Utilizing GIS Technology to Improve Fire Prevention Activities in an Urban Fire Department.

The Baltimore City Fire Department (BCFD) has been installing smoke alarms city wide for more than three decades. Though data on each visit are entered into a database, no system existed for using these data for planning or evaluation. The objective of this study is to use Geographic Information System (GIS) technology and existing databases to 1) determine the number of residences in need of a home visit; 2) determine total visits, visits per household, and number of homes entered for eligible households; and 3) demonstrate integration of various data via GIS for use in prevention planning. The tax assessment database was queried to determine the number of eligible (as determined by BCFD policy) residences in need of a visit. Each attempted BCFD home visit was coded to identify, if the BCFD personnel interacted with residents ("pass door") and installed alarms. Home visits were geocoded and compared to the tax assessment database to determine city wide pass door rates. Frequency of visits was run by individual residences to measure efficiency. A total of 206,850 residences met BCFD eligibility for a home visit. In 2007, the BCFD attempted 181,757 home visits and 177,213 were successfully geocoded to 122,118 addresses. A total of 122,118 eligible residences (59%) received a home visit. A total of 35,317 residences (29%) received a repeat visit attempt. The pass door rate was 22% (46,429) of all residences. GIS technology offers a promising means for fire departments to plan and evaluate the fire prevention services they provide.

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.

Changes in smoke alarm coverage following two fire department home visiting programs: what predicts success?

BACKGROUND: Door-to-door canvassing and installation of smoke alarms have been found to be effective at increasing the number of homes protected. This analysis reports on how smoke alarm coverage changes six months after a home visiting program in a large urban sample, and how this change varies by characteristics of the residents and characteristics of the services delivered during the home visit. METHODS: Fire department Standard and Enhanced home visiting programs were compared. During the home visit, fire fighters installed lithium battery smoke alarms. Residents in the Enhanced program received tailored education about fire safety. Six months after the home visit, participating residences were visited to complete a follow-up survey and to have the installed alarms checked. RESULTS: 81% of the 672 homes that had a working smoke alarm on every level of the home at the end of the home visit remained safe at follow-up, and 87% of the residents found the home visit was very useful, and these rates did not differ between the Enhanced and Standard programs. The degree to which firefighters delivered their services varied, although households in which the resident's engagement with the fire department team was rated as excellent were 3.96 times as likely to be safe at follow-up compared to those with poor or fair resident engagement (p=0.03). CONCLUSIONS: There is a need to better understand how to maximize the time spent with residents during smoke alarm home visiting programs. This study helps with the development of methods needed for implementing and evaluating such programs in real-world settings.

Still too hot: examination of water temperature and water heater characteristics 24 years after manufacturers adopt voluntary temperature setting.

Although water heater manufacturers adopted a voluntary standard in the 1980s to preset thermostats on new water heaters to 120°F, tap water scald burns cause an estimated 1500 hospital admissions and 100 deaths per year in the United States. This study reports on water temperatures in 976 urban homes and identifies water heater and household characteristics associated with having safe temperatures. The temperature of the hot water, type and size of water heater, date of manufacture, and the setting of the temperature gauge were recorded. Demographic data, including number of people living in the home and home ownership, were also recorded. Hot water temperature was unsafe in 41% of homes. Homeowners were more likely to have safer hot water temperature (<120°F) than renters (63 vs 54%; P < .01). For 11% of gas water heaters, the water temperature was >130°F, although the gauge was set at less than 75% of its maximum setting. In a multivariate logistic regression, electric water heaters were more likely to have safe hot water temperatures than gas water heaters (odds ratio R=4.99; P < .01). Water heaters with more gallons per person in the household were more likely to be at or below the recommended 120°F. Our results suggest that hot water temperatures remain dangerously high for a substantial proportion of urban homes despite the adoption of voluntary standards to preset temperature settings by manufacturers. This research highlights the need for improved prevention strategies, such as installing thermostatic mixing valves, to ensure a safer temperature.

Knowledge and injury prevention practices in homes of older adults.

This study aimed to describe the prevalence of preventive safety measures in homes with older, urban-dwelling adults; determine the relationship between sociodemographic variables and injury prevention measures; and describe older adults' knowledge of safety topics. Teams conducted interviews and home observations in 603 homes to confirm preventive safety measures. Households with older adults were rarely observed to have recommended smoke alarm (34%) or carbon monoxide coverage (22%). Water temperature was safe in 64% of homes. Among households headed by someone other than the older adult, odds of having a working smoke alarm on every floor were much lower than in older adult-headed households (95% confidence interval: 0.04-0.35). Few older adults interviewed about safety knowledge correctly answered several items related to fire and carbon monoxide. Effort is needed to improve knowledge and promote the lifesaving benefits of injury countermeasures so that older adults can be adequately protected.

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.