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Smoke alarms, fire deaths, and randomised controlled trials
  1. Ian Roberts, Director,
  2. Carolyn Diguiseppi, Senior Research Fellow
  1. Child Health Monitoring Unit, Department of Epidemiology and Public Health, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK (e-mail:

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    Each year about 300 000 people die in fires.1 Most of these deaths occur in the home and children and the elderly are at greatest risk.1 The absence of a smoke alarm is a strong risk factor for death in the event of a house fire.2 In some countries, there has been a substantial increase in the proportion of households with smoke alarms over the past two decades. In England and Wales, the proportion of homes with alarms increased from 0% in 1985 to 75% in 1995. This increase in alarms coincided with a substantial fall in fire deaths, although a number of factors apart from smoke alarms might have been responsible for the decline.3 Despite the overall increase in smoke alarm use, ownership is substantially lower (less than 50%) in disadvantaged inner city neighbourhoods and among families living in rented accommodation.4 Because the risk of fire and fire related injury is greater in rented and inner city accommodation,5, 6 increasing the prevalence of functioning smoke alarms in these homes may have a disproportionate effect on the occurrence of fire deaths and injuries. This would also have the potential to reduce socioeconomic differentials in …

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