Professional Documents
Culture Documents
WORKING
SMOKE
ALARMS
SAVE LIVES
Morally Correct ?
AT TA C H M E N T S
CONTENTS
Description
Page
Cover Page
Attachments
1. First Alert BRK | Photoelectric-Specific Legislation
3-4
5-6
7 - 10
11 - 17
SUMMARY
25 August 2016
Th World Fire Safety Foundation (WFSF) report, Is the Slogan Working Smoke
Alarms Save Lives Morally Correct? is at:
www.Scribd.com/doc/322111021
This report challenges the decades old fire industry slogan: 'Working Smoke Alarms
Save Lives'.
The following pages cotain the four attachments to the above report that were
contained in the original email sent from Boston Fire Chief Jay Fleming
(see page 6 of the master report at: www.Scribd.com/doc/322111021).
To:
Photoelectric-Specific Legislation
The Vermont State Legislature recently approved Senate Bill 226 requiring
photoelectric-type smoke alarms to be installed in new and existing single-family homes.
This bill was signed by Governor Jim Douglas on Thursday May 29, 2008 for passage into
law. Massachusetts already abides by a state law that mandates the usage of photoelectric
smoke alarms near specified rooms. Similar legislation is pending in Tennessee House Bill
2528 and Senate Bill 2600. Smoke sensing technology type policy discussions are also being
discussed in Indiana, Iowa, Ohio, Utah, and California.
Clearly there is a growing consensus within state legislatures as well as the fire
service community that favors photoelectric technology. First Alert has played a crucial
role in a tremendous industry effort to inform consumers on the importance of the home
safety technologies; and more specifically the differences between smoke sensing
technologies. In light of recent studies and ongoing industry-performed field research
regarding the comparison of photoelectric and ionization smoke alarms, First Alert is
offering the following two scientifically substantiated determinations:
1. Field research indicates photoelectric smoke alarms exhibit significantly
fewer nuisance alarms than ionization smoke alarms.1 2
2. To silence a triggered smoke alarm, about 22% of consumers will remove
the battery, leaving the alarm inoperable and potentially putting the
residence and its occupants at risk should a true fire occur. 3
Considering photoelectric smoke alarms are determined by industry experts to be
significantly less prone to nuisance alarm and potential disabling of the batteries by
consumers, we support and encourage fire service administration and lawmakers that are
moving toward the use of photoelectric smoke sensing technology. In addition, First Alert
aims to reassure all public safety advocates that ours is an organization that actively
supports our consumers amidst this safety-related legislation through our comprehensive
1
Cleary, Thomas. Residential Smoke Alarm Performance. Building and Fire Research Laboratory, National
Institute of Standards and Technology. UL Smoke and Fire Dynamics Seminar. November, 2007.
2
Mueller, B.A. Randomized controlled trial of ionization and photoelectric smoke alarm functionality.
Injury Prevention BMJ, 2008; 14;80-86.
3
1997 Fire Awareness/Escape Planning Study for National Fire Protection Association, Quincy, MA,
August 1997, Tables 3 & 4.
photoelectric product line. For your reference, our Battery Operated Photoelectric
Products include:
In addition, our Hardwired Photoelectric Product Line will support all new construction
and replacement needs:
Few entities exist that dedicate more time and resources towards safety-related public
policy and education as effectively as the fire service. Please use this information in your
safety education efforts. You are encouraged to contact our External Communications
department with any questions or concerns. Let us be a resource for your efforts in public
safety education. For more information please contact Tom Russo of Public Relations at
(630) 499-3214.
"i'
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interconnected.
However, since the new regulations
been in place, BRK has witnes
considerabieconfusion over the installat
andapplicationof230V
Our experience shows that architects, local
gou..tt^.nt
specifiers and electrical
lngineers all display a distinct lack of
understanding over how the different ryPes
work, when this understanding should be a
moior influence over the choice of smoke
alarm specified. It can also mean the
differenie between life and death should a
smoke alarm perform incorrecdy, becauseit
has been specified and installed incorrectly.
