Fire-safe procurement of mattresses for the healthcare sector
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A smart checklist to use when procuring mattresses with a focus on Fire Safety and Evacuation.
”Planning for the worst-case scenario” is an essential starting point for proactive fire safety work in the healthcare sector. In the event of a real incident, time is of the essence; it is not a question of whether an evacuation is required, but of how much time staff have to carry it out safely.
Statistics show that incidents and fires occur regularly within the Swedish healthcare system, and the frequency is even higher in residential care homes [1]. Despite structural safeguards such as sprinkler systems and fire compartmentation, loose furnishings – and mattresses in particular – are a critical factor in the progression of a fire, as they can act as a primary fuel source and cause rapid smoke development.
In this section, we explain the vital difference between smoke and flame spread, why basic cigarette tests are inadequate for healthcare settings, and how the so-called 1-1-1 rule helps to maximise evacuation margins and protect immobile patients.
It is a common misconception that open flames are the primary cause of death in fires within inpatient care settings. In fact, inhalation of toxic smoke is the most fatal factor. As polyurethane is essentially a petroleum product, a burning mattress releases a fire load equivalent to its own weight in oil [2].
If an unprotected standard mattress weighing 12 kg catches fire, an average of 28,000 cubic metres of smoke is generated [2]. This enormous volume consists of an acutely toxic mixture of gases, including carbon monoxide (CO) and hydrogen cyanide (HCN).
As the mattress provides the immediate support for a patient who is often bed-bound and immobile, the physical and chemical properties of the material are absolutely critical. Choosing the right material is crucial for delaying ignition, inhibiting flame spread and minimising smoke production during the initial stage.
Why should such uncompromising standards be set for healthcare mattresses in particular? The statistics speak for themselves: one in five fires in healthcare settings starts in a patient or residential room, and in these specific cases, as many as 72 % of the fires are deliberately set [3].
A tragic and well-known example that illustrates this risk profile is the fire at Sankt Sigfrid’s Hospital in Växjö (2003), which started in a mattress in a psychiatric ward. In its report, the Swedish Accident Investigation Authority concluded that the lack of adequate flame retardancy in the ward furnishings contributed to an extremely rapid flashover, which proved fatal. Fire safety experts concluded that the scenario and the possibilities for evacuation would have been fundamentally different had the materials possessed adequate flame retardancy [3].
The risk profile is at its most critical within psychiatric care and at the homes run by the National Board of Institutional Care (SiS). In these environments, furnishings are sometimes exposed to accelerants – such as hairspray, nail varnish remover and lighter fluid – for destructive purposes.
In such high-risk environments, it is simply not enough for a mattress to be classified as ”flame-retardant” on the basis of basic consumer tests alone. To guarantee a genuine safety margin, the mattress must comply with the stringent Swedish standard SS 876 00 10, under which the material’s self-extinguishing properties are verified during direct and sustained exposure to a gas flame.
Many decision-makers rely on the building’s structural fire protection being sufficient to cope with an incident. But as Björn Sundström, a fire safety expert at RISE, emphasises:
”A bed or piece of upholstered furniture burns faster than fixed fittings and can catch fire on its own.”
In public procurement, however, it is easy to get lost in the jungle of standards. Often, only basic requirements for so-called ”normal risk” are specified, in accordance with the European standards SS-EN 597-1 and SS-EN 597-2. These tests merely verify that the flooring can withstand a burning cigarette or a brief match flame under controlled conditions [4].
For environments classified as ”High risk”, this test level is clearly inadequate. From a proactive risk analysis perspective, the more stringent Swedish standard SS 876 00 10 should instead be applied. The difference in test method and actual outcome is fundamental:
Once a fire has broken out, time is of the essence. The average response time for the emergency services is often 10–15 minutes [5], which means that the primary responsibility for patients’ safety during the initial and most crucial phase rests entirely with the staff on duty at the facility.
A conventional evacuation using a stretcher or manual lifts usually requires up to four carers per patient – a staffing requirement that poses significant organisational challenges, particularly during night-time shifts. The solution to this problem is to introduce evacuation mats with integrated evacuation functions or permanently fitted rescue sheets.
This preparedness is particularly critical for immobile patients being cared for on dynamic mattress systems (alternating pressure mattresses), as these individuals often have significant functional impairment and a limited ability to self-evacuate. Historically, dynamic mattresses have posed technical and ergonomic challenges during emergency transfers due to their bulk and friction against the surface. Modern systems, such as OptiCell Evac, however, address this through integrated solutions that make it possible to include even these resource-intensive patients in the strategic 1-1-1 planning:
The 1-1-1 Rule
1 Care staff must be able to evacuate independently…
1 a patient lying down…
under 1 minute.
Empirical data supports this methodology. Large-scale and standardised evacuation drills, including a comprehensive field study in Krefeld, Germany, show that the use of integrated rescue systems reduces the need for immediate emergency response personnel by 75 % and halves the total evacuation time [5].
When drawing up the tender, it is crucial to assess the system’s overall performance, rather than individual product features. Use the following parameters to ensure that you receive tenders with verified and documented security:
Evidence-based pest control
Gain deeper insight into life-saving technology. In this White Paper, we review clinical studies and provide you with a smart checklist to use when procuring pressure-relieving mattresses.
Suggestions for procurement documents
A smart checklist for procuring mattresses with a focus on pressure relief.