03Evidence B

Install smoke alarms; those heating with coal or gas in winter should also add a carbon monoxide alarm

A properly functioning smoke alarm can cut the risk of dying in a home fire by roughly 60%. Forty percent of fire victims are asleep at the time, so they won’t wake up just from the smell of smoke. For anyone heating their home with coal or gas during winter, adding a carbon monoxide alarm is essential. In China, 11,500 people died from carbon monoxide poisoning in 2018; 70% of those deaths occurred at home during the three winter months.

Cost

A smoke alarm costs between 30 and 100 yuan. A carbon mono…

Benefit

A study in North Carolina examined homes that had experienced fires versus those that hadn’t. It found that ha…

Cost

A smoke alarm costs between 30 and 100 yuan. A carbon monoxide alarm costs between 50 and 150 yuan. After installation, the batteries need to be replaced once a year.

Benefit

A study in North Carolina examined homes that had experienced fires versus those that hadn’t. It found that having a working smoke alarm lowered the death risk by about 60%. The odds ratio was 0.39, with a 95% confidence interval ranging from 0.18 to 0.83. Between 2018 and 2020, 24% of fatal residential fires in the U.S. happened in homes without smoke alarms, and 41% of victims were asleep when the fire started. In 2018, China reported 11,523 deaths from carbon monoxide poisoning; of these, 72.59% occurred at home in December, 67.42% in January, and 66.48% in February.

Original sources

Marshall SW 等 (1998). Fatal residential fires: who dies and who survives? JAMA. https://doi.org/10.1001/jama.279.20.1633 ; USFA (2022). Fatal Fires in Residential Buildings (2018-2020), Topical Fire Report Series 22(2). https://www.usfa.fema.gov/downloads/pdf/statistics/v22i2.pdf ; You J 等 (2020). Number of Deaths due to Carbon Monoxide Poisoning by Month and by Place of Death — China, 2018. China CDC Weekly. https://doi.org/10.46234/ccdcw2020.008

Open source link
Book note

This grade is assigned because only one study exists on smoke alarms; it compared past fire incidents in various homes rather than using a randomized trial design. No research has shown that carbon monoxide alarms reduce mortality rates. The reported benefits are inferred from the fact that most poisoning deaths happen at home during winter.

My note