Mortality of firesetters: a follow-up study of Finnish male firesetters who underwent a pretrial forensic examination in 1973-1998.

Little is known about mortality among firesetters. However, they hold many risk factors associated with elevated mortality. This study aimed to investigate mortality rates and patterns in the course of a 39-year follow-up of a consecutive sample (n=441) of pretrial male firesetters evaluated in a forensic psychiatric unit in Finland. For each firesetter, four controls matched for age, sex and place of birth were randomly selected from the Central Population Register. Mortality data was obtained from the Causes of Death statistics. By the end of the follow-up period, 48.0% of the firesetters and 22.0% of the controls had died (OR 2.47, 95% CI 2.00-3.05). Altogether, 24.1% of the firesetters and 17.6% of the control subjects had died of natural causes (OR 1.49, 95% CI 1.16-1.92), whereas 20.9% and 3.8% respectively, died an unnatural death (OR 6.71, 95% CI 4.79-9.40). Alcohol-related deaths were more frequent among firesetters than controls. Our findings confirm that fire-setting behavior is associated with high mortality. More attention must be paid to the treatment of suicidality, psychiatric comorbidities and alcohol use disorders within this group both during and after their sentences.

Child fatalities in Scottish house fires 1980-1990: a case of child neglect?

This paper considers 168 child (< 17 years) fatalities killed in house fires in Scotland. Data were obtained from the records retained by the procurators fiscal, as part of a survey into all Scottish fire fatalities during the period 1980 to 1990. Although these fires were generally perceived as being tragic "accidents," we conclude that they were largely a direct result of the activities of adults in the home. We analyze this in terms of contemporaneous supervision and the child-care environment. The role of alcohol in domestic fires is particularly important. Behavioral patterns of parents and caregivers are seen to be placing children in a very high risk category and fatality rate could be significantly reduced if behavior was modified to reduce the risk. Whether these considerations imply "neglect" is partly a question of definition. It is important to recognize that the fire safety message could usefully be integrated within a more general child care or family welfare scheme. Front line professionals in these fields are ideally placed to convey this message and to make a contribution towards reducing the risk of children being killed or injured in fire.