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Incidence of fires and related injuries after giving out free smoke alarms: cluster randomised controlled trial

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7371.995 (Published 02 November 2002) Cite this as: BMJ 2002;325:995
  1. Carolyn DiGuiseppi, associate professor (Carolyn.DiGuiseppi{at}uchsc.edu)a,
  2. Ian Roberts, professorb,
  3. Angie Wade, senior lecturerc,
  4. Mark Sculpher, professord,
  5. Phil Edwards, research fellowb,
  6. Catherine Godward, research fellowc,
  7. Huiqi Pan, research fellowc,
  8. Suzanne Slater, public health project officere
  1. a Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Campus Box B-119, Denver, CO 80262, USA
  2. b London School of Hygiene and Tropical Medicine, London WC1B 3DP
  3. c Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College London, London WC1N 1EH,d Centre for Health Economics, University of York, York YO1 5DD,e Department of Public Health, Camden and Islington Health Authority, London NW1 1LJ
  4. d Centre for Health Economics, University of York, York YO1 5DD
  5. e Department of Public Health, Camden and Islington Health Authority, London NW1 1LJ
  1. Correspondence to: C DiGuiseppi
  • Accepted 15 April 2002

Abstract

Objective: To measure the effect of giving out free smoke alarms on rates of fires and rates of fire related injury in a deprived multiethnic urban population.

Design:Cluster randomised controlled trial.

Setting: Forty electoral wards in two boroughs of inner London, United Kingdom.

Participants: Primarily households including elderly people or children and households that are in housing rented from the borough council.

Intervention: 20 050 smoke alarms, fittings, and educational brochures distributed free and installed on request.

Main outcome measures: Rates of fires and related injuries during two years after the distribution; alarm ownership, installation, andfunction.

Results: Giving out free smoke alarms did not reduce injuries related to fire (rate ratio 1.3; 95% confidence interval 0.9 to 1.9), admissions to hospital and deaths (1.3; 0.7 to 2.3), or fires attended by the fire brigade (1.1; 0.96 to 1.3). Similar proportions of intervention and control households had installed alarms (36/119 (30%) v 35/109 (32%); odds ratio 0.9; 95% confidence interval 0.5 to 1.7) and working alarms (19/118 (16%) v 18/108 (17%); 0.9; 0.4 to 1.8).

Conclusions: Giving out free smoke alarms in a deprived, multiethnic, urban community did not reduce injuries related to fire, mostly because few alarms had been installed or were maintained.

What is already known on this topic

What is already known on this topic In the United Kingdom, residential fires caused 466 deaths and 14 600 non-fatal injuries in 1999

The risk of death from fire is associated with socioeconomic class

One study reported an 80% decline in hospitalisations and deaths from residential fires after free smoke alarms were distributed in an area at high risk, but these results may not apply in other settings, and evidence from randomised controlled trials is lacking

What this study adds

What this study adds Giving out free smoke alarms in a multiethnic poor urban population did not reduce injuries related to fire or fires

Giving smoke alarms away may be a waste of resources and of little benefit unless alarm installation and maintenance is assured

Footnotes

  • Funding Medical Research Council, with additional funding from the Home Office (Fire Research and Development Group and National Community Fire Safety Centre), Department of Health (Health Promotion Division), Camden and Islington Councils, the British Medical Association, and the Camden and Islington Health Authority.

  • Competing interests None declared.

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