Fatal Residential Fires: Who Dies and Who Survives?

• Published in: JAMA : the journal of the American Medical Association 1998-05, Vol.279 (20), p.1633-1637
• Main Authors: Marshall, Stephen W, Runyan, Carol W, Bangdiwala, Shrikant I, Linzer, Mary A, Sacks, Jeffrey J, Butts, John D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Burns; Child; Child, Preschool; Comparative analysis; Fatalities; Female; Fires; Fires - statistics & numerical data; Housing - statistics & numerical data; Humans; Infant; Logistic Models; Male; Medical sciences; Middle Aged; Mortality; Risk; Survival; Traumas. Diseases due to physical agents; United States - epidemiology
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.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.