Predictors of Mortality From Fires in Young Children

Abstract

ABSTRACT. Background. In the United States in 1994, fires claimed 3.75 lives per 100 000 child years and accounted for 17.3% of all injury deaths in children <5 years of age.Objectives. To conduct a historical cohort study that uses maternal demographic characteristics to identify young children at high risk of fire-related deaths, thus defining appropriate targets for prevention programs.Methods. The cohort consisted of children born to mothers who resided in the state of Tennessee between 1980 and 1995. Information was obtained by linking birth certificates, 1990 census data, and death certificates. Children were eligible for the study if they were <5 years of age at any time within the study period and if key study variables were present (99.2% of births).Birth certificates provided information on maternal characteristics including age, race, education, previous live births, use of prenatal care, and residence (in standard metropolitan statistical area). Child characteristics included gender, gestational age, and birth type (singleton/multiple gestation). Neighborhood income was estimated by linking the mother's address at the time of birth to the 1990 census (block group mean per capita income).The study outcome was a fire resulting in at least one fatality (fatal fire event) during the study period, identified from death certificates (coded E880 through E889 in the International Classification of Diseases, 9th rev). We calculated the fatal fire event rate corresponding to each stratum of maternal/child characteristics. We assessed the independent association between each characteristic and the risk of a fatal fire event from a Poisson regression multivariate analysis.Results. During the study period, 1 428 694 children contributed 5 415 213 child years to the cohort: there were 270 deaths from fire (4.99 deaths per 100 000 child years) and 231 fatal fire events. In the multivariate analysis, factors associated with greater than a threefold increase in fatal fire events included maternal education, age, and number of other children. Compared with children whose mothers had a college education, children whose mothers had less than a high school education had 19.4 times (95% confidence interval [CI], 2.6 -142.4) an increased risk of a fatal fire event. Children whose mothers had more than two other children had 6.1 times (95% CI, 3.8 -9.8) an increased risk of a fatal fire event compared with children whose mothers had no other children. Children of mothers <20 years of age had 3.9 times (95% CI, 2.2-7.1) increased risk of a fatal fire event compared with children whose mothers were >30 years old. Although both maternal neighborhood income and race were associated strongly with increased rates of fatal fire events in the univariate analysis, this association did not persist in the multivariate analysis. Other factors that were associated with increased risk of fatal fire events in the multivariate analysis were male gender and having a mother who was unmarried or who had delayed prenatal care.The three factors...

Fire fatalities among children: an analysis across Philadelphia's census tracts

“…38 A second problem is that, in the case of a fire, there is only one parent to rescue children, as has been pointed out in other studies. 3,37 The logistic regression technique can be useful, not only from a theoretical perspective, but in indicating to fire departments which are the areas of greatest risk and in which neighborhoods preventative measures are likely to be needed, such as distributing smoke detectors and educating families about escape measures in the event of a fire. In Philadelphia, six census tracts fall into the highest quartile for the three significant dichotomous independent variables, and therefore are at greatest risk (tracts 137, 161, 167, 169, 177 and 195).…”

“…33, 37 Hussey 38 found that a low level of education of the head of the household was associated with increased unintentional injury mortality, including fire mortality, in children and young adults. 38 Al- though the relationship between education and fire deaths is not well understood, it is likely that loweducation parents living in hazardous living conditions are less knowledgeable about injury prevention.…”

“…37,40 It has been found that children living with a single parent, on the average, have less supervison and fewer resources. 38 In addition, in the event of a fire, there may be fewer adults present to rescue children.…”

“…Research has found that high-vulnerability groups such as the elderly or the very young are most likely to survive a fire if a potential rescuer is present 3 or if the number of children in a family is small. 37 Therefore, we speculated that the higher the proportion of children to adults in the census tract, the fewer the potential rescuers in the case of fire.…”

Neighborhood and Community

“…In addition, demographic characteristics such as maternal education and age and number of other children in the household may influence the risk of childhood fire mortality (Scholer et al, 1998).…”