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Preventing deaths and injuries from house fires: an outcome evaluation of a community-based smoke alarm installation programme
  1. Gregory R Istre1,
  2. Mary A McCoy1,
  3. Billy J Moore2,
  4. Carey Roper3,
  5. Shelli Stephens-Stidham1,
  6. Jeffrey J Barnard4,
  7. Debra K Carlin3,
  8. Martha Stowe1,5,
  9. Ron J Anderson2
  1. 1Injury Prevention Center of Greater Dallas, Dallas, Texas, USA
  2. 2Parkland Health and Hospital System, Dallas, Texas, USA
  3. 3Inspection and Life Safety Education Division, Dallas Fire Rescue Department, Dallas, Texas, USA
  4. 4The Southwestern Institute of Forensic Sciences, Office of the Medical Examiner, Dallas, Texas, USA
  5. 5Vickery Meadow Youth Development Foundation, Dallas, Texas, USA
  1. Correspondence to Dr Gregory R Istre,  Injury Prevention Center of Greater Dallas, 6300 Harry Hines Blvd., Suite 240, Dallas, TX 75235, USA; greg.istre{at}{at}


Background Few studies have examined the impact of community-based smoke alarm (SA) distribution programmes on the occurrence of house fire-related deaths and injuries (HF-D/I).

Objective To determine whether the rate of HF-D/I differed for programme houses that had a SA installed through a community-based programme called Operation Installation, versus non-programme houses in the same census tracts that had not received such a SA.

Methods Teams of volunteers and firefighters canvassed houses in 36 high-risk target census tracts in Dallas, TX, between April 2001 and April 2011, and installed lithium-powered SAs in houses where residents were present and gave permission. We then followed incidence of HF-D/I among residents of the 8134 programme houses versus the 24 346 non-programme houses.

Results After a mean of 5.2 years of follow-up, the unadjusted HF-D/I rate was 68% lower among residents of programme houses versus non-programme houses (3.1 vs 9.6 per 100 000 population, respectively; rate ratio, 0.32; 95% CI 0.10 to 0.84). Multivariate analysis including several demographic variables showed that the adjusted HF-D/I rate in programme houses was 63% lower than non-programme houses. The programme was most effective in the first 5 years after SA installation, with declining difference in rates after the 6th year, probably due to SAs becoming non-functional during that time.

Conclusions This collaborative, community-based SA installation programme was effective at preventing deaths and injuries from house fires, but the duration of effectiveness was less than 10 years.

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