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Rapid Responses: Rapid Responses published:
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Smoke alarms
- Godfrey G Hill (2 November 2002)
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Why studies on smoke alarms are important and why "feckless" is a loaded word
- Richard Smith (4 November 2002)
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Reducing fire related injuries and deaths
- Arun Patel (5 November 2002)
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Godfrey G Hill, Retired Berkhamsted HP4 1HN
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When I was a student - admittedly 50 years ago - the BMJ was a prestigious publication whose articles I read with interest and some profit. What is then one to make of six pages devoted to the hardly surprising fact that feckless families do not bother to use smoke alarms. Not only that but the Editor gives the articles headline status on the front page! The Journal is not what it used to be. Competing interests: None declared |
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Richard Smith, Editor BMJ
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Dr Hill must think whatever he thinks about the BMJ, but he makes a bad mistake with his implication that studies of the effectiveness of smoke alarms are somehow worthless. Medicine, Dr Hill would agree, is about the treatment and prevention of sickness and injury. House fires kill 500 people a year in England and Wales and injure another 15 000. The figure for the whole world will thus be tens of thousands killed and hundreds of thousands injured. It thus makes sense to study what can be done to reduce this enormous amount of pain and suffering. The New England Journal of Medicine, the general medical journal with the highest impact factor (a rough measure of scientific importance), published a controlled before and after study showing that the installation of smoke alarms in one area at high risk reduced admissions to hospital and deaths by 80%. This thus seemed to be a highly effective intervention--more effective, Dr Hill will agree, than many of the interventions that doctors have to offer. Authorities around the world might thus have started offering free smoke alarms to people in deprived areas. But this would not have been sensible after the results of just one study, particularly as the study was not a randomised trial and was undertaken in one particular set of circumstances. The authors of the studies that Dr Hill dismisses thus conducted a rigorous evaluation of whether the intervention would work. It didn't. So now new questions arise. Dr Hill rather gives away his view of the world with the use of the word "feckless." I suggest that he tries living for a few months on a very low income in one unheated room with several children in a rough and dangerous area of London. He might discover that "feckless" is a highly loaded word. Richard Smith, editor, BMJ Competing interests: I am the editor of the BMJ, which Dr Hill disdains. |
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Arun Patel, Specialist Regsitrar in PHM Newark PCT.
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The study makes an important contribution towards this very crucial Public Health concern. We learn that most accident prevention strategies work by three Es – education, enforcement & engineering. The study highlights that ‘any thing short of the three Es is less likely to succeed’. Provision of fire alarm with leaflets covers education and engineering aspect. What about “enforcement”? Perhaps your suggestions of compulsory water sprinklers (in council housing and elderly residential places), may go long way to resolve the issue. Competing interests: None declared |
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