E929.0), poisoning (E850-E869, E929.2), falls (E880-E888, E929.3), burns/fire (E890-E899, E924, E929.4), drowning (E830, E832, E910), other accidents - all codes from E800-E949 not already noted. Suicide ICD-9 codes are E950-E959; homicide (E960-E969); "other" consists of legal intervention (E970-E978), undetermined if accidental or purposely inflicted (E980-E989) and war operations (E990-E999).

Heart Disease:
Tables under this heading include deaths due to:

• rheumatic/valvular: 391-398, 424
  
• hypertension: 401-405
  
• ischemic: 410-414, 429.2
  
• conductive & dysrythmic: 426-427
  
• heart failure: 428
  
• congenital: 745-746
  
• other: pulmonary - 415-417, inflammatory - 420-423, 429.0, cardiomyopathy - 425, 429.3,
  degenerative - 429.1, other, ill-defined or unspecified - 429.4-429.9

ICD-9:
The ninth revision of International Classification of Diseases, World Health Organization, Geneva, 1977. An internationally used system of approximately 12,000 four digit numbers representing a system of categories to which morbid entities are assigned according to an established criteria. ICD provides a common basis of disease and injury classification that facilitates storage, retrieval, and tabulation of statistical data.

Infant Deaths:
Deaths of children under one year of age.

Low Birth Weight:
Any liveborn infant weighing less than 2500 grams.

Neoplasms (ICD-9 140-239):
Although the vast majority of deaths in this category are due to malignant cancer, also included are benign, in-situ, and unspecified "tumours". Detailed ICD-9 breakdown used in "Neoplasm Deaths" tables are;

• lung: includes trachea, bronchus, lung (162) and pleura (163).
  
• female breast: (174).
  
• colorectal: includes colon (153) and rectum, rectosigmoid junction and anus (154).
  
• other G.I. (Gastrointestinal): includes esophagus (150), stomach (151), small intestine and duodenum (152), liver & intrahepatic bile ducts (155), gallbladder and extra-hepatic ducts(156), pancreas (157), peritoneum (158), other and ill-defined within digestive organs (159).
  
• female reproductive: includes uterus (179), cervix (180, 182), placenta (181), ovary and adnexa (183), vagina & external genitalia (184).
• prostate (185).
  
• blood lymph: includes lymphatic and haematopoietic tissue (eg. lymphomas and leukemias, 200-208).
  
• other malignancy: includes malignant neoplasms of other (e.g. lip, oral cavity, pharynx, nose, ear, larynx, heart, bone and connective tissue, urinary tract, eye, brain, endocrine glands), ill-defined or unspecified sites (140-149, 160, 161, 164, 165, 170-173, 175, 186-199).
  
• non-malignant & unspecified: includes benign (210-229), in-situ (230-234), and neoplasms of unspecified nature (e.g. "tumor" - 239).

Other Selected Death Statistics:
Tables under this heading include deaths due to:

• diabetes (250).
  
• alcohol related - see above.
  
• AIDS: includes AIDS and HIV infections (042-044).
  
• other infectious diseases (0010 to 0419, 0450-1398).
  
• cerebro and other vascular: includes cerebrovascular disease (430-438), disease of arteries and veins (440-456),
  hypotension (458), and other circulatory system disease (459).
  
• liver disease: (570-573).
  
• ALS/MS: amyotrophic lateral sclerosis and multiple sclerosis (3352 & 340).
  
• Alzheimer's disease (3310).
  
• Parkinson's disease (3320).
  

Premature/Pre-term:
Any live born infant less than 37 weeks gestation at delivery.

Respiratory Disease Death Statistics:
Tables under this heading include deaths due to the following:

• emphysema (492).
  
• COPD - chronic obstructive pulmonary disease (496).
  
• pneumonia (480-486).
  
• influenza (4870-4879).
  
• asthma (4930-4939).
  
• lung disease due to external agents, e.g. aspiration pneumonia, asbestosis, silicosis (500-5089).
  
• pulmonary fibrosis (515).
  
• other respiratory diseases (460-4789, 490-4919, 494-4959, 5100-514, 5160-5199).
  

Standardized Mortality Ratio (SMR):
The ratio of the number of deaths occurring to residents of a geographic area (e.g. LHA) to the expected number of deaths in that area based on provincial age specific mortality rates.

Stillbirth:
The complete expulsion or extraction from its mother after at least 20 weeks of pregnancy or after attaining a weight of at least 500 grams, of a product of conception in which, after expulsion or extraction, there is no breathing, beating of the heart, pulsation of the umbilical cord or unmistakable movement of voluntary muscle.

Teenage Mother:
Any mother who was age 19 or less at the time of delivery.

UCOD:
Underlying cause of death - based upon application of standard international coding rules for determining sequential relationships of conditions and diseases from immediate cause backwards to underlying cause.

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Contributors' Note:

The editorial staff would like to invite any readers who wish to contribute an article or paper summary for publication in this Quarterly Digest to contact the Information and Resource Management Branch of the British Columbia Vital Statistics Agency. Articles should focus on health status issues in British Columbia. It is preferable that submissions be in "electronic media" format (e.g. Word, Word Perfect, Excel, Power Point, Corel, Pagemaker, etc.). Article presentation will be subject to space allowances and publishing deadlines.

Readers' Note:

Re: "Letters to the Editor", or mailing and distribution.

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