U.S. STRUCTURE FIRES IN NURSING HOMES. Jennifer Flynn Fire Analysis and Research Division National Fire Protection Association

Transcription

1 U.S. STRUCTURE FIRES IN NURSING HOMES Jennifer Flynn Fire Analysis and Research Division National Fire Protection Association September 2008 National Fire Protection Association, 1 Batterymarch Park, Quincy, MA

2 Abstract In , U.S. fire departments responded to an estimated average of 2,810 nursing home structure fires, annually. These fires caused an annual average of 16 civilian deaths, 130 civilian injuries, and $6.6 million in direct property damage. In this report, nursing home refers only to nursing homes licensed by the state, providing 24-hour nursing care for four or more persons. These estimates are based on data from the U.S. Fire Administration s (USFA) National Fire Incident Reporting System (NFIRS) and the National Fire Protection Association s (NFPA) annual fire department experience survey. More than half of the fires in these properties were caused by cooking, but fires that started with mattresses or bedding material or electrical wire or cable insulation caused a disproportionate share of the casualties and injuries. Keywords: fire statistics, nursing home Acknowledgements The National Fire Protection Association thanks all the fire departments and state fire authorities who participate in the National Fire Incident Reporting System (NFIRS) and the annual NFPA fire experience survey. These firefighters are the original sources of the detailed data that make this analysis possible. Their contributions allow us to estimate the size of the fire problem. We are also grateful to the U.S. Fire Administration for its work in developing, coordinating, and maintaining NFIRS. For more information about the National Fire Protection Association, visit or call To learn more about the One-Stop Data Shop go to or call Copies of this analysis are available from: National Fire Protection Association One-Stop Data Shop 1 Batterymarch Park Quincy, MA osds@nfpa.org phone: NFPA No. PKG 33 Copyright 2008, National Fire Protection Association, Quincy, MA

3 Table of Contents Table of Contents... i List of Figures and Tables... iii Nursing Home Structure Fire Fact Sheet... v Structure Fires in Nursing Homes... 1 Appendix A How National Estimates Statistics Are Calculated Appendix B Methodology and Definitions Used in Leading Cause Tables Appendix C Previously Published Firewatch Incidents Involving Nursing Homes Appendix D Previously Published Catastrophic Fires Involving Nursing Homes Appendix E Nursing Home Fire Investigations Appendix F Previously Published Articles from Fire Journal and NFPA Journal U.S. Structure Fires in Nursing Homes, 9/08 i NFPA Fire Analysis and Research Division, Quincy, MA

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5 List of Figures and Tables Figure 1. U.S. Structure Fires in Nursing Homes by Alarm Year, Figure 2. Structure Fires in Nursing Homes by Alarm Time, Table A. Fire Protection Features in Non-Confined Structure Fires in Nursing Homes... 3 Reported to Public Fire Departments, Annual Averages Figure 3. Operation of Automatic Suppression System when System Present... 4 in Non-Confined Structure Fires in Nursing Homes, Annual Averages Table 1. Structure Fires in Nursing Homes by Year: Table 2. Structure Fires in Nursing Homes, by Month, Annual Averages... 7 Table 3. Structure Fires in Nursing Homes, by Day of Week, Annual Averages... 7 Table 4. Structure Fires in Nursing Homes, by Alarm Time, Annual Averages... 8 Table 5. Leading Causes of Structure Fires in Nursing Homes, Annual Averages... 9 Table 6. Structure Fires in Nursing Homes, by Equipment Involved in Ignition Annual Averages Table 7. Structure Fires in Nursing Homes, by Heat Source, Annual Averages Table 8. Structure Fires in Nursing Homes, by Area of Origin, Annual Averages Table 9. Structure Fires in Nursing Homes, by Item First Ignited, Annual Averages Table 10.Structure Fires in Nursing Homes, by Extent of Flame Damage Annual Averages U.S. Structure Fires in Nursing Homes, 9/08 iii NFPA Fire Analysis and Research Division, Quincy, MA

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7 One-Stop Data Shop Fire Analysis and Research Division One Batterymarch Park, Quincy, MA Nursing Home Structure Fire Fact Sheet In , an estimated 2,810 structure fires in nursing homes were reported to municipal fire departments annually. These fires resulted in an estimated 16 civilian deaths, 130 civilian injuries, and $6.6 million in direct property damage, annually. The kitchen was the leading area of origin for nursing home structure fires; the bedroom was the leading area of origin for civilian fire casualties. Fires that began with mattress or bedding material and electrical wiring or cable insulation caused a disproportionate share of civilian deaths and injuries. The deadliest nursing home fire during this period was an intentional fire set in a Connecticut nursing home, killing 16 people and injuring dozens. Leading Cause of Structure Fires in Nursing Homes, Source: NFIRS and NFPA Survey The death rate per 1,000 fires was 94% lower when automatic suppression systems were present in nursing home structure fires. The death rate per thousand non-confined fires was almost sixteen times as high when automatic extinguishing equipment was not present. U.S. Structure Fires in Nursing Homes, 9/08 v NFPA Fire Analysis and Research Division, Quincy, MA

