Quantitative epidemiological studies have identified victim- or fire-related risk factors for fire mortality and have shown radical sociodemographic differences. Whilst important, such studies are limited in explaining the underlying reasons why some individuals are more vulnerable than others. Based on focus group interviews with nurses at burn clinics in Sweden, this qualitative study therefore aims to deepen the understanding of the risk factors surrounding individuals with severe burns and the fires that caused them. The testimonies from the nurses show, with few exceptions, that the patients have extensively challenging backgrounds and are, therefore, more similar to fatal fire victims than victims with minor or no injuries. By applying a qualitative approach rather than the traditional epidemiological methodology, nurses' testimonies contextualise the individual risk factors often highlighted in fire-related research. As such, we put forth that the underlying cause is a “systemic vulnerability”, that the victims are alienated from the rest of society due to a combination of physical, cognitive, economic, social, and external factors that limit the available compensating resources. In turn, this means that their ability to handle a potentially dangerous situation is severely compromised, thereby requiring a more holistic preventative approach. • Severely injured fire victims often share a complex history of vulnerability. • Study reveals systemic vulnerability behind fire risk factors. • Technical solutions are insufficient; interventions must be multifactorial. • Identifying at-risk individuals requires collaboration across local authorities. • Severely burned victims share traits with fatal fire cases.
Gustavsson et al. (Sun,) studied this question.