The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #68243

Gregory R. Istre, MD¹, Mary McCoy¹, Joe Pierce², Martha Stowe, MSW¹, and Jeffrey J. Barnard, MD³. (1) Injury Prevention Center of Greater Dallas, P.O. Box 36067, 5000 Harry Hines Blvd. Suite 101, Dallas, TX 75235, 214-590-4455, gistre@aol.com, (2) Education and Inspection Division, Dallas Fire and Rescue Department, 2014 Main Street, Room 401, Dallas, TX 75201-4420, (3) Chief Medical Examiner, Dallas County, Office of Medical Examiner of Dallas County, 5230 Medical Center Drive, Dallas, TX 75235

Background: One obstacle to the elimination of residential fire-related deaths is the occurrence of deaths despite the presence of a working smoke alarm (SA+ deaths). Characterization of these deaths may be useful in designing other prevention approaches. Population: Residents of Dallas, TX Methods: We linked residential fire-related deaths identified through the Medical Examiner for 1991-2000 to records of the Fire Department, to identify demographics and circumstances of the fire. SA+ deaths were compared to deaths that occurred in residences without a working smoke alarm (SA- deaths). Results: For the ten years, there were 16,744 residential fires, of which 123 resulted in 167 deaths; house fires--124 deaths; apartment fires--40 deaths; mobile home fires--3 deaths. Of the 3225 SA+ fires, 18 resulted in 26 SA+ deaths. SA+ deaths were more likely at the extremes of age (< 2 years or 80+ years) than SA- deaths (11/26 (42%) vs. 19/130 (15%); RR 2.9; 95% CI 1.6-5.3), implying that impaired response to a SA may have contributed to these deaths. The remaining SA+ deaths (i.e., those 3-79 years) had the following contributing factors: fireplay-related (3), ethanol intoxication (3), re-entering burning residence (2), smoking in bed (2), or arson (2). Thus 23/26 (88%) of SA+ deaths had at least one of these potential contributing factors. Conclusion: Most deaths that occur despite the presence of a working smoke alarm may be prevented by dissemination of currently available preventive measures, including automatic fire sprinklers, and education about child fireplay prevention and escape from fire.

Learning Objectives:

• Identify the proportion of residential fire-related deaths that are not prevented by smoke alarms.
• Describe characteristics of persons who die in residential fires despite the presence of a working smoke alarm.
• List other potential preventive measures that may be effective in preventing these deaths.

Keywords: Injury Risk, Injury Prevention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.