Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2000 May;82(5):341–348. doi: 10.1136/adc.82.5.341

Systematic review of controlled trials of interventions to promote smoke alarms

C DiGuiseppi 1, J Higgins 1
PMCID: PMC1718310  PMID: 10799419

Abstract

AIMS—To evaluate the effects of promotion of residential smoke alarms.
METHODS—Electronic databases, conference proceedings, and bibliographies were systematically searched, and investigators and organisations were contacted, in order to identify controlled trials evaluating interventions designed to promote residential smoke alarms. The following were assessed: smoke alarm acquisition, ownership, and function; fires; burns; and fire related injuries. Odds ratios (OR) were estimated by meta analysis of randomised trials.
RESULTS—A total of 26 trials were identified, of which 13 were randomised. Overall, counselling and educational interventions had only a modest effect on the likelihood of owning an alarm (OR = 1.26; 95% confidence interval (CI): 0.87 to 1.81) or having a functional alarm (OR = 1.19; 95% CI: 0.85 to 1.66). Counselling as part of primary care child health surveillance had greater effects on ownership (OR = 1.93; 95% CI: 1.04 to 3.58) and function (OR = 1.72; 95% CI: 0.78 to 3.78). Results were sensitive to trial quality, however, and effects on fire related injuries were not reported. In two non-randomised trials, direct provision of free alarms significantly increased functioning alarms and reduced fire related injuries. Media and community education showed little benefit in non-randomised trials.
CONCLUSION—Counselling as part of child health surveillance may increase smoke alarm ownership and function, but its effects on injuries are unevaluated. Community smoke alarm give away programmes apparently reduce fire related injuries, but these trials were not randomised and results must be interpreted cautiously. Further efforts to promote smoke alarms in primary care or through give away programmes should be evaluated by adequately designed randomised controlled trials measuring injury outcomes.



