Smoke alarms and residential fire mortality in the United States: an ecologic study

Abstract

Death and injury from residential fires remains a major public health challenge in the United States and operable smoke alarms on each level of a home have been estimated to reduce the risk of death and injuries from residential fires. A multiple-group analytic ecologic study was undertaken with ecologic data at both the group- and individual-level for each state of the United States. The age standardized mortality rates for residential fire in the US was 1.61 per 100,000, with the highest fire-mortality rates occurring in the southeastern states of the US. An estimated 93.6% of US households have a smoke alarm. The findings of the analysis highlight that smoke alarms, when represented at an ecologic-level, have a significant, negative, association with residential fire mortality ( eRR=0.92, 95% CI=0.85–0.99). The finding of a negative ecologic association between smoke alarms and residential fire mortality reflects findings reported in studies using individual-level data, namely, that operable smoke alarms provided adequate warning and protection against death in residential fires. The ecologic association identified in this study is not strong and this may be due, in part, to the fact the prevalence rates for smoke alarms used in the study do not reflect the functional status of the alarms.