Theopticalsmokealarm
soundercircuit.
is lesslikely to reactto the results
cooking and this makes it far more suitable
r installation near kitchens or in confined
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Domesticsmokealarms
- a guidefor sPecifiers
N THE surface, current building
regularions governing the installation
ofdomestic smoke darms seemfairly
srraightforward. The basic requirement is
that all homes completed after June 1992
slrould haveat leastone mains-powered smoke
alarm installed on each floor. If more than
one alarm is fitted then each has to be
to remember that
be sited at least 3m
and external doors.
fitted near hot air
The idealprocedure
is :
E At firct fix, contracr,
cabletothepointwhr
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There has also been
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:":l':'iT,'iro,:,:'li:'J,t"
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prior to handthesubsequentdusryactivides
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, TechnicalSdles
'$Tiring
in
Smokc alarms should bc rcsrcd oncc each week - usually rhis is done
by prcssing thc tcst button
Battery back-up
To appeasethe concern shown
over mains fulure, BRK also
supplies230VAC smokedarms
with DC back-up which
sustainsthe smoke darm for uo
to two yeifs in the event of a
power failure.. Concern over
mains failure is obviouslyshared
by many specifiers as 85olo of
hard-wired smoke alarm sales
are for DC back-up rypes.
Original Research
ABSTRACT Objective To compare rates of nuisance alarms and disconnection between ionization and
photoelectric smoke alarms. Design A prospective cohort study. Setting Four Inupiat Eskimo villages in
the Northwest Arctic Borough region of Alaska, 48 km (30 mi) above the Arctic Circle. Subjects Households in 4 communities with similar populations, number of homes, mean income, size of household, and
square footage per home. Intervention Two villages had photoelectric alarms installed (58 homes), and 2
other villages had ionization alarms installed (65 homes) in standard locations. Follow-up household surveys
were conducted after 6 months to determine rates of false alarms and detector disconnection. All of the
households that could be contacted 104/123 agreed to participate in the follow-up surveys. Main outcome
measures The proportion of households experiencing false alarms and the proportion of disabled alarms in
households in each of the test communities. Results Homes with ionization alarms had more than 8 times
the rate of false alarms as those with photoelectric alarms. Eleven of the ionization alarms (19%) were
disconnected compared with 2 of the photoelectric devices (4%). Conclusions In small rural residences,
photoelectric smoke alarms have lower rates of false alarms and disconnection. Photoelectric alarms may be the
preferred choice for dwellings with limited living space or frequent false alarms.
Between the years 1986 and 1995, an annual average of
5,000 people lost their lives and another 28,000 were
injured in US fires.1(p2) The problem for Native Americans is even worse, with a fire fatality rate that is 3.6 times
higher than the national rate of 1.28 per 100,000 people.2
Alaska has the highest fire fatality rate among states in the
United States.3 The fire fatality rate for Native Alaskans
(12.3/100,000) is 9.6 times the national rate and 3.5 times
higher than the Alaska rate for all races of 3.47 per
100,000.4 For the 19 Alaska residential fires involving 23
deaths in 1996, only 5 homes (26%) had a smoke alarm
installed, and only 1 of them (5%) was operational at the
time of the fire.5 Most rural Native Alaskans live in small
homes with electrical heating systems that do not meet
accepted industry standards. When the fact that most rural
villages have little or no fire-fighting capabilities is added,
the potential for disaster is great. This situation is not
unlike that seen in other poor rural US communities,
mobile home parks, and some apartment complexes.
Therefore, early detection and escape become essential elements in preventing fire fatalities among these populations.
A working smoke alarm has been reported to reduce
the risk of death from residential fires from 50% to
70%.6,7 There are basically 3 different types of residential
smoke alarms: the ionization alarm, the photoelectric
alarm, and the combination alarm. The US Fire Administration reports that more than 88% of the homes in the
United States have at least 1 smoke alarm installed, but
60% of the residential fire deaths occur in homes without
an operational alarm.8 According to a 1994 study of US
residential smoke alarm use, the leading cause of smoke
alarm disconnection was nuisance alarms.9 Frequent nuisance alarms can generate a dangerous sense of compla-
Thomas M Fazzini
Injury Prevention
Specialist
Maniilaq Health Center
Kotzebue, Alaska
Ron Perkins
Director
Injury Prevention
Program
Alaska Area Native
Health Service
Anchorage
David Grossman
.....................................................................................................................................................................
Co-Director
Harborview Injury
Prevention and Research
Center
Seattle, WA
Correspondence to:
Mr Perkins
West J Med
2000;173:89-92
METHODS
This was a prospective cohort study of households in
4 rural Alaskan villages. The outcomes of interest were
Volume 173 August 2000 wjm 89
.............................................
Original Research
Summary points
Functioning smoke alarms can reduce the risk of death
in residential fires from 50% to 70% each year
Of the residential fire deaths in the United States, 60%
occur in homes without a functioning smoke alarm
Smoke alarms are often disconnected because of
frequent false (nuisance) alarms
Higher rates of false alarms seem to be associated
with small dwellings, use of wood fuel for heat, and
location of alarms near cooking areas
Photoelectric smoke alarms have a lower rate of false
alarms and subsequent rates of disconnection than do
ionization alarms
Patients should be informed about the advantages of
photoelectric smoke alarms in dwellings that have
frequent false alarms
.............................................
Original Research
Photoelectric alarm
Village A
Village B
Variable
Population, No.
298
416
Ionization alarm
Village C
Village D
575
249
..................................................................................................................................................................................................................
Older/total homes
33/71
30/58
40/115
45/67
..................................................................................................................................................................................................................
..................................................................................................................................................................................................................
2
88.6 (954)
85.9 (925)
101.3 (1,090)
90.6 (975)
..................................................................................................................................................................................................................
<20,000
<20,000
<25,000
<20,000
..................................................................................................................................................................................................................
4.0 (13)
4.3 (14)
4.6 (15)
4.4 (14.5)
munity because 1 of the barriers to improved fire protection is the maintenance of smoke alarms already installed
in homes. Replacing ionization alarms in household areas
prone to nuisance alarms with photoelectric alarms could
potentially lead to a marked reduction in the proportion
of disconnected alarms. This research should be useful for
any dwelling in which frequent false alarms are experienced or in dwellings with less than 93 m2 (<1,000 sq ft)
of living space. These criteria are by no means unique to
rural Alaska.
Research on Native American smoke alarm use and
experience is sparse. A 1996 survey of 80 households on
the Devils Lake Sioux Reservation in North Dakota reported that 79% of the 109 ionization smoke alarms installed had false alarms during the previous year.15 Of the
homes experiencing false alarms, almost half had more
than 25 alarms per smoke alarm. Because of these nuisance alarms, 49% of the alarms had been disconnected
over the previous year. Only 3 of the 112 alarms in the
Devils Lake study were photoelectric, none of which had
a nuisance alarm reported.
The fact that ionization alarms produce more false
alarms but are slower to respond to smoky fires is not the
enigma that it seems. Smoke from cooking tends to contain smaller particles (<1 m) that will activate the ionization alarms, whereas larger smoke particles are necessary to
activate the photoelectric alarms.8 A possible barrier to the
increased use of photoelectric alarms is their higher cost
(about $20), which is roughly double that of the ionization alarms. New alarms featuring both types of sensors in
1 unit are currently available but, if located too close to the
kitchen or other ignition sources, nuisance alarms could
still be a problem.
This study has several limitations. First, we are uncertain about the generalizability of our findings. Factors such
as housing size, cooking practices, crowding, and air exchange may all play a role in increasing the likelihood of
nuisance alarms. It is unclear if similar findings would be
Volume 173 August 2000 wjm 91
.............................................
Original Research
encountered if this study were replicated in a middleincome community with a larger average house size. Another limitation of the study was the baseline differences in
the village groups before installation of the alarms. The
groups receiving photoelectric alarms were less likely to
have alarms at baseline.
Bias may have potentially affected the results in 2 ways.
First, recall bias may have influenced respondents answers
regarding alarms. Those who experienced more alarms
may have been more likely to recall their occurrence than
those experiencing fewer alarms. However, it is unlikely
that differential recall bias existed between groups and
highly unlikely that the magnitude of difference between
groups could be explained by recall bias. A larger proportion of the homes in the photoelectric group were also
unable to be recontacted, which may have led to differential bias in the outcome measurements between groups.
However, if every household that could not be contacted
in the photoelectric group had experienced nuisance
alarms (18/58, or 31%), the magnitude of difference between groups would still be an absolute difference of 61%.
Homes in the 2 village groups may have differed in
some unmeasured dimension that could have influenced
the rate of disconnection or nuisance alarms. This is unlikely given that the homes, cultural profiles, and socioeconomic status of the 4 villages were virtually identical.
Furthermore, the distance of the alarms from possible ignition sources was standardized between groups. The primary reason given for false alarms was cooking, and the
average distance differential between the 2 groups was only
15 cm (6 in). Finally, neither the occupants nor the investigators conducting the outcome assessments were
blinded by the type of device installed in the home. This can
lead to differential ascertainment bias between the groups.