Full Text

The Full Text of this article is available as a PDF (149.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bass J. L., Christoffel K. K., Widome M., Boyle W., Scheidt P., Stanwick R., Roberts K. Childhood injury prevention counseling in primary care settings: a critical review of the literature. Pediatrics. 1993 Oct;92(4):544–550. [PubMed] [Google Scholar]
  2. Bass J. L., Mehta K. A., Ostrovsky M. Childhood injury prevention in a suburban Massachusetts population. Public Health Rep. 1991 Jul-Aug;106(4):437–442. [PMC free article] [PubMed] [Google Scholar]
  3. Ciliska D., Hayward S., Thomas H., Mitchell A., Dobbins M., Underwood J., Rafael A., Martin E. A systematic overview of the effectiveness of home visiting as a delivery strategy for public health nursing interventions. Can J Public Health. 1996 May-Jun;87(3):193–198. [PubMed] [Google Scholar]
  4. Clamp M., Kendrick D. A randomised controlled trial of general practitioner safety advice for families with children under 5 years. BMJ. 1998 May 23;316(7144):1576–1579. doi: 10.1136/bmj.316.7144.1576. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. DerSimonian R., Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2. [DOI] [PubMed] [Google Scholar]
  6. DiGuiseppi C., Roberts I. Injury mortality among children and teenagers in England and Wales, 1992. Inj Prev. 1997 Mar;3(1):47–49. doi: 10.1136/ip.3.1.47. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. DiGuiseppi C., Roberts I., Li L. Smoke alarm ownership and house fire death rates in children. J Epidemiol Community Health. 1998 Nov;52(11):760–761. doi: 10.1136/jech.52.11.760. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dickersin K., Scherer R., Lefebvre C. Identifying relevant studies for systematic reviews. BMJ. 1994 Nov 12;309(6964):1286–1291. doi: 10.1136/bmj.309.6964.1286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Easterbrook P. J., Berlin J. A., Gopalan R., Matthews D. R. Publication bias in clinical research. Lancet. 1991 Apr 13;337(8746):867–872. doi: 10.1016/0140-6736(91)90201-y. [DOI] [PubMed] [Google Scholar]
  10. Guyer B., Gallagher S. S., Chang B. H., Azzara C. V., Cupples L. A., Colton T. Prevention of childhood injuries: evaluation of the Statewide Childhood Injury Prevention Program (SCIPP). Am J Public Health. 1989 Nov;79(11):1521–1527. doi: 10.2105/ajph.79.11.1521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hauck W. W., Gilliss C. L., Donner A., Gortner S. Randomization by cluster. Nurs Res. 1991 Nov-Dec;40(6):356–358. [PubMed] [Google Scholar]
  12. Jenkins H. M., Blank V., Miller K., Turner J., Stanwick R. S. A randomized single-blind evaluation of a discharge teaching book for pediatric patients with burns. J Burn Care Rehabil. 1996 Jan-Feb;17(1):49–61. [PubMed] [Google Scholar]
  13. Kelly B., Sein C., McCarthy P. L. Safety education in a pediatric primary care setting. Pediatrics. 1987 May;79(5):818–824. [PubMed] [Google Scholar]
  14. Kendrick D., Marsh P., Fielding K., Miller P. Preventing injuries in children: cluster randomised controlled trial in primary care. BMJ. 1999 Apr 10;318(7189):980–983. doi: 10.1136/bmj.318.7189.980. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. MacKay A. M., Rothman K. J. The incidence and severity of burn injuries following Project Burn Prevention. Am J Public Health. 1982 Mar;72(3):248–252. doi: 10.2105/ajph.72.3.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mallonee S., Istre G. R., Rosenberg M., Reddish-Douglas M., Jordan F., Silverstein P., Tunell W. Surveillance and prevention of residential-fire injuries. N Engl J Med. 1996 Jul 4;335(1):27–31. doi: 10.1056/NEJM199607043350106. [DOI] [PubMed] [Google Scholar]
  17. Marshall S. W., Runyan C. W., Bangdiwala S. I., Linzer M. A., Sacks J. J., Butts J. D. Fatal residential fires: who dies and who survives? JAMA. 1998 May 27;279(20):1633–1637. doi: 10.1001/jama.279.20.1633. [DOI] [PubMed] [Google Scholar]
  18. McLoughlin E., Vince C. J., Lee A. M., Crawford J. D. Project Burn Prevention: outcome and implications. Am J Public Health. 1982 Mar;72(3):241–247. doi: 10.2105/ajph.72.3.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Miller R. E., Reisinger K. S., Blatter M. M., Wucher F. Pediatric counseling and subsequent use of smoke detectors. Am J Public Health. 1982 Apr;72(4):392–393. doi: 10.2105/ajph.72.4.392. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Munro J., Coleman P., Nicholl J., Harper R., Kent G., Wild D. Can we prevent accidental injury to adolescents? A systematic review of the evidence. Inj Prev. 1995 Dec;1(4):249–255. doi: 10.1136/ip.1.4.249. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Murray D. M., Rooney B. L., Hannan P. J., Peterson A. V., Ary D. V., Biglan A., Botvin G. J., Evans R. I., Flay B. R., Futterman R. Intraclass correlation among common measures of adolescent smoking: estimates, correlates, and applications in smoking prevention studies. Am J Epidemiol. 1994 Dec 1;140(11):1038–1050. doi: 10.1093/oxfordjournals.aje.a117194. [DOI] [PubMed] [Google Scholar]
  22. Ploeg J., Black M. E., Hutchison B. G., Walter S. D., Scott E. A., Chambers L. W. Personal, home and community safety promotion with community-dwelling elderly persons: response to a public health nurse intervention. Can J Public Health. 1994 May-Jun;85(3):188–191. [PubMed] [Google Scholar]
  23. Roberts I. Smoke alarm use: prevalence and household predictors. Inj Prev. 1996 Dec;2(4):263–265. doi: 10.1136/ip.2.4.263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Runyan C. W., Bangdiwala S. I., Linzer M. A., Sacks J. J., Butts J. Risk factors for fatal residential fires. N Engl J Med. 1992 Sep 17;327(12):859–863. doi: 10.1056/NEJM199209173271207. [DOI] [PubMed] [Google Scholar]
  25. Schulz K. F., Chalmers I., Hayes R. J., Altman D. G. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995 Feb 1;273(5):408–412. doi: 10.1001/jama.273.5.408. [DOI] [PubMed] [Google Scholar]
  26. Schwarz D. F., Grisso J. A., Miles C., Holmes J. H., Sutton R. L. An injury prevention program in an urban African-American community. Am J Public Health. 1993 May;83(5):675–680. doi: 10.2105/ajph.83.5.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Thomas K. A., Hassanein R. S., Christophersen E. R. Evaluation of group well-child care for improving burn prevention practices in the home. Pediatrics. 1984 Nov;74(5):879–882. [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES