Surveillance and prevention of residential-fire injuries

N Engl J Med. 1996 Jul 4;335(1):27-31. doi: 10.1056/NEJM199607043350106.


Background: The majority of severe and fatal burn injuries result from residential fires. We studied the effectiveness of a smoke-alarm-giveaway program in the prevention of burn injuries in an area with a high rate of such injuries.

Methods: We collected data on burn injuries in Oklahoma City from September 1987 through April 1990. The target area for the intervention was an area of 24 square miles (62 km2) with the highest rate of injuries related to residential fires in the city. We distributed smoke alarms door to door in the target area and then surveyed alarm use and function in a sample of the homes that had received an alarm. We also calculated the rates of fire injury per 100,000 population and per 100 fires for both the target area and the rest of the city before and after the smoke-alarm giveaway.

Results: Before the intervention the rate of burn injuries per 100,000 population was 4.2 times higher in the target area than in the rest of Oklahoma City. An initial survey indicated that 11,881 of the 34,945 homes in the target area (34 percent) did not have smoke alarms. A total of 10,100 smoke alarms were distributed to 9291 homes; 45 percent were functioning four years later. The annualized fire-injury rates declined by 80 percent in the target area during the four years after the intervention (from 15.3 to 3.1 per 100,000 population), as compared with a small increase in the rest of the city (from 3.6 to 3.9 per 100,000 population). There was also a 74 percent decline in the target area in the injury rate per 100 fires (from 5.0 to 1.3; rate ratio, 0.3; 95 percent confidence interval, 0.1 to 0.6), as compared with a small increase in the rest of the city.

Conclusions: A targeted intervention involving a smoke-alarm-giveaway program can reduce the incidence of injuries from residential fires.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Burns / epidemiology
  • Burns / etiology
  • Burns / prevention & control*
  • Fires / prevention & control*
  • Fires / statistics & numerical data
  • Housing
  • Humans
  • Incidence
  • Oklahoma / epidemiology
  • Outcome Assessment, Health Care
  • Population Surveillance
  • Program Evaluation