House fire injury prevention update. Part I. A review of risk factors for fatal and non-fatal house fire injury.

Objective: To summarize house fire injury risk factor data, using relative risk estimation as a uniform method of comparison.

Methods: Residential fire risk factor studies were identified as follows: MEDLINE (1983 to March 1997) was searched using the keywords fire*/burn*, with etiology/cause*, prevention, epidemiology, and smoke detector* or alarm*. ERIC (1966 to March 1997) and PSYCLIT (1974 to June 1997) were searched by the above keywords, as well as safety, skills, education, and training. Other sources included: references of retrieved publications, review articles, and injury prevention books; Injury Prevention journal hand search; government documents; and internet sources. When not provided by the authors, relative risk (RR), odds ratio, and standardized mortality ratios were calculated, to enhance comparison between studies.

Results: Fifteen relevant articles were retrieved, including two case-control studies. Non-modifiable risk factors included young age (RR 1.8-7.5), old age (RR 2.6-3.6), male gender (RR 1.4-2.9), non-white race (RR 1.3-15.0), low income (RR 3.4), disability (RR 2.5-6.5), and late night/early morning occurrence (RR 4.1). Modifiable risk factors included place of residence (RR 2.1-4.2), type of residence (RR 1.7-10.5), smoking (RR 1.5 to 7.7), and alcohol use (RR 0.7-7.5). Mobile homes and homes with fewer safety features, such as a smoke detector or a telephone, presented a higher risk of fatal injury.

Conclusions: Risk factor data should be used to assist in the development, targeting, and evaluation of preventive strategies. Development of a series of quantitative systematic reviews could synthesize existing data in areas such as house fire injury prevention.