Runyan C W, Bangdiwala S I, Linzer M A, Sacks J J, Butts J
Injury Prevention Research Center, University of North Carolina, Chapel Hill 27599.
N Engl J Med. 1992 Sep 17;327(12):859-63. doi: 10.1056/NEJM199209173271207.
Residential fires are the most important cause of fire-related mortality in the United States. Previous research has concentrated on fatal fires in urban areas; considerably less is known about fatal fires in rural areas.
We studied fatal and nonfatal residential fires in predominantly rural areas. Using a case-control design, we compared all 151 fatal fires (cases) in single-family dwellings in North Carolina during a 13-month period with a sample of nonfatal fires (controls). Case fires were identified through the medical-examiner system, and control fires that occurred within a few weeks of the case fires were chosen from the records of randomly selected fire departments statewide. For each fire, fire officials were interviewed about the dwelling, the fire, the people involved, and the fire-response system.
Although heating incidents were the leading cause of fires, fatal fires were more likely to have been caused by smoking (31 percent of fatal fires vs. 6 percent of nonfatal fires). Mobile homes posed a higher risk of death if a fire occurred (odds ratio, 1.7; 95 percent confidence interval, 1.1 to 2.6), as did the absence of a smoke detector (odds ratio, 3.4; 95 percent confidence interval, 2.1 to 5.6). Smoke detectors were more protective against death in fires involving young children and when no one present was impaired by alcohol or drugs or had a physical or mental disability. The presence of an alcohol-impaired person was the strongest independent risk factor for death in the case of a fire (odds ratio, 7.5; 95 percent confidence interval, 4.4 to 12.7).
Residential fires are most likely to be caused by heating equipment or smoking materials. The risk of death is greatest in fires in mobile homes, in those involving alcohol-impaired persons, and in those in houses without smoke detectors.
住宅火灾是美国火灾相关死亡的最重要原因。以往的研究主要集中在城市地区的致命火灾；而对农村地区致命火灾的了解则少得多。
我们研究了主要为农村地区的致命和非致命住宅火灾。采用病例对照设计，我们将北卡罗来纳州在13个月期间单户住宅中的151起致命火灾（病例）与非致命火灾样本（对照）进行了比较。病例火灾通过法医系统识别，在病例火灾发生几周内发生的对照火灾从全州随机选择的消防部门记录中选取。对于每起火灾，消防官员接受了关于住宅、火灾、相关人员和火灾应对系统的访谈。
虽然取暖事故是火灾的主要原因，但致命火灾更有可能是由吸烟引起的（31%的致命火灾与6%的非致命火灾）。如果发生火灾，移动房屋造成死亡的风险更高（优势比，1.7；95%置信区间，1.1至2.6），没有烟雾探测器的情况也是如此（优势比，3.4；95%置信区间，2.1至5.6）。烟雾探测器在涉及幼儿的火灾中以及当现场无人因酒精或药物受损或有身体或精神残疾时，对预防火灾死亡更有保护作用。在火灾情况下，有酒精受损人员在场是死亡的最强独立风险因素（优势比，7.5；95%置信区间，4.4至12.7）。
住宅火灾最有可能由取暖设备或吸烟材料引起。移动房屋火灾、涉及酒精受损人员的火灾以及没有烟雾探测器的房屋火灾中死亡风险最大。
