Preventing Home Fires During the Holidays

In the coldest parts of the country, only thoughts of the winter holidays can bring warmth to this time of year. We look at blowing snow and frozen lakes and think about a building a cozy fire, fixing a hot drink and snuggling under enormous quilts until the bitter temperatures slowly begin to rise (here in Wisconsin, usually around June). Because of the dropping degrees, the holiday season brings an increased risk of fire: the majority of home fires take place during December, January and February. Cooking and smoking remain the two leading causes of residential fires, but holiday trees and other decorations, alcohol consumption, portable heaters, fireplaces and stoves also play a role.

Fires and burns are responsible for at least 5,000 deaths and 1.4 million injuries each year in the United States – the fourth leading cause of unintentional injury deaths in the country. The overwhelming majority of these deaths (73%) occur in private homes. It takes only two minutes for a house fire to get out of control and kill, so it’s worth taking some extra precautions during the holidays to avoid this worst-case scenario.

Alcohol
Alcohol contributes to about 40% of residential fire deaths, approximately 85% of which occur in single-family homes and duplexes. Alcohol consumption is a ritual part of many American holiday celebrations, but should be enjoyed at the appropriate time and place. Overconsumption – or consumption during activities with an inherent fire risk – can cloud judgment and reflexes and lead to injuries or property destruction. Be moderate when consuming alcohol this season, especially in situations such as cooking and decorating where potential fire hazards exist.

Cooking
Although careless smoking is the leading cause of US fire deaths, cooking is actually the leading cause of home fires and home fire injuries. According to the Federal Emergency Management Agency’s United States Fire Administration, most residential fires start in the kitchen. It’s easy to see why, especially during the holidays: family and visitors create a flurry of activity; an assortment of food is usually being prepared at once; and disruption of daily routines leads to multiple distractions for the cook. Try to prepare as many foods as you can in advance of the big day and keep same-day preparation to a minimum. You’ll have more time to enjoy yourself, relax and visit with guests. When cooking, never leave food on the stove or in an oven unattended, and avoid wearing clothes with long, loose-fitting sleeves that can catch fire.

Decorating
Whether installing holiday lights outdoors or in, creating a display of gleaming candles or keeping your living space warm, there are a few rules that you should follow during the holidays and every day:

• Do not use damaged or frayed electrical cords, extension cords or lights – check each one before even thinking about using it.
• Never leave burning candles unattended. Kids, pets, an errant gust of wind – any of these could turn a gentle glow into an inferno under the right circumstances.
• Keep matches and lighters away from children or anywhere they can reach.
• Safely store flammable substances used around the home before guests arrive.

Fire Facts and Prevention
The top location for fires in US homes is the kitchen, and the second most common location for residential fires is the bedroom. Be especially cautious when using open flames, smoking materials or heaters in these areas. The US Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control offers these additional facts and recommendations:

• Careless smoking is the leading cause of US fire deaths. Do not smoke in bed or empty smoldering ashes into trash cans; never leave burning cigarettes unattended; and keep ashtrays away from upholstered furniture and curtains.
• Heating devices are the second leading cause of residential fires and fire deaths. Use heating sources such as portable space heaters carefully, and only according to the manufacturer’s directions. Do not use extension cords with heating or air conditioning equipment.
• Chimneys, fireplaces, heating stoves and heating vents should be checked at least yearly to ensure that they remain unobstructed and safe. Make sure draperies, upholstery and other flammable materials are kept well away from any open sources of heat or flame.
• Children under the age of five, adults over 65, people in lower income groups and those living in manufactured homes (such as trailers) built before 1976 are at the greatest risk of dying from a fire. Everyone should create a fire escape plan and practice it every six months. Families and roommates should come up with at least two different ways to get out of every room and designate a safe place in front of the house to meet after exiting from a fire.
• If a fire does occur, do not stop to get dressed or gather valuables. Seconds count. Once you're out, do not re-enter under any circumstances.
• Install smoke alarms on every floor of the home (including the basement) and outside each sleeping area.

Smoke Detectors
Death from fire is two to three times more likely in a home that doesn't have a working smoke detector, according to the US Preventive Services Task Force. The National Institutes of Health Public Safety News reported that almost 93% of US homes had at least one smoke detector, and that nearly 50% of all home fires and 60% of home fire deaths occurred in the 7% of homes with no smoke detectors.

Smoke detectors should be approved by an independent testing laboratory such as Underwriters Laboratories or Factory Mutual. The National Fire Protection Association recommends replacing the entire smoke detector every 10 years. The NFPA suggests mounting smoke alarms on the wall 4-12 inches from the ceiling. Ceiling-mounted fire alarms should be four inches from the nearest wall or at the highest point of the ceiling.

About 25% of residential smoke detectors do not work because the batteries have been removed or expired. If regular batteries are used, change them every year or when the alarm chirps to warn that the battery is expiring. Lithium-powered batteries, although more expensive in the short term, can last up to 10 years. Most alarms have a “hush button” so nuisance alarms caused by steam, etc. can be quickly silenced. Some smoke detectors are “hard-wired” into the home’s electrical system. They don’t require batteries, but they don’t work during power outages. There are no significant fire protection advantages between the two types of alarms; but do remember to test each one every month.

Medical College of Wisconsin Research
In a study of fatal childhood injuries in Milwaukee County in 1989-90, Medical College of Wisconsin researchers led by Stephen W. Hargarten, MD, MPH, Chairman and Professor of Emergency Medicine and Director of the Medical College's Wisconsin Injury Research Center, found that house fires were the leading cause of death by injury (38%) for children 15 years of age and younger. Nearly 75% of victims were either dead at the scene or pronounced dead at the emergency room.

In Milwaukee County, the average annual death rate for children ages 0-14 from fires was 5.6 per 100,000 - 2½ times the 1989 national rate of 2.2. This may be due in part to the county's urban setting, which includes many low-income families, as well as Wisconsin's lengthy heating season, when most fires occur. Another study found that people with no access to primary healthcare, which may include low-income families, have higher rates of "injury-prone behaviors," including the lack of a working smoke detector in their home.

In their article appearing in Academic Emergency Medicine (Vol. 8, No. 9), Dr. Hargarten and Leslie A. Maas Cortes, MHS, Assistant Director of the Injury Research Center, cited a study in which 92% of participants who received free smoke detectors from a clinic installed them; 88% of the smoke detectors were working four to nine months later. As a way to prevent death and injuries from fires, some physicians now counsel patients about installing smoke detectors, and clinics or community groups in certain areas distribute smoke detectors for free or at a reduced cost.

Eileen Early, RN, BSN
HealthLink Editor
Office of Clinical Informatics
Medical College of Wisconsin

This article includes information from:
Medical College of Wisconsin Injury Research Center
US Fire Administration (Federal Emergency Management Agency)
National Center for Injury Prevention and Control (US Centers for Disease Control and Prevention).

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.