title: Fatal residential fires: who dies and who survives?
abstract: BACKGROUND
  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.
  
  
  METHODS
  Data on fatal residential fires were collected from the medical examiner and interviews with local fire officials.
  
  
  METHODS
  North Carolina.
  
  
  METHODS
  Persons in residential fires with at least 1 fatality in a 1-year period.
  
  
  METHODS
  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.
authors.affiliation: Injury Prevention Research Center, Department of Epidemiology, University of North Carolina, Chapel Hill 27599-7505, USA. smarshall@unc.edu
authors.forename: S W
authors.initials: SW
authors.lastname: Marshall
authors.forename: C W
authors.initials: CW
authors.lastname: Runyan
authors.forename: S I
authors.initials: SI
authors.lastname: Bangdiwala
authors.forename: M A
authors.initials: MA
authors.lastname: Linzer
authors.forename: J J
authors.initials: JJ
authors.lastname: Sacks
authors.forename: J D
authors.initials: JD
authors.lastname: Butts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005390:Fires / Q000706:statistics & numerical data*; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009026:Mortality; D012306:Risk; D013534:Survival; D014481:United States / Q000453:epidemiology