OBJECTIVES: To analyse all child deaths in house fires in Scotland between 1980 and 1990. METHODS: Retrospective study of all child house fire fatalities based on the 'sudden death' investigation instigated by the procurator fiscal in whose jurisdiction the death occurred. The necropsy, toxicology, police, and fire brigade reports were examined in each case. RESULTS: There were 168 child deaths occurring in 118 house fires. In the 0-5 years age group 40% of deaths occurred in fires started as a direct result of the actions of children. The careless disposal of smoking materials was the most frequent cause of fatal fires killing older children. Upholstery and bedding were common materials of first ignition, accounting for over half the incidents. The majority of children were dead before the arrival of the emergency services and most died as a result of the inhalation of smoke. CONCLUSIONS: This survey emphasises the importance of 'self escape' which, particularly in the case of young children, requires the assistance of adult carers. The number of fires started as a result of children playing with sources of ignition raises important questions of supervision and the provision of a safe environment. There is, we contend, a need to highlight the importance of individual behaviour and responsibility while recognising the need to develop measures that are relevant to, and effective in, a particular socioeconomic context.
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