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9 Structure Fires in Nursing Homes Roughly 2,800 structure fires were reported in these properties per year. During the four-year period of , an estimated average of 2,810 structure fires were reported per year. These fires caused an annual average of 16 civilian deaths, 130 civilian injuries, and $6.6 million in direct property damage. In this report, the term nursing home refers only to nursing homes licensed by the state, providing 24-hour nursing care for four or more persons. Nursing homes are identified by property use code 311 in Version 5.0 of the U.S. Fire Administration s National Fire Incident Reporting System. See Appendix A for more information on NFIRS and the methodology used in this analysis. Assisted living facilities and residential board and care facilities are not supposed to be coded here and have their own property use code of 459, in the residential group. Elderly housing, where people cook for themselves and maintain their own apartments is considered residential and is not included here. Only fires reported to municipal fire departments are included in these statistics. A fire with multiple casualties and injuries can have a significant impact on annual averages. In 2003, an intentional fire in a Connecticut nursing home resulted in the deaths of sixteen casualties and dozens of injuries. At the time of the fire 148 patients were being cared for at the facility. The fire began early in the morning when a patient intentionally lit bedding material with a lighter. The fire department responded to the fire at 2:45 a.m. and found the fire in one wing of the building and staff removing patients from that wing and other affected areas. The fire fighters and staff were faced with a growing fire, heavy smoke, and a large number of non-ambulatory patients exposed to smoke and heat. It was later determined that the patient that started the fire was not competent to stand trial and charges were not pursued. A single fire with multiple casualties and injuries can have a significant impact on annual averages. This incident was included in the calculation of annual averages and therefore estimates of civilian fire deaths and injuries should be considered with caution. Figure 1. U.S. Structure Fires in Nursing Homes by Alarm Year, Source: NFIRS and NFPA Survey *Estimates for are based on data collected originally in NFIRS 5.0 only. Due to the smaller share of NFIRS data collected in these years are not included in Figure 1. U.S. Structure Fires in Nursing Homes, 9/08 1 NFPA Fire Analysis and Research Division, Quincy, MA

10 Since 1980, structure fires in nursing homes fell 26%. As Table 1 and Figure 1 show, structure fires in nursing homes fell 26% from 3,720 in 1980 to 2,740 in In comparison, structure fires of all types declined 52% from 1980 to 2005 and structure fires in non-homes declined 61%. Figure 2. Structure Fires in Nursing Homes by Alarm Time, Source: NFIRS and NFPA Survey Structure fires in nursing homes peak twice during daytime hours. Tables 2, 3, and 4 show reported structure fires in these properties by month, day of week and alarm time, respectively. Winter months were the peak months for fires in nursing homes. The smallest number of fires occurred in August. Saturday was the peak day for fires in these properties. Figure 2 shows that fires in these properties peak twice during the day, once between the hours of 8 a.m. to 12 p.m. and again from 4 p.m. to 7 p.m. More than half of reported structure fires in nursing homes were caused by cooking. Table 5 shows the leading causes of fires in these properties with data summarized from several NFIRS fields. In some cases, the equipment involved in ignition is most relevant; heat source, the field cause, and factor contributing to ignition also provide relevant information. The causes shown in this table are not mutually exclusive when they have been pulled from different fields. More detailed information on equipment involved in ignition may be found in Table 6; more information on heat source is in Table 7; further explanation of the methodology used is in Appendix B. In NFIRS Version 5.0, beginning in 1999, causal data is generally not required for certain types of confined fires, including confined cooking fires, chimney fires, trash fires, and fuel burner or boiler fires. Although causal information is not required for these incidents, it is provided in some cases. Confined fires are analyzed separately from non-confined fires; estimates are based on the share with causal data. Caution should be used when comparing the information with earlier analyses as differences may be due to changes in data collection practices rather than actual variations in the fire experience. U.S. Structure Fires in Nursing Homes, 9/08 2 NFPA Fire Analysis and Research Division, Quincy, MA

11 Overall, cooking equipment was involved in 54% of the fires reported in nursing homes; cooking equipment was listed as the equipment involved in ignition in 3% of these fires and an additional 52% reported as confined cooking fires. Clothes dryers or washers were involved in 12% of the fires. Overall, heating equipment was involved in 9% of nursing home fires and civilian fire deaths; heating equipment was listed as the equipment involved in 5% of nursing home fires, with an additional 4% reported as confined heating fires. Electrical distribution or lighting equipment was involved in 3% of the fires. Smoking materials 1 caused 3% of the fires and 5% of the fire deaths in these properties. Only one percent of nursing home structure fires were intentionally set, however these fires caused 75% of the civilian fire deaths. In 2003, an intentional fire set in a nursing home in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths and injuries. The kitchen was the leading area of origin for nursing home structure fires; the bedroom was the leading area of origin for civilian casualties. Four percent of the fires in facilities that care for the aged originated in the kitchen or cooking area. Area of origin is generally not collected for confined fires but it is probable that most of the confined cooking fires (52%) also started in the kitchen, meaning that 56% of these fires started in the kitchen. Ten percent started in the laundry room. Although only 7% of fires originated in the bedroom, these fires caused 92% percent of the civilian fire deaths. (See Table 8.) Fires that started with either (a) electrical wiring or cable insulation or (b) mattress and bedding were more likely to result in injury. Presumably most of the confined cooking fires (52%) began with food or cooking materials, although this information is not routinely collected for these fires. Cooking materials, including foods, were identified as the items first ignited in 1% of these fires, meaning that more half of the fires in these properties began with these items. Unclassified items were first ignited in 4% of the fires. Although electrical wire or cable insulation was first ignited in 7% of fires, these fires resulted in 25% of the civilian injuries. Mattress or bedding resulted in 19% of civilian injuries. Table A. Fire Protection Features in Non-Confined Structure Fires in Nursing Homes Reported to Public Fire Departments: Annual Averages Percent of non-confined fires in buildings with automatic extinguishing equipment 71% Deaths per 1,000 non-confined fires with automatic extinguishing equipment 2.6 Deaths per 1,000 non-confined fires with no automatic extinguishing 40.6 equipment present Reduction in deaths per 1,000 non-confined fires when automatic 94% extinguishing equipment was present Average loss per non-confined fire when automatic $5,265 1 A proportional share of fires involving heat from unclassified open flame or smoking materials is included in the estimates for fires involving candles and smoking materials. U.S. Structure Fires in Nursing Homes, 9/08 3 NFPA Fire Analysis and Research Division, Quincy, MA

