title: Economic evaluation of smoke alarm distribution methods in Baltimore, Maryland.
abstract: OBJECTIVE
  This paper analyses costs and potential lives saved from a door-to-door smoke alarm distribution programme using data from a programme run by the Baltimore City Fire Department in 2010-2011.
  
  
  METHODS
  We evaluate the impact of a standard home visit programme and an enhanced home visit programme that includes having community health workers provide advance notice, promote the programme, and accompany fire department personnel on the day of the home visit, compared with each other and with an option of not having a home visit programme (control).
  
  
  RESULTS
  Study data show that the home visit programme increased by 10% the number of homes that went from having no working alarm to having any working alarm, and the enhanced programme added an additional 1% to the number of homes protected. We use published reports on the relative risk of death in homes with and without a working smoke alarm to show that the standard programme would save an additional 0.24 lives per 10,000 homes over 10 years, compared with control areas and the enhanced home visit programme saved an additional 0.07 lives compared with the standard programme. The incremental cost of each life saved for the standard programme compared with control was $28,252 per death averted and $284,501per additional death averted for the enhanced compared with the standard.
  
  
  CONCLUSIONS
  Following the US guidelines for the value of a life, both programmes are cost effective, however, the standard programme may offer a better value in terms of dollars per death averted. The study also highlights the need for better data on the benefits of current smoke alarm recommendations and their impact on injury, death and property damage.
authors.affiliation: Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Nadia
authors.initials: N
authors.lastname: Diamond-Smith
authors.affiliation: Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: David
authors.identifier: http://orcid.org/0000-0003-0714-9062
authors.initials: D
authors.lastname: Bishai
authors.affiliation: Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Elise
authors.initials: E
authors.lastname: Perry
authors.affiliation: Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Shields
authors.affiliation: Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gielen
mesh_terms: D002056:Burns / Q000401:mortality; D003362:Cost-Benefit Analysis; D061388:Firefighters; D005390:Fires / Q000517:prevention & control* / Q000706:statistics & numerical data; D006798:Housing; D006801:Humans; D008396:Maryland; D011314:Preventive Health Services / Q000191:economics / Q000458:organization & administration; D011482:Protective Devices / Q000191:economics* / Q000600:supply & distribution; D012449:Safety / Q000191:economics*; D015208:Smoke Inhalation Injury / Q000401:mortality