RAPIDLY AGING SOCIETY AND ITS IMPACT ON FIRE RISKS

Japan is continuing to experience an aging population with trends toward a declining total population and a rising percentage of adults aged 65 years or older as seen in Figure 1. When Japan's "baby boom generation" (those born between 1947 and 1949) exceed 65 years of age in 2015, the elderly population will be 34.0 million. The population aged 65 or older is expected to continue growing over the next 20 years, and it is expected to reach 33.4% of the total population by 2035. This increase will create a super-aged society in which one in three people are 65 years or older.

Figure 1: Total Population and the Ratio of Aged, 65 or Older in Japan1,2


An aging population is in many ways a positive social phenomenon. There are many countries with high fertility and average life expectancy in the 40s and 50s. Although the proportion of the aged population in these countries is naturally low, many of these countries do not have a high standard of living. An aging population is one facet of the so-called long-life society. A large elderly population can be viewed as evidence not only of the enhancement of the Japanese national health care system, but also that Japan has achieved an extremely peaceful and economically stable society for 70 years in the post-war period. This phenomenon should not be viewed negatively, but it is something to be proud of. Japanese people should consider this a challenging problem to which they can take the lead in finding a solution. Doing so is one of the responsibilities of a peaceful and mature country.

It is not possible to immediately resolve all problems related to an aging population; yet it is necessary to, for example, improve frameworks and systems for employing elderly people who are willing and able to work and promoting their participation in society.

Incidentally, challenges caused by an aging population are found in all aspects of society, including health and medicine, lifestyle and housing, family and community relationships, the economy, and fire safety. In Japan, approximately 1,400 people die annually in fires (excluding suicide by fire). The ratio of people aged 65 years or older accounts for approximately 60% of these fire fatalities.

Figure 2 compares the risk of fire death between age groups, showing the number of deaths per 100,000 population due to fires. It is clear that the risk increases suddenly in the elderly age range, with the value for the group aged 76 and over particularly high. In contrast, the value is uniformly low for people aged 55 years or younger, with very few deaths of people aged 35 years or younger. Even though the state of a fire may change rapidly, in contrast to motor vehicle collisions, fires do not occur in a single instant. Differences in physical capabilities in terms of ability to respond to danger after a fire is discovered, and the ability to evacuate in particular, are thought to have a large effect on survival.

Figure 2: Ratio of Per Capita Fire Deaths by Age Group in Japan for 20103


In any case, when one considers further aging of Japanese society, there is little doubt that the number of deaths due to fires will rise in the future. In addition, a new problem has recently arisen: a proliferation of halfway nursing homes in poor condition in terms of fire safety. The proliferation in these halfway nursing homes occurred in order to accommodate the increasing number of aged people requiring nursing care. Even with some improvements to fire safety equipment in these facilities, there remains the problem of how to provide fire safety for elderly people who may find evacuation difficult.

Against this background, the author analyzed trends in the residences of elderly people and the risk of death due to fire by using fire incident report data4 created by fire departments and various social statistical data,5,6,7,8,9 that include elements related to fires. The remainder of this article explores how the residential environment affects the risk of death due to fire and what kinds of highly effective fire prevention measures exist.

FIRE RISK BY TYPE OF FACILITY AND RESIDENCE FOR ELDERLY PEOPLE

Figure 3 shows the number of injuries and deaths due to fire per million people by type of residence. The results for wooden apartments are particularly high. Next highest are residences such as wooden detached houses and non-wooden apartments, whereas the rates of fatalities and injuries were relatively low in welfare and medical facilities.

Figure 3: The Average Annual Rates of Fire Fatalities and Fire Injuries Per Million People During 2004-2008


The likely reason is that, although hospitals and special care nursing homes have a high proportion of residents unable to evacuate by themselves, these facilities are equipped with fire protection equipment and have staff that can assist with evacuations.

Because general residences are less subject to regulations, they are not equipped with fire protection equipment and don't have staff available to assist in emergencies. This makes it easier for fires to occur and for elderly people to have difficulty evacuating from a fire. As such, the rates of injuries and deaths due to fire are higher in individual housing, particularly wooden apartment housing.

Among welfare and medical facilities, group homes for elderly people with dementia exhibited the highest numbers of deaths due to fire. This is likely because such homes include facilities that have been transferred from a residence, and because the fire safety measures are not as extensive as in hospitals or special care nursing homes.

Figure 4 similarly shows the fire risk by type of facility and residence. It also shows the number of deaths and number of serious injuries per occurrence of fire. There are no large differences in the number of deaths or serious injuries per fire between welfare facilities, medical facilities, and each type of residence, with the exception of group homes. The number of deaths and injuries per fire is clearly high in group homes, with an average of 0.75 serious injuries and 0.58 deaths occurring per fire.

Figure 4: The Annual Average Rates of Fire Fatalities and Fire Injuries Per Incident During 2004-2008


By any definition, this is an extremely high risk. Under Japanese national standards, group homes are required to have only one staff member at night per nine residents with dementia. If a fire occurs at night, it is essentially impossible for a single staff member to simultaneously perform initial firefighting, call the fire department, and evacuate nine elderly people with dementia in a short period of time. The above results are evidence of the magnitude of the potential fire risk due to insufficient nursing staff at night in small welfare facilities.

In such a facility, where mobility-impaired people are in the majority and where there are very limited staff, it is not possible to rely on staff to save these occupants during a fire emergency. There may be no solution other than providing a sprinkler system that can automatically control the fire. In fact, after experiencing several fatal fires in group homes, the Japanese Fire Service Law was revised in 2007 to require the installation of sprinkler systems in all group homes and similar small nursing care homes greater than 275 m2 where more than half of the occupants need assistance to evacuate.

ANNUAL TRENDS IN THE RISK OF DEATH BY FIRE BY AGE GROUP

The author investigated trends over 30 years (1979 to 2009) in the risk of death due to structure fire (number of structure fire deaths occurring per 100,000 population) by age group.

First, looking at trends in the absolute number of deaths by structure fires in Figure 5, large differences appear in the increases or decreases by age group, reflecting changes in the population age composition over the past 30 years. For example, the number of deaths among the elderly greatly increased over these 30 years. The "75 years or older" group doubled (105% increase). In contrast, the "6-64 years" group remained level, and the "5 years or younger" group greatly decreased to approximately one-fifth (an 82% decrease). These trends reflect the declining birthrate and aging population of Japan.

Figure 5: Trend of the Number of Structure Fire Deaths by Age Group
(1995-2009: Excluding Incendiary Suicides)


In contrast, Figure 6 shows trends in the number of deaths due to fire per 100,000 population for various age groups. While the fire death rate in the "6-64 years" group remained flat over this period at 0.5, the death rate for the "65-74 years" group decreased from 2.79 to 1.57 (a 44% reduction), and the death rate for the "75 and older" group decreased from 6.82 to 3.59 (a 47% reduction), virtually halving in each case. The biggest reduction was in the "5 years or younger" group, with the number of deaths decreasing by 71% from 1.55 to 0.45. In summary, the death rate due to fire per population greatly decreased over the past 30 years, not only among the child group, but also among the elderly groups.

Figure 6: Trend of Fire Death Rate Per 100,000 Population by Age
Group (1995-2009: Excluding Incendiary Suicides)


The significant reduction in the death rate among the "5 or younger" group can be attributed to the fact that children less frequently play with fire. The decreasing trend in death rates among the elderly has continued uniformly from the 1980s to today, and is thus not due to the recent increase in use of residential smoke detectors. Furthermore, since no particular fire safety measures were mandated in homes during this period, it cannot be the effect of other fire safety measures. Several factors are conceivable as causing the decreasing trend among elderly people. One such factor may be the improved health of elderly people in general, particularly those who recently entered the elderly age group who are beneficiaries of more widespread medical treatment and a focus on health in recent years. Another possible reason is improvements in social care and in the residential environments of elderly people.

Although there has been an increasing absolute number of fire deaths in elderly people to some extent, which is attributed to the rapid increase in the population of aged people, the number of deaths due to fire as predicted by that demographic shift is not increasing proportionally. Looking at the elderly age group in particular, the number of fire deaths per population over the past 30 years has greatly decreased, and the fire safety level has consistently improved. It is important to analyze trends in the number of deaths due to disasters using risk indicators such as the number of deaths per population in combination with other relevant factors such as age and type of facility. This allows searching for factors that underlie death risks, investigating ways to reduce the number of deaths, and creating the possibility of measures for reducing casualties.

FLEXIBLE IDEAS FOR FIRE SAFETY MEASURES

The author would like to discuss the balance between fire safety and the quality of life of elderly people. Physical fitness and mobility inevitably deteriorate as people age, and it becomes easier to be injured during any kind of accident, not only a fire. As the population continues to age, it is natural that the trend of increasing numbers of deaths will continue as far as the population of elderly people increases. The problem may be influenced by factors such as deterioration of mutual assistance from family members and communities, as the low birth rate, aging population, and trend away from multi-generational households continue. However, the risk of death due to fire among elderly people is decreasing, according to the trend in recent years in Japan, as shown in Figure 6.

Although the improved health of elderly people is one important explanation, it is not the only one to explain the above fact. The increased safety of appliances for cooking and heating, and the increased safety and quality of housing environments certainly has had an effect.

The majority of fires that occur in residential homes are related to human error, such as forgetting to turn off or incorrectly using an appliance. Solely relying on people being cautious has limits for preventing the occurrence of careless accidents, and it is impossible to expect that they can be completely prevented. By contrast, if one develops safe appliances, where careless errors do not result in fires, or makes further advances in measures for preventing the outbreak of fires so that people simply do not encounter fires, then the number of deaths due to fire naturally decreases along with the number of fires.

Therefore, the development of fire-safe appliances that are not affected by attributes such as user age and physical fitness should be prioritized as an important measure for preventing fires. It also is important to improve the health and living environment for elderly people. Reducing fire risks, even a little, and thereby providing a safe and comfortable life in residential homes in which the majority of elderly people live, is something that everyone wants.

Ai Sekizawa is with Tokyo University of Science.

References:

  1. National Institute of Population and Security Research (2015).
  2. Bureau of Statistics of Ministry of Home Affairs (2010).
  3. Fire and Disaster Management Agency, Japan, White Book on Fire Service in Japan, 2010 edition.
  4. Fire and Disaster Management Agency, Database of Fire Incident Report (2004-2008).
  5. Bureau of Statistics of Ministry of Home Affairs, Survey of Social Welfare Facility (2004-2008).
  6. Ministry of Health, Labor and Welfare, Survey of Patient (2004-2008).
  7. Bureau of Statistics of Ministry of Home Affairs, Survey of Housing and Land, 2008 edition.
  8. Ministry of Health, Survey of Demographic Statistics.
  9. Taichi Yamamura, Ai Sekizawa, Akihiro Notake, Atsushi Mammoto, Daisuke Oiwa, Study on Fire Risk of Aged Population in Consideration of Residential Facilities for the Elderly, Proceedings of the Annual Conference of Japan Association of Fire Science and Engineering, 2011.