12 extinguishing equipment was present Average loss per non-confined fire with no automatic extinguishing equipment $7,403 Reduction in loss per non-confined fire when automatic -29% extinguishing equipment was present Source: National estimates based on NFIRS and NFPA survey. The death rate per 1,000 fires was 94% lower when automatic suppression systems were present. The collection of suppression system data is not required in NFIRS 5.0 when fires are confined; therefore we can only examine the suppression system presence, operation, and type in non-confined fires. As Table A shows, automatic suppression systems were present in 71% of non-confined nursing home structure fires in The death rate per thousand nonconfined fires was almost sixteen times as high when this equipment was not present. The average loss per non-confined fire was higher in properties with suppression equipment. Twenty-eight percent of the direct property damage in nursing homes with suppression systems present was due to the system s failure to operate. Sixteen percent of direct property damage resulted when the fire was too small to cause the sprinkler to operate and another 15% of property damage resulted in fires where the sprinkler operated but was not effective. Figure 3. Operation of Automatic Suppression System when System Present in Non-Confined Structure Fires in Nursing Homes Annual Averages Source: NFIRS and NFPA Survey U.S. Structure Fires in Nursing Homes, 9/08 4 NFPA Fire Analysis and Research Division, Quincy, MA

13 Beginning in March of 2005, the Centers for Medicare & Medicaid Services (CMS) required that battery-operated smoke alarms be installed in all patient rooms and public areas in longterm care facilities, nationwide, that do not have sprinklers. In addition to this requirement, all new sprinkler systems in nursing homes must meet NFPA technical specifications. 2 Only 3% of nursing home fires spread beyond room of origin. Sixty-one percent of the reported fires in nursing homes were confined or contained fires. In addition to the 61% of contained or confined fires, 27% were confined to the object of origin. Only 3% spread beyond the room of origin. Ten percent of the civilian fire deaths and 46% of the civilian injuries resulted from fires that were confined to the object of origin. Thirty-seven percent of the civilian injuries resulted from fires that expanded beyond the object of origin but were confined to the room of origin. (See Table 10.) An average of 1,400 outside and other fires per year were reported at these properties. During , an estimated annual average of 1,400 outside and other fires on these properties caused an average of eleven civilian injuries and $0.3 million in direct property damage per year. An average of 150 vehicle fires reported on these properties caused an average of three civilian injuries and $0.3 million in direct property damage per year. No civilian fire deaths resulted from vehicle fires reported on these properties that were reported to NFIRS. Civilian fire deaths from outside fires on these properties averaged less than one per year. Residents of these facilities are particularly vulnerable. People over 65 face more than twice the risk of dying in a home fires as the general population and risk increases with age. 3 Consequently, the aged are considered a high-risk population. Institutional facilities that care for older adults must work diligently to prevent fires and to train staff and to equip the property (e.g., active systems) for effective response should a fire occur. The deadliest fire in U.S. history in this property class was the 1957 Katie Jane Nursing Home fire in Warrenton, Missouri, that killed 72 people. Additional information sources NFPA members can download a number of investigation reports on nursing home and board and care fires at no cost from Non-members may order investigation reports through the NFPA library. Two chapters found in the 20th edition of the NFPA Fire Protection Handbook, Information and Analysis for Fire Protection by John R. Hall, Jr. and Arthur Cote, and Human Behavior and Fire by John L. Bryan, describe some of the special fire safety concerns for these properties. 2 FS-World.com, Fire Sprinkler Systems Mandated for Nursing Homes in USA, June 24, 2008, 3 Jennifer D. Flynn, Characteristics of Home Fire Victims, NFPA Division of Fire Analysis and Research July 2008, pg 1. U.S. Structure Fires in Nursing Homes, 9/08 5 NFPA Fire Analysis and Research Division, Quincy, MA

14 Table 1. Structure Fires in Nursing Homes by Year: Direct Property Damage (in Millions) As Reported In 2005 Dollars Year Fires Civilian Injuries , $1.5 $ , $1.8 $ , $1.4 $ , $1.6 $ , $3.4 $ , $4.2 $ , $2.0 $ , $1.7 $ , $2.0 $ , $3.0 $ , $2.5 $ , $3.9 $ , $4.7 $ , $4.6 $ , $5.6 $ , $2.3 $ , $5.6 $ , $3.2 $ , $4.0 $ , $8.5 $ , $4.2 $ , $12.4 $ , $6.2 $ , $9.1 $ , $6.4 $ , $4.9 $4.9 *Estimates for are based on data collected in NFIRS 5.0 only. Due to the smaller share of NFIRS data collected in , statistics for these years should be viewed with caution. Deaths are not included in this table due to the large number of deaths in 2003 intentionally set fire in a Connecticut nursing home and its impact on estimates. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars Sources: NFIRS and NFPA survey. Inflation adjustments were based on Table No. 697, Purchasing Power of the Dollar: 1950 to 2006, U.S. Census Bureau s Statistical Abstract of the United States: 2008, 127 th Edition, U.S. Structure Fires in Nursing Homes, 9/08 6 NFPA Fire Analysis and Research Division, Quincy, MA