We conclude that the incidence of nuisance alarms is
much higher in small dwellings using ionization smoke
alarms. The higher rates of alarm disconnection in the
homes with ionization alarms are likely related to the high
rate of nuisance alarms in these homes. The use of photoelectric smoke alarms in small dwellings may lead to a
lower rate of disconnection and improved survival in the
event of fire. Randomized controlled trials comparing
these types of alarms in different types of dwellings should
be conducted to confirm these findings.
We acknowledge the contributions and support received from Maniilaq
Association and the residents of the participating villages.
....................................................................................................
References
Original article
ABSTRACT
Objective: To compare functionality, reasons for nonfunction, and nuisance alarm levels of two common types
of smoke alarms after installation in low- to mid-level
income households in King County, Washington.
Methods: Randomized controlled trial of 761 households.
An ionization or photoelectric smoke alarm was installed
between June 1, 2000 and July 31, 2002. Main outcome
measures were: percentage of study alarms that were
working, observed reasons for non-functional status, and
self-reported frequency of nuisance alarms at 9 and 15
months of follow-up.
Results: At 9 months after installation, 20% of ionization,
vs 5% of photoelectric alarms were non-functional, a
difference that persisted at 15 months, with the most
common reasons for both types being a disconnected or
absent battery. The risk ratio for ionization, relative to
photoelectric alarms, being non-functional or removed
was 2.7 (95% CI 1.8 to 4.1) at 15 months of follow-up.
These findings were not altered by educational level, or
the presence of smokers, children ,5 years, or adults
>65 years.
Conclusions: Burn prevention efforts are geared towards
increasing smoke alarm ownership and improving maintenance of functional status. Results suggest that the
selective use of photoelectric alarms by fire injury
prevention programs or consumers may provide longerterm protection in similar populations. Designing smoke
alarms that minimize nuisance alarming may also result in
longer term functionality.
METHODS
Participant identification
A proprietary database of all private property in
King County in 2000 (MetroScan) identified
owner-occupied dwellings within the lower quartile of assessed values (,$164 000) in census tracts
with above-median density (755+ homes). This
was to include homes at greatest risk of injury
from residential fires, given the inverse association
observed between socioeconomic status or income
level and fire injury risk.13 14 Condominiums were
excluded, as the studys smoke alarm installation
and placement protocols may conflict with those
specified in condominium covenants. Selected
residences were mailed a letter inviting participation in a fire safety study in cooperation
with the King County Fire Chiefs Association,
involving installation of smoke alarms and provision of fire extinguishers. Homeowners were not
informed of underlying hypotheses. Up to 10
phone calls and 2 messages were attempted to
invite participation.
Only 58 participants enrolled after 4 months, an
accrual rate that would have yielded insufficient
participants. Thus, a blockwalk approach was
initiated in which study staff visited households.
From the pool of eligible dwellings, we identified
clusters of potential participants using Thomas
Guide map grids15 to maximize efficiency of
identification. Twenty multi-day blockwalks to
these areas were conducted, each targeting 200800
potential residences. Within each blockwalk,
households were randomly selected to receive
either an ionization or photoelectric alarm.
Ultimately, 6236 homes were identified for
approach using this method (fig 1).
Staff worked in pairs during home visits during
June 1, 2000 to July 31, 2002. If potential
participants were at home, the team invited
participation, either then or later. If nobody was
at home, they left a letter indicating that a smoke
alarm installation team would return on a future
date. Residents could call to refuse, schedule an
appointment, or be visited on the return date.
Injury Prevention 2008;14:8086. doi:10.1136/ip.2007.016725
Original article
Figure 1 Flow of households through the trial. *Four homes in ionization and two in photoelectric study groups excluded from follow-up analyses
because original zinc batteries replaced with alkaline batteries. {Study smoke alarm never installed. {Renters.
Procedures were approved by the Human Subjects Division at
the University of Washington prior to study conduct.
Baseline visits
A standardized survey was conducted, followed by installation
of one study alarm per household. The survey queried
demographics, fire safety practices and behaviors, history of
fire or related injuries, building characteristics, heating and
cooking fuel sources, sources of fires, flames, or smoke, and
presence and locations of existing smoke alarms. A target date
was set for the first 9-month follow-up. No appointment time
was arranged, to keep subsequent inspections unannounced and
decrease the likelihood of observing behavior altered by
anticipation of a repeat visit.
