The U.S. has one of the highest fire death rates in the industrialized world.  In the year 2002, a fire death occurred every three hours. Fires and burns are the leading cause of unintentional injury-related death for children aged 1-4 years and it is the second leading cause of death for children aged 5-9 years. Over 80% of these fire deaths occur in residences, and most residential fires occur in older, wood-frame housing.

Poor children are at especially high risk of fire death.  They often live in older, substandard housing; their homes often lack working smoke alarms and their families are more likely to use alternative heating sources. Furthermore, economic constraints can limit adequate adult supervision (i.e., children cooking meals while their parents work).

Although most residential fires originate in the cooking area of a home, the majority that result in child fatalities start in either the family room area or sleeping area. Hazards related to cigarettes and smoking is the primary cause of fire-related deaths. Common sources of ignition in all fatal fires include cooking and heating implements, cigarette smoking materials, candles and faulty wiring.

Children playing with fire-starting materials cause a significant number of the fires in which children die.  Matches and lighters are the first and second most common ignition sources in fires started by children, and over half of these fires originate in sleeping areas.  Young children often play with matches or lighters while in their bedrooms to conceal their activities, and then they hide in closets or elsewhere when the fire breaks out.  As a result, others in the home or rescue personnel cannot locate them in time to save them.

Candle-related fires increased by 20% between  1998 and 1999, hitting a 20 year peak.  The rate of these types of fires has only gone up since this peak. The leading cause of candle-related fires is children playing with or near a burning candle.

There have been recent findings of fire deaths caused by highly flammable and toxic polyurethane foam materials used in upholstered furniture.  This foam can ignite very readily and create very high heat and extremely toxic fumes.  The CPSC is studying recommendations by the National Association of State Fire Marshals to require that warning labels be placed on furniture made of this foam.

Smoke and fire detectors and sprinkler systems are the most effective means with which to prevent fire deaths.  One important case-control study found that a working smoke detector decreased the risk of a fire fatality in 71% of house fires.  National data show that nearly three out of every five residential fire deaths occurred in the small number of homes in the U.S. (only seven percent) that had no smoke alarms present.  Although 93% of the homes in the U.S. had at least onesmoke alarm, only 74% of all homes had at least one working smoke alarm.  Because this study excluded households without telephones, the prevalence of smoke alarms is probably overestimated.

The chances of dying in a residential fire are cut by an estimated 62% when automatic sprinkler systems are present.  Smoke alarms and sprinkler systems combined could reduce fire-related deaths by 82%.  New technologies that improve fire alarms are expected to increase the prevalence of working fire alarm systems in homes.  These include ten-year, non-removable batteries in smoke detectors, sprinkler systems and smoke detectors that are hard-wired into new homes.

In Michigan, MDCH is completing the first year of a three-year smoke alarm distribution project.  They have distributed and installed more than 2,000 lithium battery-powered smoke detectors in high-risk homes, in four targeted Michigan communities.

The City of Grand Rapids passed an ordinance in 1999 requiring that all homes, including pre-existing residences, install hard-wire smoke detection systems by the end of 2000.  Child death review team findings from a large number of residential fires in 1995-1999 were key in the effort to pass this ordinance.

Fire escape preparedness is an important prevention strategy, yet a national survey about fire safety behaviors found that only 53% of Americans have a family escape plan and of those, only 16% have practiced it.  Further, those with household incomes of at least $45,000 a year are more likely than those with lower incomes to have an escape plan and to have practiced it.  The survey also found that everyone, including preschoolers, could be taught the basics of home fire escape.

Many fires result in multiple deaths. Alcohol use by adults is a high risk factor in these deaths. An impaired person is not able to respond quickly in alerting and/or in helping others to safety.  Alcohol also can play a part in the negligence that results in a fire being started.