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Medline ® Abstract for Reference 34

of 'Promoting safety in children with disabilities'

Fatal residential fires: who dies and who survives?
Marshall SW, Runyan CW, Bangdiwala SI, Linzer MA, Sacks JJ, Butts JD
JAMA. 1998;279(20):1633.
CONTEXT: The United States has one of the highest fire fatality rates in the developed world, and three quarters of these deaths are in residential fires.
OBJECTIVE: To compare characteristics of those who die and those who survive in the same residential fire.
DESIGN: Data on fatal residential fires were collected from the medical examiner and interviews with local fire officials.
SETTING: North Carolina.
SUBJECTS: Persons in residential fires with at least 1 fatality in a 1-year period.
MAIN OUTCOME MEASURE: Dying vs surviving a fatal residential fire that occurred with more than 1 person at home.
RESULTS: Of the 190 decedents, 124 (65%) were male, 78 (41%) were home alone, and 69 (53%) of 130 adults who had blood alcohol measured were intoxicated (blood alcohol content>22 mmol/L [100 mg/dL]). Of the 254 persons present during fires in which more than 1 person was at home, 112 died. Individuals more likely to die (high-vulnerability group) were younger than 5 years or 64 years or older, had a physical or cognitive disability, or were impaired by alcohol or other drugs (risk of death for group, odds ratio [OR], 4.01; 95% confidence interval [CI], 2.29-7.03). The presence of an adult with no physical or cognitive disabilities who was unimpaired by alcohol or other drugs (a potential rescuer) reduced the risk of death in the high-vulnerability group (OR, 0.49; 95% CI, 0.24-0.99) but not the low-vulnerability group. Overall, a functioning smoke detector lowered the risk of death (OR, 0.39; 95% CI, 0.18-0.83).
CONCLUSIONS: Smoke detectors were equally effective in both low- and high-vulnerability populations. The high-vulnerability group was more likely to survive if, in addition to a smoke detector, a potential rescuer was present. Further research should seek to identify prompts that facilitate speedy egress from a burning structure and that can be incorporated into residential fire alarm systems.
Injury Prevention Research Center, Department of Epidemiology, University of North Carolina, Chapel Hill 27599-7505, USA. smarshall@unc.edu