15 Table 2. Structure Fires in Nursing Homes, by Month, Annual Averages Month Fires Civilian Deaths* Civilian Injuries Direct Property Damage (in Millions) January 260 (9%) 0 (0%) 14 (11%) $0.3 (4%) February 230 (8%) 13 (80%) 17 (13%) $0.3 (4%) March 250 (9%) 1 (8%) 20 (15%) $0.2 (4%) April 210 (8%) 0 (0%) 5 (4%) $1.4 (22%) May 240 (8%) 0 (0%) 10 (8%) $0.3 (5%) June 220 (8%) 0 (3%) 8 (6%) $0.4 (5%) July 220 (8%) 0 (0%) 11 (9%) $0.3 (5%) August 200 (7%) 0 (0%) 7 (5%) $1.2 (18%) September 230 (8%) 0 (0%) 8 (6%) $0.4 (5%) October 240 (9%) 0 (2%) 7 (5%) $1.0 (15%) November 240 (9%) 0 (3%) 8 (6%) $0.3 (5%) December 260 (9%) 1 (5%) 17 (13%) $0.6 (9%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) Average 230 (8%) 1 (8%) 11 (8%) $0.5 (8%) Table 3. Structure Fires in Nursing Homes, by Day of Week, Annual Averages Day Fires Civilian Deaths* Civilian Injuries Direct Property Damage (in Millions) Sunday 410 (15%) 1 (5%) 7 (6%) $1.0 (16%) Monday 380 (14%) 1 (8%) 12 (10%) $0.7 (11%) Tuesday 370 (13%) 0 (3%) 16 (12%) $0.6 (10%) Wednesday 390 (14%) 13 (81%) 23 (18%) $2.0 (30%) Thursday 390 (14%) 0 (0%) 26 (20%) $0.5 (8%) Friday 420 (15%) 0 (0%) 21 (16%) $0.9 (13%) Saturday 440 (16%) 1 (3%) 24 (19%) $0.8 (13%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) Average 400 (14%) 2 (14%) 19 (14%) $0.9 (14%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars. Property damage has not been adjusted for inflation. Totals may not equal sums due to rounding errors. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 7 NFPA Fire Analysis and Research Division, Quincy, MA

16 Table 4. Structure Fires in Nursing Homes, by Alarm Time Annual Average Time of Day Fires Civilian Deaths* Civilian Injuries Direct Property Damage (in Millions) Midnight-12:59 a.m. 70 (3%) 1 (3%) 4 (3%) $0.2 (3%) 1:00-1:59 a.m. 60 (2%) 1 (3%) 13 (10%) $1.2 (18%) 2:00-2:59 a.m. 50 (2%) 12 (75%) 17 (13%) $0.1 (1%) 3:00-3:59 a.m. 40 (2%) 1 (5%) 1 (1%) $0.4 (6%) 4:00-4:59 a.m. 50 (2%) 0 (2%) 5 (4%) $0.1 (2%) 5:00-5:59 a.m. 60 (2%) 0 (0%) 1 (0%) $0.2 (2%) 6:00-6:59 a.m. 90 (3%) 0 (0%) 3 (2%) $0.2 (2%) 7:00-7:59 a.m. 150 (5%) 0 (0%) 10 (7%) $0.1 (2%) 8:00-8:59 a.m. 170 (6%) 0 (0%) 2 (1%) $0.2 (3%) 9:00-9:59 a.m. 170 (6%) 0 (0%) 5 (4%) $0.1 (2%) 10:00-10:59 a.m. 160 (6%) 0 (0%) 4 (3%) $0.2 (2%) 11:00-11:59 a.m. 170 (6%) 0 (0%) 5 (4%) $0.2 (2%) 12:00-12:59 p.m. 130 (5%) 0 (0%) 3 (2%) $0.1 (2%) 1:00-1:59 p.m. 130 (5%) 0 (3%) 4 (3%) $0.1 (2%) 2:00-2:59 p.m. 130 (4%) 0 (0%) 4 (3%) $0.2 (3%) 3:00-3:59 p.m. 130 (5%) 0 (0%) 4 (3%) $0.7 (11%) 4:00-4:59 p.m. 160 (6%) 0 (0%) 8 (6%) $0.5 (7%) 5:00-5:59 p.m. 160 (6%) 0 (0%) 7 (5%) $0.2 (3%) 6:00-6:59 p.m. 170 (6%) 0 (0%) 7 (5%) $0.6 (9%) 7:00-7:59 p.m. 140 (5%) 0 (2%) 9 (7%) $0.2 (4%) 8:00-8:59 p.m. 130 (5%) 0 (3%) 6 (5%) $0.3 (5%) 9:00-9:59 p.m. 90 (3%) 0 (0%) 3 (2%) $0.1 (2%) 10:00-10:59 p.m. 90 (3%) 0 (0%) 3 (2%) $0.1 (2%) 11:00-11:59 p.m. 80 (3%) 1 (5%) 4 (3%) $0.4 (7%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) Average 120 (4%) 1 (4%) 5 (4%) $0.3 (4%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 8 NFPA Fire Analysis and Research Division, Quincy, MA