Study personnel were trained in smoke alarm installation as
described by the US Fire Administration16 using the National
Fire Alarm Code Handbook.17 Participants were not informed of
hypotheses or type of alarm installed, although they were
informed they would receive an alarm endorsed by the National
Fire Protection Agency (NFPA) for residential use. Because of
the different appearance of the two alarms, it was not possible
to blind study staff to alarm type; however, staff were not
informed of underlying hypotheses. Teams were asked to install
study alarms on main levels, in rooms adjacent to kitchens.
Adjacent rooms without alarms were the highest priority in
selecting the location. Alarms were mounted on the wall 3 feet
from the kitchen entrance and 412 inches from the ceiling, a
Injury Prevention 2008;14:8086. doi:10.1136/ip.2007.016725
Follow-up visits
At both follow-ups, we queried the status of all smoke alarms,
occurrence of any fires and related alarms, and occurrence of
nuisance alarms (ascertained separately for study and existing
alarms) and their perceived causes. If alarms were reported nonfunctional, the reasons were asked. Teams inspected and tested
study alarms to determine functionality, noted reasons for nonfunction, and observed battery status. If batteries were
81
Original article
Table 1 Characteristics of respondents, households, and houses
reported at baseline interview, by randomized study alarm type
Characteristic
Respondent
Female
Age (years)
(24
2544
4564
>65
Race/ethnicity
White
Asian/Pacific Islander
African-American
Hispanic
Native American
Multiracial
Other
Education
,High school
High school/GED
Vocational/technical/some college
>College
Household
Number of residents
1
2
34
>5
>1 resident aged
(4 years
(14 years
>65 years
>1 resident smokes{
>1 resident drinks alcohol{
House
Single family residence
Year built
(1920
19211940
19411960
19611980
19811996
Ever structurally remodeled
Year built or last remodeled
(1940
19411960
19611980
19812001
Number of floors
1
2
>3
Years in current house
,1
15
610
>11
Kitchen stove type1
Electric
Gas
Frequency of kitchen stove use
Daily
Multiple days per week
Ionization
(n = 366*) (%)
Photoelectric
(n = 384*) (%)
64.7
63.5
2.6
42.5
31.9
23.1
2.3
38.3
40.3
19.2
78.2
10.7
3.6
3.0
0.8
3.0
0.6
76.2
11.4
5.0
3.2
1.3
1.3
1.6
5.2
21.2
30.0
43.7
8.7
25.2
30.5
35.7
20.5
32.5
36.9
10.1
19.0
31.5
35.7
13.8
16.2
33.8
29.0
24.4
25.9
15.7
35.3
25.5
25.0
25.3
98.9
100.0
9.1
17.8
42.7
22.5
7.9
51.0
11.2
15.2
41.3
21.2
11.2
52.7
9.2
27.4
28.4
35.0
7.4
22.9
26.3
43.3
39.9
47.3
12.8
40.1
48.7
11.2
6.6
31.7
16.9
44.8
4.2
29.0
21.9
44.9
89.6
10.7
90.6
9.4
64.5
27.2
66.6
24.5
Continued
Ionization
(n = 366*) (%)
Characteristic
Rarely/occasionally/weekends only
Main heat source
Electric
Natural gas
Oil
Wood
Other
Electric main or secondary heat source
Natural gas main or secondary heat source
Oil main or secondary heat source
Open-element space heater
Wood fireplace
Gas fireplace insert
Wood or pellet stove
Frequency of fireplace or stove use"
Daily/weekly
Bi-monthly/monthly
Rarely/never
Photoelectric
(n = 384*) (%)
8.3
9.0
24.9
54.4
18.8
1.7
0.3
33.6
53.5
19.0
19.5
37.5
4.9
20.8
31.8
49.2
17.4
1.3
0.3
40.6
49.3
18.5
20.8
47.1
1.8
20.8
39.1
12.1
48.8
30.2
14.3
55.5
*Among households that were eligible for analyses (had study alarm installed, were
home owners, and received a zinc battery in the study alarm).
{Defined as smoking a pack (20 cigarettes) or more per week.
{Defined as drinking 5 or more alcoholic beverages on occasion.
1Not mutually exclusive since some kitchens have two stoves, so percentages may
add to .100%.
"Based on the single most frequently used fireplace or stove per household.
