Fire fatalities among New Mexico children

Study objective: To explore the relationship between social conditions and fire mortality rates among children. Design: Retrospective analysis of fire fatalities in children 0 to 14 years old in New Mexico. Setting: State Office of the Medical Investigator. Type of participants: All 57 New Mexico children 0 to 14 years old who died from fire-related injuries from 1981 through 1991. Interventions: Medical investigator and autopsy records were reviewed and abstracted. Demographic and housing figures were obtained from US Census reports. Data were analyzed by χ² or by Fisher's exact test, with Bonferroni correction for multiple comparisons. Results: Two thirds of decedents were male (P = .0014), and three fourths were less than 5 years old (P < .0001). Children living in mobile homes had triple the mortality rate of those in houses or apartments, and children in homes without plumbing (substandard) had more than ten times the mortality rate of those in houses or apartments (P < .0001). Two thirds of the victims in substandard homes were Native American (P < .0001). Errors or negligence of adults occurred in more than half of the deaths. Eighty-two percent of decedents died at the scene; only 11% reached a burn center. Conclusion: Substandard homes are associated with an increased fire mortality rate among children. Strategies to prevent childhood fire fatalities should address housing conditions and adult safety practices. Enhanced prehospital or burn unit care is unlikely to greatly affect childhood fire mortality rates.