17 Table 5. Leading Causes of Structure Fires in Nursing Homes Annual Averages Causes Fires Civilian Deaths* Civilian Injuries Direct Property Damage (in Millions) Cooking equipment fires 1,520 (54%) 0 (0%) 15 (11%) $0.4 (6%) Confined cooking fires 1,450 (52%) 0 (0%) 6 (5%) $0.1 (2%) Identified cooking equipment 80 (3%) 0 (0%) 9 (7%) $0.3 (4%) Clothes dryer or washer 340 (12%) 0 (0%) 25 (19%) $2.2 (33%) Heating equipment fires 270 (9%) 1 (9%) 20 (15%) $0.4 (6%) Confined heating equipment 110 (4%) 1 (5%) 1 (1%) $0.0 (1%) Identified heating equipment 150 (5%) 1 (4%) 18 (14%) $0.4 (6%) Electrical distribution and lighting equipment 100 (3%) 0 (0%) 0 (0%) $0.6 (9%) Smoking materials 70 (3%) 1 (5%) 15 (11%) $0.6 (9%) Intentional 40 (1%) 12 (75%) 13 (10%) $0.1 (1%) Contained trash or rubbish fire 150 (5%) 0 (0%) 2 (2%) $0.0 (0%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are the leading causes, obtained from the following list: intentional (from the NFIRS field cause ); playing with fire (from factor contributing to ignition); confined heating (including confined chimney and confined fuel burner or boiler fires), confined cooking, and contained trash or rubbish (from incident type); identified heating, identified cooking, clothes dryer or washer, torch (including burner and soldering iron), electrical distribution and lighting equipment (from equipment involved in ignition); and smoking materials, (from heat source). The statistics on smoking materials include a proportional share of fires in which the heat source was heat from an unclassified open flame or smoking material. Because contained trash or rubbish fires are a scenario without causal information, they are shown at the bottom of the table if they account for at least 2% of the fires. Casual information is not routinely collected for confined incidents. The same fire can be listed under multiple causes, based on multiple data elements. Details on handling of unknowns, partial unknowns, and other underspecified codes may be found in the Appendix. These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand. Property damage has not been adjusted for inflation. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 9 NFPA Fire Analysis and Research Division, Quincy, MA

18 Table 6. Structure Fires in Nursing Homes, by Equipment Involved in Ignition Annual Averages Direct Property Damage (in Millions) Equipment Involved in Ignition Fires Civilian Deaths* Civilian Injuries Confined cooking fire 1,450 (52%) 0 (0%) 6 (5%) $0.1 (2%) Clothes dryer or washer 340 (12%) 0 (0%) 25 (19%) $2.2 (33%) None 190 (7%) 0 (0%) 23 (18%) $1.9 (29%) Confined fuel burner or boiler fire 90 (3%) 1 (5%) 1 (1%) $0.0 (1%) Unclassified heating, ventilating and air conditioning 80 (3%) 1 (4%) 18 (14%) $0.2 (4%) Fan 60 (2%) 0 (0%) 9 (7%) $0.6 (10%) Air conditioner 50 (2%) 0 (0%) 6 (4%) $0.1 (1%) Fixed or portable space heater 40 (1%) 0 (0%) 0 (0%) $0.1 (1%) Lamp, bulb, or lighting 40 (1%) 0 (0%) 0 (0%) $0.0 (0%) Wiring switch or outlet 40 (1%) 0 (0%) 0 (0%) $0.2 (4%) Range with or without oven, cooking surface 30 (1%) 0 (0%) 7 (6%) $0.1 (2%) Unclassified equipment involved in ignition 30 (1%) 0 (0%) 1 (1%) $0.1 (2%) Water heater 20 (1%) 0 (0%) 0 (0%) $0.0 (1%) Confined chimney or flue fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Dishwasher 20 (1%) 0 (0%) 1 (1%) $0.0 (0%) Microwave oven 10 (1%) 0 (0%) 0 (0%) $0.0 (0%) Other confined fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Other known equipment 150 (5%) 15 (91%) 31 (24%) $0.8 (12%) Contained trash or rubbish fire 150 (5%) 0 (0%) 2 (2%) $0.0 (0%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars. Property damage has not been adjusted for inflation. These statistics include a proportional share of fires in which the item first ignited was undetermined or not reported. Fires in which the equipment involved in ignition was undetermined or not reported were allocated proportionally among fires with known equipment involved in ignition. Fires in which the equipment involved in ignition was entered as none but the heat source indicated equipment involvement or the heat source was unknown were also treated as unknown and allocated proportionally among fires with known equipment involved. Sums may not equal due to rounding errors. Estimates of zero mean that the actual number rounded to zero it may or may not actually be zero. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 10 NFPA Fire Analysis and Research Division, Quincy, MA

19 Table 7. Structure Fires in Nursing Homes, by Heat Source Annual Averages Direct Property Damage (in Millions) Heat Source Fires Civilian Deaths* Civilian Injuries Confined cooking fire 1,450 (52%) 0 (0%) 6 (5%) $0.1 (2%) Unclassified heat from powered equipment 300 (11%) 0 (0%) 17 (13%) $1.1 (17%) Radiated, conducted heat from operating equipment 210 (8%) 1 (3%) 36 (27%) $0.8 (13%) Arcing 180 (6%) 0 (0%) 22 (17%) $2.3 (35%) Confined fuel burner or boiler fire 90 (3%) 1 (5%) 1 (1%) $0.0 (1%) Smoking materials 70 (3%) 1 (5%) 15 (11%) $0.6 (9%) Spark, ember or flame from operating equipment 60 (2%) 0 (0%) 4 (3%) $0.2 (3%) Unclassified hot or smoldering object 60 (2%) 0 (0%) 2 (1%) $0.2 (3%) Unclassified heat source 50 (2%) 0 (0%) 2 (1%) $0.0 (1%) Lighter 30 (1%) 14 (87%) 18 (14%) $0.1 (1%) Hot ember or ash 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Spontaneous combustion or chemical reaction 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Confined chimney or flue fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Flame or torch used for lighting 10 (1%) 0 (0%) 3 (2%) $0.2 (3%) Other confined fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Other known heat source 60 (2%) 0 (0%) 4 (3%) $0.8 (13%) Contained trash or rubbish fire 150 (5%) 0 (0%) 2 (2%) $0.0 (0%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars. Property damage has not been adjusted for inflation. Non-confined and non-contained structure fires in which the heat source was unknown or not reported have been allocated proportionally among fires with known heat source. Totals may not equal sums due to rounding errors. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 11 NFPA Fire Analysis and Research Division, Quincy, MA

