Examining fire department injury data as a tool for epidemiological investigation.

Residential fires, while constituting a small fraction of fire incidents, are responsible for the majority of civilian fire-related injuries. This study investigates census tract neighborhood socioeconomic factors as correlates of civilian injuries occurring during residential fires in Baltimore, Maryland, between 2004 and 2007. Civilian residential fire related injuries were geocoded and linked to the American Community Survey 2005-2009 data. Negative binomial regression was used to analyze the relationship between fire-injury rates and neighborhood socioeconomic indicators including household income and percentages of households below the poverty line, persons aged 25 years or older with at least a bachelor's degree, homes built in 1939 or earlier, vacant properties, and owner-occupied homes. Between January 2004 and July 2007, there were 482 civilian fire-related injuries that occurred during 309 fires. At the census tract level, a 10% increase in the number of vacant homes was associated with an increase in injury rates by a factor of 1.28 (95% confidence interval 1.05-1.55). A 10% increase in persons aged more than 25 years with at least a bachelor's degree was associated with a decrease in injury rates by a factor of 0.86 (95% confidence interval 0.77-0.96). Neighborhood measures of education and housing age proved good indicators for identifying areas with a higher burden of fire-related injuries. Such analyses can be useful for fire department planning.

Enhancing fire department home visiting programs: results of a community intervention trial.

This study evaluates the impact of an enhanced fire department home visiting program on community participation and installation of smoke alarms, and describes the rate of fire and burn hazards observed in homes. Communities were randomly assigned to receive either a standard or enhanced home visiting program. Before implementing the program, 603 household surveys were completed to determine comparability between the communities. During a 1-year intervention period, 171 home visits took place with 8080 homes. At baseline, 60% of homes did not have working smoke alarms on every level, 44% had unsafe water temperatures, and 72% did not have carbon monoxide alarms. Residents in the enhanced community relative to those in the standard community were significantly more likely to let the fire fighters into their homes (75 vs 62%). Among entered homes, those in the enhanced community were significantly more likely to agree to have smoke alarms installed (95 vs 92%), to be left with a working smoke alarm on every level of the home (84 vs 78%), and to have more smoke alarms installed per home visited (1.89 vs 1.74). The high baseline rates of home hazards suggest that fire department home visiting programs should take an "all hazards" approach. Community health workers and community partnerships can be effective in promoting fire departments' fire and life safety goals. Public health academic centers should partner with the fire service to help generate evidence on program effectiveness that can inform decision making about resource allocation for prevention.