Welcome to Best Practices in Prevention Oriented Child Death Review


List of Potential Interventions




Fire departments in the U.S. respond to approximately 399,000 residential fires 1 resulting in 13,600 injuries, 2,865 deaths, and $7.4 billion in direct damage each year.2  Residential fires account for nearly 90% of all fire-related fatalities, and they are the third leading cause of unintentional deaths caused by an injury in the home and the ninth leading cause of home injuries resulting in an emergency department visit.1,3,4 On average, in the United States someone dies in a fire every 162 minutes and someone is injured every 32 minutes. 5
Each year, approximately 490 children ages 14 and under die in residential fires. Half of all children who die in a fire are under age 5, and rates of death due to fire rise again in the 10 to 14 age group. 6 While the most significant cost of these fire-related deaths is in the pain and suffering of the children and families involved, they have a high financial cost as well. The total annual cost of fire- and burn-related deaths among children ages 14 and under is more than $2.6 billion.  Children ages 4 and under account for more than $1.4 billion of these costs.17

Several factors are associated with increased risk of death due to a house fire. The risk of a residential fire resulting in a child’s death is greater for families living in rural areas, in southern states, 13 or in manufactured homes or substandard housing. 9,10 During the cold-weather months of December through March, residential fires and home fire-related deaths are more likely to occur. In addition, children are more likely to die in a residential fire at night14, and both African-American and male children are at greater risk,7,8

A range or stovetop is the leading cause of reported home fires in the United States.13 However, fires started by lighted tobacco products, principally cigarettes, constitute the leading cause of residential fires that result in death. 7 In addition, alcohol use contributes to an estimated 40% of deaths due to residential fires.1,14 

Although only 5% of residential fires are caused by children playing with fire, such activity causes 40% of fire-related deaths among children. 11 In fact, children under 5 years old playing with lighters cause more than 5,000 residential fires a year, resulting in approximately 150 deaths, and more than 1,000 injuries. 12 Moreover, each year approximately $280 million in property is destroyed in the United States by children playing with fire.16

In almost two-thirds (65%) of residential fires that result in a child’s death, the home in which the fire occurred had either no smoke alarm or no working smoke alarms.7, 15 As such, every dollar spent on smoke alarms is estimated to save $69 in fire-related costs. 11

In order to prevent the human and financial costs of injury and death due to residential fires, a variety of fire safety initiatives have been developed. Fire safety refers to precautions that are taken to prevent or reduce the likelihood of a fire that may result in death, injury, or property damage; alert those in a structure to the presence of a fire in the event that one occurs; better enable those threatened by a fire to survive; or to reduce the damage cause by a fire.


  1. Runyan, C. and C. Casteel, eds. The State of Home Safety in America: Facts About Unintentional Injuries in the Home. 2nd ed. 2004, Home Safety Council: Washington, DC.
  2. Karter MJ. Fire loss in the United States during 2006,. Quincy (MA): National Fire Protection Association, Fire Analysis and Research Division; 2007.
  3. FPA's "Children Playing with Fire" report by John R. Hall, Jr., April 2005. http://www.nfpa.org/index.asp
  4. Hall JR. Burns, toxic gases, and other hazards associated with fires: Deaths and injuries in fire and non-fire situations. Quincy (MA): National Fire Protection Association, Fire Analysis and Research Division; 2001.
  5. U.S. Consumer Product Safety Commission (CPSC).  CPSC releases new report on residential fires.  Release #01-176.  Washington (DC): U.S. CPSC, 2001 June.
  6. National Center for Health Statistics.  Centers for Disease Control and Prevention.  National Vital Statistics System.  2000 to 2004 mortality data.  Hyattsville (MD): National Center for Health Statistics, 2007.
  7. Ahrens M. The U.S. fire problem overview report: leading causes and other patterns and trends. Quincy (MA): National Fire Protection Association; 2003.
  8. United States Fire Administration.  Socioeconomic factors and the incidence of fire.  Emmitsburg (MD): U. S. Fire Administration, 1997 June
  9. Runyan CW, Bangdiwala SI, Linzer MA, Sacks JJ, Butts J. Risk factors for fatal residential fires. New England Journal of Medicine 1992;327(12):859–63.
  10. Parker DJ, Sklar DP, Tandberg D, Hauswald M, Zumwalt RE. Fire fatalities among New Mexico children. Annals of Emergency Medicine 1993;22(3):517–22.
  11. National SAFE KIDS Campaign. Fire safety fact sheet. 2004, National SAFE KIDS Campaign: Washington, DC. Accessed on: September 26, 2008. http://www.usa.safekids.org/content_documents/2007_Fact_Sheet_Fire.doc
  12. U.S. Consumer Product Safety Commission. Fires Caused by Children Playing with Lighters. An Evaluation of the CPSC Safety Standard for Cigarette Lighters. September 2000. Hazard Analysis Division, Directorate for Epidemiology.
  13. National Center for Injury Prevention and Control. Fire deaths and injuries: fact sheet. 2005. http://www.cdc.gov/ncipc/factsheets/fire.htm. Accessed on October 17, 2006.
  14. Centers for Disease Control and Prevention. Deaths resulting from residential fires and the prevalence of smoke alarms - United States 1991–1995. Morbidity and Mortality Weekly Report 1998; 47(38): 803–6.
  15. 15 United States Fire Administration.  Children and fire: the experiences of children and fire in the United States.  Emmitsburg (MD): U. S. Fire Administration, 1997 January.
  16. Hill D.  Personal communication. Landover (MD): Children's Safety Network, Economics and Insurance Resource Center, 2004.