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Psychotropic Drug Usage and Human Behaviour During Fire Emergencies

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Psychotropic Drug Usage and Human Behaviour During Fire Emergencies Psychotropic Drug Usage and Human Behaviour During Fire Emergencies Submitted by Chris Lykiardopoulos PostGradDip (Psych), GradDip (Psych), BBA Victoria University This thesis is submitted in total fulfilment of the requirements for the degree of Doctor of Philosophy School of Psychology Victoria University, Melbourne, Australia December 2014 DRUG USE AND HUMAN BEHAVIOUR DURING FIRE EMERGENCIES ii Declaration I, Chris Lykiardopoulos, declare that the PhD titled “Psychotropic Drug Usage and Human Behaviour During Fire Emergencies” is no more than 100,000 words in length including quotes and exclusive of tables, figures, appendices, bibliography, references and footnotes. This thesis contains no material that has been submitted previously, in whole or in part, for the award of any other academic degree or diploma. Except where otherwise indicated, this thesis is my own work. Signature: Date: DRUG USE AND HUMAN BEHAVIOUR DURING FIRE EMERGENCIES iii Abstract Relatively little is known about the impact psychotropic drugs, particularly sedatives, have on human behaviour in a residential fire emergency. Two separate but related avenues of investigation were conducted to explore human behaviour in fire when under the influence of psychotropic drugs. In Study One the efficacy of current and alternative smoke alarm signals was tested after the consumption of hypnotics. A supplementary objective was to examine the relationship between sleep quality and arousal thresholds. Study Two retrospectively analysed an Australian database of fire fatalities using advanced algorithmic modelling techniques to determine: (a) if users of psychotropics and hypnotics were overrepresented in the Australian fire fatality statistics; and (b) the relationship between psychotropic drug consumption and a number of behavioural, environmental, and demographic risk factors. The research provided new, important evidence revealing an uncomfortably high level of risk to users of psychotropic drugs, particularly hypnotics, in a residential fire context. This was the first time psychoactive drug usage had been considered in such detail in the international literature. The major findings of the research centred around five key areas: 1. Smoke alarms and a safety culture The 520 Hz square significantly outperformed the 3100 Hz sine wave in users of hypnotics. A strong case is building challenging the effectiveness of the existing smoke alarm to alert vulnerable people from fire, and the results provide additional support for the continued adoption of the 520 Hz square wave. However, a fatality may not be avoided even when a potential victim has been alerted to danger. Therefore, a preventative focus facilitated by the adoption of a safety culture provides a more satisfactory answer to the fire threat. 2. Psychoactive drugs and the fire response The results indicate that psychotropic drugs and especially sedatives have a profound impact on behaviour when facing a fire emergency, particularly amongst middle aged adults. Alarm responsiveness was significantly attenuated after the consumption of a hypnotic and users of psychotropic drugs are greatly overrepresented in the Australian fire fatality statistics compared to population statistics. A key risk is the impact sedatives DRUG USE AND HUMAN BEHAVIOUR DURING FIRE EMERGENCIES iv may have on human error, evidenced by the relationship between time of fire and hypnotic consumption, which was largely responsible for most accidents. 3. Complexity and research design Fires are complex events. Algorithmic modelling was found to be better suited to analysing fire fatality statistics or other intricate data sets produced from fire incidents compared to traditional forms of regression. Furthermore, it is argued that a greater balance in research design that considers internal and external validity is necessary when investigating residential fires. This will produce more persuasive and realistic research outcomes that can educate and inform decision makers in the fire industry. 4. Sleep quality and arousal thresholds There is a possible relationship between sleep quality and arousal thresholds, which would challenge existing work that claims there is no difference in arousal thresholds between good and poor sleepers. However, no conclusive evidence was found regarding the relationship between sleep quality and arousal thresholds due to issues of power. A difference in arousability during the night is only predicted in patients who suffer from sleep maintenance issues, which is an insomnia subtype notably absent in previous research. 5. Embracing a multi-disciplinary approach The broader significance of this project is the contribution made to a shift in the approach to understanding fire accidents from one that focuses on organisational accidents analysed from technologically driven perspectives to a concentration on individual accidents examined from a psychological perspective. DRUG USE AND HUMAN BEHAVIOUR DURING FIRE EMERGENCIES v Acknowledgements I would like to convey my special thanks to my supervisors, Professor Dorothy Bruck and Dr. Michelle Ball for their unyielding support, wisdom and insightful feedback. I also owe a debt of gratitude to the many research assistants who have contributed to the Victoria University Coroners' Database, including Erin Read, Lynette Walpole, Kara Dadswell and Lin Xiong. Thanks also to Samara Neilson for your assistance with the arousal program, Dr. Simon Frenkel for your guidance on sedatives and to Neil Diamond for your advice on algorithmic modelling. I would also like to thank my family, particularly my wife, Michelle and my son, Isaac. I would not have started nor finished were it not for you both. DRUG USE AND HUMAN BEHAVIOUR DURING FIRE EMERGENCIES vi TABLE OF CONTENTS Declaration.......................................................................................................................................ii Abstract...........................................................................................................................................iii Acknowledgements..........................................................................................................................v Table of Contents............................................................................................................................vi List of Tables................................................................................................................................viii List of Figures.................................................................................................................................ix Introduction ................................................................................................................................... 1 CHAPTER 1 – Literature Review ............................................................................................... 4 Smoke Alarm Development and Current Standards ................................................................... 4 Sleep and Insomnia ................................................................................................................... 11 Sedatives and Other Psychotropic Drugs .................................................................................. 18 Auditory Arousal Thresholds .................................................................................................... 27 Fire Fatality Statistics ............................................................................................................... 35 Accident Causation and Human Error ...................................................................................... 44 Research Aims .......................................................................................................................... 50 CHAPTER 2 – STUDY ONE – Arousal Thresholds ............................................................... 51 Brief Introduction...................................................................................................................... 51 Method ...................................................................................................................................... 55 Participants ............................................................................................................................ 55 Medication Issues.................................................................................................................. 57 Materials ............................................................................................................................... 58 Procedure .............................................................................................................................. 61 Results ....................................................................................................................................... 69 Discussion ................................................................................................................................. 75 CHAPTER 3 – STUDY TWO – Coronial Investigation ......................................................... 92 Brief Introduction...................................................................................................................... 92 Method ...................................................................................................................................... 93 Participants ...........................................................................................................................
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