Current Trends Deaths Associated with Fires, Burns, and Explosions -- New Mexico, 1978-1983

The New Mexico Health and Environment Department (NMHED) examined fire-, burn-, and explosion-associated deaths occurring in the state during 1978-1983. Data were collected from death certificates recorded by the Vital Statistics Bureau of NMHED, death reports from the Office of the Medical Investigator (OMI), and fire-fatality reports from the New Mexico State Fire Marshal's Office. Included were all deaths caused unintentionally by fire and flames (E890-899), explosive material (E923), and hot substance or object, caustic or corrosive material, and steam (E924).* Also included were fire-associated deaths by suicide (E958.1) and assault (E968.1) and of undetermined intent (E988.1). Rates were calculated using 1980 census data for New Mexico. Ninety-four percent of persons whose deaths were coded as above were residents of New Mexico.

During 1978-1983, 204 deaths in New Mexico were identified as caused by fires, burns, or explosions. Of these deaths (identified from all three sources) 196 (97%) were identified in the OMI records; 195 (96%) were identified through death certificates listing cause of death; and 94 (46%) were found in the Fire Marshal records.

The average annual crude mortality rate was 2.6 per 100,000 persons (Table 2). The sex- and age-adjusted death rate for American Indians was twice that for white, non-Hispanics; the rate for persons of Hispanic origin was slightly higher than that for white, non-Hispanics.

Mortality rates varied by age, sex, and urban or rural location as defined by Standard Metropolitan Statistical Areas (SMSAs). The average annual age-adjusted death rate for males (4.0/100,000) was about three times that for females (1.4/100,000). Age-specific mortality rates were similar for males and females up to 14 years of age. Among persons older than 14 years, rates were higher for males than for females, with the highest rates for persons over age 75 years. The average annual death rate in the urbanized SMSAs (1.5/100,000) was 45% of that outside SMSAs (3.3/100,000).

Thirty (15%) of the New Mexico deaths occurred in the workplace, compared with 5%-6% nationally (1). Of the 30, 14 (47%) were caused by gas explosions (Table 3). Fires or explosions involving homes, mobile homes or other structures accounted for 119 deaths. Thirty-two (27%) of these deaths in homes or other structures occurred in mobile and trailer homes, which account for only 12% of year-round housing in New Mexico.

Although not shown here, work-related deaths were equally distributed throughout the year; however, the frequency of nonwork-related deaths during winter months was twice that observed for the summer months.

Cigarette smoking, use of natural or propane gas, and alcohol consumption all contributed to fire-related deaths in New Mexico. Thirty-nine (19%) fire-related deaths were associated with cigarette smoking. Use of natural or propane gas was associated with 30 (15%) deaths. Blood alcohol concentrations (BAC) were measured at hospital admission or autopsy for 128 persons 10 years of age or older; 55 (43%) persons had BACs of 0.1 mg/dl or greater. Reported by GA Conway, MD, formerly of the University of New Mexico School of Medicine, J Smialek, MD, M Starr, Office of the Medical Investigator, Albuquerque, T Langhorst, New Mexico State Fire Marshal's Office, T Ortiz, HF Hull, MD, State Epidemiologist, New Mexico Health and Environment Dept; Div of Injury Epidemiology and Control, Center for Environmental Health, CDC.

Editorial Note

Editorial Note: The distribution of fire-, burn-, and explosion-related death rates by the age and sex of the victim in New Mexico is similar to that seen nationally (2,3). Rates are highest for males, preschool-aged children, and persons over 75 years of age. In addition, the seasonal distribution of deaths is consistent with national patterns. Home fires occur more frequently during winter months when heating is required and more time is spent indoors.

The New Mexico findings show an increased risk of fire-, burn-, and explosion-related deaths among American Indians, compared with that of other racial or ethnic groups. However, the risk for this group is similar to that for persons outside SMSAs. Ninety-five percent of fire-related deaths among American Indians in New Mexico occurred outside SMSAs. Reasons for this increased risk for fire fatality outside SMSAs may include decreased availability and response of fire department services, decreased likelihood of early discovery, less safe structures, and greater use of unsafe heating methods (2).

New Mexico has one of the lowest rates of mortality from house fires (2), possibly because of widespread use of materials other than wood, especially adobe, in home construction. In contrast, persons living in mobile homes in New Mexico have an increased risk of death from fires. Further study of mobile home dwellers would help identify risk factors and would, therefore, help target prevention programs. House-fire fatalities could be reduced by proper installation and maintenance of smoke detectors, regardless of structure type (4-6).

New Mexico has developed a model reporting system for injury surveillance based on collaboration between the state health department and organizations not often recognized as partners in public health. The OMI and Fire Marshal data provided important details surrounding the cause of death and identified 12 fire-related deaths not found by death certificates alone. The OMI in New Mexico is one of the first state medical examiner's offices to develop a computerized data system. As more such offices become computerized, all mortality surveillance, including injury surveillance, should improve.

References

1. National Safety Council. Accident facts, 1983. Chicago: National Safety Council, 1983.

2. Baker SP, O'Neill B, Karpf RS. The injury fact book. Lexington, Massachusetts: Lexington Books, 1984.

3. Feck G, Baptiste MS, Tate CL, Jr. An epidemiologic study of burn injuries and strategies for prevention. Atlanta, Georgia: U.S. Department of Health, Education, and Welfare, Public Health Service, Centers for Disease Control, January 1978.

4. Mierley MC, Baker SP. Fatal house fires in an urban population. JAMA 1983;249:1466-8.

5. McLoughlin E, Marchone M, Hanger SL, German PS, Baker SP. Smoke detector legislation: its effect on owner-occupied homes. Am J Public Health 1985;8:858-62.

6. Smith GS, Falk H, Coleman P. Unintentional injuries intervention strategies and their potential for reducing human losses. A position paper for the Carter Center "closing the gap" project. Atlanta, Georgia: Emory University, 1984. *Based on International Classification of Diseases, 9th Revision. Supplementary Classification of External Cause of Injury.

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