Data analysis
Continued
82
Table 1
Original article
alarms at first follow-up). The functional status of study alarms
at each visit was compared. Associations between alarm type
and non-functional or removed status at follow-up were
estimated with cumulative incidence risk ratios (RR) and 95%
CIs. Effect-modification by respondent and household characteristics was explored using stratified analyses and the
MantelHaenszel test for homogeneity. Generalized linear
models specifying the binomial family and log link, appropriate
for cohort studies of common binary outcomes, were used to
adjust simultaneously for combinations of respondent and
household characteristics.18 The presence of confounding was
evaluated by the magnitude of change in RRs after adjustment
for relevant factors, alone and in combination. No appreciable
changes were noted after adjustment for potential confounders;
unadjusted RRs are presented.
The majority of study variables were missing few values (0
2%). Exceptions included the years homes were built or
remodeled, secondary heating sources, household testing of fire
safety devices, and fire history. Participating households with
missing values were dropped from analyses requiring the
specific missing variable(s).
RESULTS
Nearly all alarms (99%) were installed on main floors, with 65% in
both ionization and photoelectric groups installed in hallways,
dining rooms, or living rooms adjacent to kitchens. Study alarms
were installed in kitchens for 20% of residences randomized to
receive ionization alarms and 16% of those with photoelectric
alarms; 16% and 18%, respectively, were installed elsewhere.
Similar proportions of ionization (88%) and photoelectric (90%)
alarms were installed on walls, the remainder on ceilings. The
mean (SD) distances between alarm locations and kitchen stoves
were similar, at 136.0 (44.1) and 137.8 (47.2) inches.
Respondent, household, and house characteristics were
similar for both groups, including the proportions of smokers
and use of kitchen stoves and fireplaces, with a few exceptions
(table 1). A slightly greater proportion of respondents with
ionization alarms had college degrees (44%) than those with
photoelectric alarms (36%). Homes receiving ionization alarms
were slightly less likely to have been built or remodeled after
1980 (35% vs 43% of homes with photoelectric alarms), and
have electrical heating as their main heat source (25% vs 32%),
or wood-burning fireplaces (38% vs 47%). Homes with
ionization alarms were slightly more likely to report natural
gas as their main heating source (54% vs 49%), or have gas
fireplace inserts (5% vs 2%).
The self-reported number of smoke alarms already present,
presence of fire safety equipment, and residential fire history
were similar across groups (table 2). Photoelectric study group
households reporting a prior residential fire were slightly more
likely to have had fire-related injuries among residents (9%)
than were those within the ionization group (6%).
Nuisance alarms by non-study alarms between baseline and
first follow-up visits were similarly common among homes with
ionization (43%) and photoelectric (45%) study alarms (table 3).
Ionization units, however, reportedly were more likely than
photoelectric units to have alarmed (78% vs 39%, p,0.001), and
alarmed more often (56% vs 17% had .3 alarm episodes,
p,0.001). Similar differences were observed for the interval
between first and second follow-ups. On direct observation at
first follow-up, ionization study alarms were more likely to be
non-functional (20% vs 5% photoelectric, p,0.001), with the
most common reasons being a disconnected (6% ionization vs
1% photoelectric, p,0.001), or absent battery (13% ionization
Injury Prevention 2008;14:8086. doi:10.1136/ip.2007.016725
Ionization
(n = 366) (%)
Safety practice
No. of smoke alarms present*
0
9.3
1
40.2
2
29.2
>3
21.3
Smoke alarm tested within past{
06 months
77.0
612 months
14.2
.12 months
5.7
Never
3.2
>1 carbon monoxide alarm
20.3
Carbon monoxide alarm tested within past{
06 months
48.5
612 months
27.3
.12 months
6.1
Never
18.2
>1 fire ladder{
7.8
>1 fire extinguisher
67.5
Extinguisher pressure check within past
31.1
9 months1
Designated meeting location"
31.7
Know water temperature
47.0
Water temperature ,120u F**
64.9
Fire history
Prior fire
11.0
Fire-related injuries{{
5.9
Prior fire
Never
89.0
Fire without injuries
