FATAL RESIDENTIAL FIRES - WHO DIES AND WHO SURVIVES

Context.-The United States has one of the highest fire fatality rates in the developed world, and three quarters of these deaths are in resi dential fires. Objective.-To compare characteristics of those who die and those who survive in the same residential fire. Design.-Data on fa tal residential fires were collected from the medical examiner and int erviews with local fire officials. Setting.-North Carolina. Subjects.- Persons in residential fires with at least 1 fatality in a 1-year peri od. Main Outcome Measure.-Dying vs surviving a fatal residential fire that occurred with more than 1 person at home. Results.-Of the 190 dec edents, 124 (65%) were male, 78 (41%) were home alone, and 69 (53%) of 130 adults who had blood alcohol measured were intoxicated (blood alc ohol content >22 mmol/L [100 mg/dL]). Of the 254 persons present durin g fires in which more than 1 person was at home, 112 died. Individuals more likely to die thigh-vulnerability group) were younger than 5 yea rs or 64 years or older, had a physical or cognitive disability, or we re impaired by alcohol or other drugs (risk of death for group, odds r atio [OR], 4.01; 95% confidence interval [CI], 2.29-7.03). The presenc e of an adult with no physical or cognitive disabilities who was unimp aired 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 de tector lowered the risk of death (OR, 0.39; 95% CI, 0.18-0.83). Conclu sions.-Smoke detectors were equally effective in both low-and high-vul nerability populations. The high-vulnerability group was more likely t o survive if, in addition to a smoke detector, a potential rescuer was present. Further research should seek to identify prompts that facili tate speedy egress from a burning structure and that can be incorporat ed into residential fire alarm systems.