Fatal residential fires: who dies and who survives?

JAMA. 1998 May 27;279(20):1633-7. 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.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Fires / statistics & numerical data*
  • Housing / statistics & numerical data*
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Middle Aged
  • Mortality*
  • Risk
  • Survival*
  • United States / epidemiology