In the United States, 271 children (0-17) died from fires or burns in 2012 (29 of these deaths were homicide). Over half of the children who died were ages 0-4, and over half again of those were boys. Small children are less likely to recognize the dangers of playing with fire, more likely to hide once a fire breaks out, and less likely to have been taught home fire escape.
Poverty increases this risk, in part because lower income families are more likely to live in older, wood frame housing; less likely to have working smoke alarms; less likely to have a family escape plan and to practice it; more likely to use less safe alternative heating sources; more likely to have malfunctioning wiring or appliances, and more likely to have barriers to escape or rescue. The latter includes having children’s bedrooms in basements with small or no access windows, security bars on windows and back doors or windows nailed shut for security or warmth.
Cooking fires are the leading cause of home fires and injuries, followed by appliance/electrical fires and cigarette-caused fires. Most residential fires occur during winter, and alcohol use is a frequent contributing factor.
A significant portion of the fires that result in child fatalities are started by children in the home playing with incendiary devices such as matches and lighters. Between 2005-2009, 83% of child-playing structure fires in homes were started by boys; 44% of them were started by a child between the ages of 4 and 6.
Statistically, the number of outside child-play fires peaks during the afternoon hours from 3-6 pm; nearly one-quarter of these are started during July (most around July 4). Fireworks are the heat source in 33% of non-trash outside or unclassified fires caused by children playing; lighters the source in 25%, and matches the source in 21%. Ninety-three percent of child-playing-outside or unclassified fires are started by boys.
The single most important factor in reducing child fire fatalities is the presence in the home of a working smoke alarms. Almost two-thirds of home fire deaths from 2005-2009 occurred in homes that lacked working smoke alarms. Although 94-97% of households say they have at least one smoke alarm, the detectors may not contain good batteries or be in working order. The National Fire Protection Association (NFPA) recommends monthly testing, yearly battery replacement and replacing entire alarms after 10 years. Detectors with lithium batteries that last 10 years, hard-wired smoke alarm systems and residential sprinklers can dramatically reduce the risk of dying in a fire.
Learning the basics of home fire escape is another proven way to reduce fire fatality risk. Research shows that children, including preschoolers, are capable of learning life-saving means of home fire escape. Risk Watch is NFPA’s successful child injury prevention local school curriculum. A large part of this curriculum deals with fire safety, including age-appropriate lessons on home fire escape for pre-school children through age eight.
Major Risk Factors
- No working smoke alarm
- Alcohol use by supervisor
- Child’s access to lighters, matches, fireworks or other incendiary devices.
- Tap water too hot
- Children under age five
- Black and American Indian males
- Children from low income families
- Quality of supervision at time of fire or burn
- Members of household falling asleep while smoking or leaving candles burning
- No fire safety education or fire escape plan
- Use of alternative heating sources, substandard appliances or outdated wiring
- Residence not up to code
- Timeliness of fire rescue response
Records Needed for Case Review
- Autopsy reports
- Scene investigation reports and photos
- Fire marshal reports that include source of fire and presence of detectors
- EMS run reports
- Emergency Department reports
- Information on zoning or code inspections and violations
- Prior CPS history on child, caregivers and persons supervising child at time of death
- Names, ages and genders of other children in home
- Criminal background checks on persons supervising child at time of death
- Reports of home visits from public health or other services
- Any information on prior deaths of children in family
- Working smoke alarms
- Smoke detector distribution programs targeted in low-income neighborhoods, with non-removable, lithium batteries
- Existence and enforcement of codes requiring hard-wired detectors in new housing stock and requiring installation of detectors in existing housing, especially when combined with multifaceted community education and distribution programs
- Risk Watch or similar programs in schools, preschools and daycare settings to teach children fire safety and home fire escape
- Hot water heaters with maximum temperature of 120 degrees
- Less porous cigarette paper