20 Table 8. Structure Fires in Nursing Homes, by Area of Origin Annual Averages Area of Origin Fires Civilian Deaths* Civilian Injuries Direct Property Damage (in Millions) Confined cooking fire 1,450 (52%) 0 (0%) 6 (5%) $0.1 (2%) Laundry room or area 270 (10%) 0 (0%) 15 (11%) $0.8 (13%) Bedroom 190 (7%) 15 (92%) 42 (35%) $0.4 (7%) Kitchen or cooking area 120 (4%) 0 (0%) 11 (8%) $0.3 (5%) Confined fuel burner or boiler fire 90 (3%) 1 (5%) 1 (1%) $0.0 (1%) Lavatory, bathroom, locker room or check room 60 (2%) 0 (0%) 12 (9%) $0.1 (1%) Unclassified equipment or service area 30 (1%) 0 (0%) 0 (0%) $1.2 (19%) Duct for HVAC, cable, exhaust, heating, or AC 30 (1%) 0 (0%) 0 (0%) $0.0 (1%) Common room, living room, family room, lounge or den 30 (1%) 0 (0%) 5 (4%) $0.2 (3%) Unclassified function area 30 (1%) 0 (0%) 3 (3%) $0.1 (1%) Attic or ceiling/roof assembly or concealed space 30 (1%) 0 (0%) 2 (2%) $0.8 (12%) Heating equipment room 20 (1%) 0 (0%) 6 (5%) $0.1 (1%) Unclassified area 20 (1%) 0 (0%) 1 (0%) $0.0 (1%) Wall assembly or concealed space 20 (1%) 0 (0%) 1 (0%) $0.3 (4%) Exterior roof surface 20 (1%) 0 (0%) 0 (0%) $0.5 (8%) Closet 20 (1%) 0 (0%) 1 (1%) $0.0 (1%) Hallway, corridor, mall 20 (1%) 0 (0%) 6 (4%) $0.0 (1%) Confined chimney or flue fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Machinery room or area or elevator machinery room 20 (1%) 0 (0%) 1 (1%) $0.2 (2%) Other confined fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Other known area 170 (6%) 0 (3%) 11 (9%) $1.2 (18%) Contained trash or rubbish fire 150 (5%) 0 (0%) 2 (2%) $0.0 (0%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars. Property damage has not been adjusted for inflation. Non-confined and non-contained structure fires in which the area of origin was unknown or not reported have been allocated proportionally among fires with known area of origin. Totals may not equal sums due to rounding errors. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 12 NFPA Fire Analysis and Research Division, Quincy, MA

21 Table 9. Structure Fires in Nursing Homes, by Item First Ignited Annual Averages Item First Ignited Fires Civilian Deaths* Civilian Injuries Direct Property Damage (in Millions) Confined cooking fire 1,450 (52%) 0 (0%) 6 (5%) $0.1 (2%) Electrical wire or cable insulation 200 (7%) 1 (3%) 33 (25%) $1.8 (27%) Unclassified item first ignited 110 (4%) 0 (0%) 3 (2%) $0.3 (4%) Mattress or bedding material 100 (4%) 13 (84%) 25 (19%) $0.3 (4%) Confined fuel burner or boiler fire 90 (3%) 1 (5%) 1 (1%) $0.0 (1%) Linen other than bedding 80 (3%) 0 (0%) 2 (1%) $0.3 (4%) Clothing 50 (2%) 0 (0%) 6 (5%) $0.2 (2%) Appliance housing or casing 50 (2%) 0 (0%) 6 (5%) $0.1 (2%) Dust, fiber, lint, including sawdust or excelsior 50 (2%) 0 (0%) 3 (3%) $0.1 (1%) Unclassified soft goods or wearing apparel 40 (2%) 0 (0%) 3 (2%) $0.1 (2%) Cooking materials, including food 40 (1%) 0 (0%) 4 (3%) $0.0 (1%) Structural member or framing 30 (1%) 0 (0%) 4 (3%) $0.9 (14%) Insulation within structural area 20 (1%) 0 (0%) 1 (1%) $0.5 (7%) Upholstered furniture 20 (1%) 0 (0%) 2 (2%) $0.1 (2%) Unclassified furniture or utensils 20 (1%) 0 (0%) 3 (3%) $0.1 (2%) Confined chimney or flue fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Household utensils 20 (1%) 0 (0%) 3 (2%) $0.0 (0%) Other confined fire 20 (1%) 0 (0%) 0 (0%) $0.0 (0%) Other known item 240 (9%) 1 (8%) 21 (16%) $1.6 (25%) Contained trash or rubbish fire 150 (5%) 0 (0%) 2 (2%) $0.0 (0%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars. Property damage has not been adjusted for inflation. Non-confined and non-contained structure fires in which the item first ignited was unknown or not reported have been allocated proportionally among fires with known item first ignited. Totals may not equal sums due to rounding errors. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 13 NFPA Fire Analysis and Research Division, Quincy, MA

22 Table 10. Structure Fires in Nursing Homes, by Extent of Flame Damage Annual Averages Extent of Flame Damage Fires Civilian Deaths* Civilian Injuries Direct Property Damage (in Millions) Confined or contained fire 1,720 (61%) 1 (5%) 10 (7%) $0.2 (3%) Confined to object of origin 760 (27%) 2 (10%) 60 (46%) $1.1 (16%) Confined to room of origin 260 (9%) 1 (6%) 49 (37%) $1.6 (24%) Confined to floor of origin 20 (1%) 0 (0%) 1 (1%) $0.6 (10%) Confined to building of origin 40 (2%) 13 (79%) 11 (8%) $3.1 (47%) Extended beyond building of origin 0 (0%) 0 (0%) 0 (0%) $0.0 (0%) Total 2,810 (100%) 16 (100%) 130 (100%) $6.6 (100%) * In 2003 an intentional fire in Connecticut resulted in 16 casualties and dozens of injuries. This incident has a significant impact on the estimated number of deaths per year as well as the percentage of civilian fire deaths. Note: These are national estimates of fires reported to U.S. municipal fire departments and so exclude fires reported only to Federal or state agencies or industrial fire brigades. National estimates are projections. Casualty and loss projections can be heavily influenced by the inclusion or exclusion of one unusually serious fire. Fires are rounded to the nearest ten, civilian deaths and injuries are rounded to the nearest one, and direct property damage is rounded to the nearest hundred thousand dollars. Property damage has not been adjusted for inflation. Non-confined and non-contained structure fires in which the extent of flame damage was unknown or not reported have been allocated proportionally among fires with known extent of flame damage. Totals may not equal sums due to rounding errors. Source: NFIRS and NFPA survey. U.S. Structure Fires in Nursing Homes, 9/08 14 NFPA Fire Analysis and Research Division, Quincy, MA

23 Appendix A. How National Estimates Statistics Are Calculated The statistics in this analysis are estimates derived from the U.S. Fire Administration s (USFA s) National Fire Incident Reporting System (NFIRS) and the National Fire Protection Association s (NFPA s) annual survey of U.S. fire departments. NFIRS is a voluntary system by which participating fire departments report detailed factors about the fires to which they respond. Roughly two-thirds of U.S. fire departments participate, although not all of these departments provide data every year. NFIRS provides the most detailed incident information of any national database not limited to large fires. NFIRS is the only database capable of addressing national patterns for fires of all sizes by specific property use and specific fire cause. NFIRS also captures information on the extent of flame spread, and automatic detection and suppression equipment. For more information about NFIRS visit Copies of the paper forms may be downloaded from Each year, NFPA conducts an annual survey of fire departments which enables us to capture a summary of fire department experience on a larger scale. Surveys are sent to all municipal departments protecting populations of 50,000 or more and a random sample, stratified by community size, of the smaller departments. Typically, a total of roughly 3,000 surveys are returned, representing about one of every ten U.S. municipal fire departments and about one third of the U.S. population. The survey is stratified by size of population protected to reduce the uncertainty of the final estimate. Small rural communities have fewer people protected per department and are less likely to respond to the survey. A larger number must be surveyed to obtain an adequate sample of those departments. (NFPA also makes follow-up calls to a sample of the smaller fire departments that do not respond, to confirm that those that did respond are truly representative of fire departments their size.) On the other hand, large city departments are so few in number and protect such a large proportion of the total U.S. population that it makes sense to survey all of them. Most respond, resulting in excellent precision for their part of the final estimate. The survey includes the following information: (1) the total number of fire incidents, civilian deaths, and civilian injuries, and the total estimated property damage (in dollars), for each of the major property use classes defined in NFIRS; (2) the number of on-duty firefighter injuries, by type of duty and nature of illness; and (3) information on the type of community protected (e.g., county versus township versus city) and the size of the population protected, which is used in the statistical formula for projecting national totals from sample results. The results of the survey are published in the annual report Fire Loss in the United States. To download a free copy of the report, visit Projecting NFIRS to National Estimates As noted, NFIRS is a voluntary system. Different states and jurisdictions have different reporting requirements and practices. Participation rates in NFIRS are not necessarily uniform across regions and community sizes, both factors correlated with frequency and U.S. Structure Fires in Nursing Homes, 9/08 15 NFPA Fire Analysis and Research Division, Quincy, MA

24 severity of fires. This means NFIRS may be susceptible to systematic biases. No one at present can quantify the size of these deviations from the ideal, representative sample, so no one can say with confidence that they are or are not serious problems. But there is enough reason for concern so that a second database - the NFPA survey - is needed to project NFIRS to national estimates and to project different parts of NFIRS separately. This multiple calibration approach makes use of the annual NFPA survey where its statistical design advantages are strongest. Scaling ratios are obtained by comparing NFPA s projected totals of residential structure fires, non-residential structure fires, vehicle fires, and outside and other fires, and associated civilian deaths, civilian injuries, and direct property damage with comparable totals in NFIRS. Estimates of specific fire problems and circumstances are obtained by multiplying the NFIRS data by the scaling ratios. Analysts at the NFPA, the USFA and the Consumer Product Safety Commission have developed the specific analytical rules used for this procedure. "The National Estimates Approach to U.S. Fire Statistics," by John R. Hall, Jr. and Beatrice Harwood, provides a more detailed explanation of national estimates. A copy of the article is available online at or through NFPA's One-Stop Data Shop. Version 5.0 of NFIRS, first introduced in 1999, used a different coding structure for many data elements, added some property use codes, and dropped others. Figure 1. Fires Originally Collected in NFIRS 5.0 by Year 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 94% 88% 79% 65% 48% 21% 7% Figure 1 shows the percentage of fires originally collected in the NFIRS 5.0 system. Each year s release version of NFIRS data also includes data collected in older versions of NFIRS that were converted to NFIRS 5.0 codes. For 2002 data on, analyses are based on scaling ratios using only data originally collected in NFIRS 5.0: NFPA survey projections NFIRS totals (Version 5.0) U.S. Structure Fires in Nursing Homes, 9/08 16 NFPA Fire Analysis and Research Division, Quincy, MA