9.0
Fire with injuries
0.6
Fire with unknown injuries
1.4
Photoelectric
(n = 384) (%)
9.9
35.9
33.6
20.6
73.9
14.4
6.4
5.2
21.0
50.7
14.5
10.1
24.6
5.8
67.4
32.4
34.6
44.0
66.7
10.5
8.8
89.5
8.4
0.8
1.4
Original article
Table 3 Follow-up status of study smoke alarms, by follow-up visit and alarm type
Characteristic
Participant-reported status
since last visit
Fire
Study alarm sounded
No. of times study alarm
sounded{
13
410
>11
Other alarm(s) sounded1
No. of times other alarm(s)
sounded{
13
410
>11
Follow-up 1
Follow-up 2
Ionization
Photoelectric
(n = 332) (%) (n = 340) (%)
Ionization
Photoelectric
(n = 311) (%) (n = 314) (%)
2.4
77.9
2.4
38.7
44.1
26.6
29.4
42.5
83.5
11.0
5.5
45.4
73.0
13.9
13.0
72.5
15.8
11.7
p-value{
0.97
,0.001
,0.001
0.49
0.89
Follow-up 2*
1.6
76.8
2.6
42.0
56.3
27.7
16.0
33.0
88.2
11.0
0.8
37.6
65.5
27.6
6.9
73.0
18.0
9.0
p-value{
0.41
,0.001
,0.001
0.26
0.28
Ionization
Photoelectric
(n = 248) (%) (n = 296) (%)
0.8
74.2
2.4
41.8
61.4
21.7
16.9
30.2
89.9
9.2
0.8
36.7
60.9
32.8
6.3
73.1
17.2
9.7
p-value{
0.19
,0.001
,0.001
0.14
0.07
94.7
,0.001
76.8
91.4
,0.001
85.8
93.2
0.004
0.0
0.6
1.2
1.5
0.0
0.3
1.8
0.49
,0.001
,0.001
0.73
1.00
0.12
0.3
5.5
14.5
1.3
0.0
0.3
1.3
0.3
1.3
2.2
1.3
0.3
0.0
3.2
1.00
0.004
,0.001
1.00
1.00
0.50
0.11
0.4
4.1
7.7
1.6
0.0
0.0
0.4
0.3
0.7
2.4
1.4
0.3
0.0
1.7
1.00
0.008
0.004
1.00
1.00
0.23
DISCUSSION
Compared to ionization alarms, photoelectric alarms were more
likely to be functional both 9 and 15 months after installation,
and had fewer absent or disconnected batteries. The greater
proportion of functioning photoelectric alarms may be attributable to fewer nuisance alarms. Thus, photoelectric alarms may
be preferred when a single unit is selected by consumers or
safety campaigns targeting similar populations, particularly
when the alarm is installed adjacent to a cooking area as in our
study.
These findings are consistent with previous work conducted
by this center. Among smaller residences in rural Alaskan Native
villages, eight times as many nuisance alarms by ionization
units were reported, compared to photoelectric units, after
6 months of follow-up. Ionization alarms were also more likely
to be disabled or missing batteries.11
Our findings differ from those of another trial conducted
among residents of low-income housing units in London, in
which ionization alarms were more likely than photoelectric
84
Original article
sprinkler systems may provide the most efficient use of limited
government resources in that environment. This contrasts with
some studies in other environments, where smoke alarm
installation programs appear effective.20
Limitations
Although study staff directly observed functional status of the
smoke alarms and reasons for non-function, the occurrence and
reasons for nuisance alarms were participant-reported. Another
potential limitation involved the method used to recruit
households. Because of low success using targeted mail
invitation, we switched to blockwalk recruitment targeting
high density areas and recruited people at home, given that mail
response is generally lower than in-person contact.21 We
attempted to reduce potential bias associated with nonresponse by leaving letters if occupants were absent, and
attempting re-contact. Nonetheless, some potentially eligible
homes could not be reached. The impact of this is unclear, but
we doubt differential bias because proportions consenting and
reasons for non-participation were similar between study
groups. We are also reassured that the proportion of enrolled
homes with existing smoke alarms is similar to that in surveys
from the same time.8 22 Potential biases may have been
introduced in using two different recruitment methods,
although there is evidence of no significant differences in
subjects identified by mailing and home visit.23 We also obtained
no information about presence or use of fans over cooking
surfaces. Our results are based on single family, owner-occupied
households, and it is possible that household characteristics may
vary between those in the study and those of rental units or
condominiums. Finally, it should be noted that although we
installed alarms in the room adjacent to the kitchen, current
recommendations are that alarms be installed on every level of a
home, in particular, outside every sleeping area.24
Key points
c
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