25 For 1999 to 2001, the same rules may be applied, but estimates for these years in this form will be less reliable due to the smaller amount of data originally collected in NFIRS 5.0; they should be viewed with extreme caution. A second option is to omit year estimates for from year tables. NFIRS 5.0 has six categories of confined structure fires, including: cooking fires confined to the cooking vessel, confined chimney or flue fires, confined incinerator fire, confined fuel burner or boiler fire or delayed ignition, confined commercial compactor fire, and trash or rubbish fires in a structure with no flame damage to the structure or its contents. Although causal and other detailed information is typically not required for these incidents, it is provided in some cases. In order for that limited detail to be used to characterize the confined fires, they must be analyzed separately from non-confined fires. Otherwise, the patterns in a factor for the more numerous non-confined fires with factor known will dominate the allocation of the unknown factor fires for both non-confined and confined fires. If the pattern is different for confined fires, which is often the case, that fact will be lost unless analysis is done separately. For most fields other than Property Use, NFPA allocates unknown data proportionally among known data. This approach assumes that if the missing data were known, it would be distributed in the same manner as the known data. NFPA makes additional adjustments to several fields. For Factor Contributing to Ignition, the code none is treated as an unknown and allocated proportionally. For Human Factor Contributing to Ignition, NFPA enters a code for not reported when no factors are recorded. Not reported is treated as an unknown, but the code none is treated as a known code and not allocated. Multiple entries are allowed in both of these fields. Percentages are calculated on the total number of fires, not entries, resulting in sums greater than 100%. Groupings for this field show all category headings and specific factors if they account for a rounded value of at least 1%. Type of Material First Ignited (TMI). This field is required only if the Item First Ignited falls within the code range of NFPA has created a new code not required for this field that is applied when Item First Ignited is in code (organic materials, including cooking materials and vegetation, and general materials, such as electrical wire, cable insulation, transformers, tires, books, newspaper, dust, rubbish, etc..) and TMI is blank. The ratio for allocation of unknown data is: (All fires TMI Not required) (All fires TMI Not Required Undetermined Blank) ) Heat Source. In NFIRS 5.0, one grouping of codes encompasses various types of open flames and smoking materials. In the past, these had been two separate groupings. A new code was added to NFIRS 5.0, which is code 60: Heat from open flame or smoking material, other. NFPA treats this code as a partial unknown and allocates it proportionally across the codes in the range. U.S. Structure Fires in Nursing Homes, 9/08 17 NFPA Fire Analysis and Research Division, Quincy, MA

26 61. Cigarette, 62. Pipe or cigar, 63. Heat from undetermined smoking material, 64. Match, 65. Lighter: cigarette lighter, cigar lighter, 66. Candle, 67 Warning or road flare, fusee, 68. Backfire from internal combustion engine. Excludes flames and sparks from an exhaust system, (11) 69. Flame/torch used for lighting. Includes gas light and gas-/liquid-fueled lantern. In addition to the conventional allocation of missing and undetermined fires, NFPA multiplies fires with codes in the range by All fires in range All fires in range The downside of this approach is that heat sources that are truly a different type of open flame or smoking material are erroneously assigned to other categories. The grouping smoking materials includes codes (cigarettes, pipes or cigars, and heat from undetermined smoking material, with a proportional share of the code 60s and true unknown data. Equipment Involved in Ignition (EII). NFIRS 5.0 originally defined EII as the piece of equipment that provided the principal heat source to cause ignition if the equipment malfunctioned or was used improperly. In 2006, the definition was modified to the piece of equipment that provided the principal heat source to cause ignition. However, the 2006 data is not yet available and a large portion of the fires coded as no equipment involved (NNN) have heat sources in the operating equipment category. To compensate, NFPA treats fires in which EII = NNN and heat source is not in the range of as an additional unknown. To allocate unknown data for EII, the known data is multiplied by All fires (All fires blank undetermined [fires in which EII =NNN and heat source <>40-99]) Additional allocations may be used in specific analyses. For example, NFPA s report about home heating fires treats Equipment Involved in Ignition Code 120, fireplace, chimney, other as a partial unknown (like Heat Source 60) and allocates it over its related decade of , which includes codes for fireplaces ( ) and chimneys ( ) but also includes codes for fireplace insert or stove, heating stove, and chimney or vent connector. More general analyses of specific occupancies may not perform as many allocations of partial allocations. Notes at the end of each table describe what was allocated. Rounding and percentages. The data shown are estimates and generally rounded. An entry of zero may be a true zero or it may mean that the value rounds to zero. Percentages are calculated from unrounded values. It is quite possible to have a percentage entry of up to 100%, even if the rounded number entry is zero. Values that appear identical may be associated with different percentages, and identical percentages may be associated with slightly different values. U.S. Structure Fires in Nursing Homes, 9/08 18 NFPA Fire Analysis and Research Division, Quincy, MA