AIM—To determine theprevalence of and predictors for installed, functioning smoke alarms incouncil (public) housing in a low income, multi-ethnic urban area. DESIGN—Cross sectional study. SETTING—40 materiallydeprived electoral wards in two inner London boroughs. PARTICIPANTS—Occupantsof 315 addresses randomly selected from council housing lists, with75% response rate. MAIN OUTCOMEMEASURES—Installation and function of smoke alarmsbased on inspection and testing. RESULTS—39% (95%confidence interval (CI) 33% to 46%) of council tenants owned a smokealarm, 31% (95% CI 25% to 38%) had an installed alarm (of which54% were correctly installed), and 16% (95% CI 12% to 22%) had atleast one installed, functioning alarm. Alarms most commonly failedbecause they lacked batteries (72%). In multivariate modelling, havingan installed, functioning alarm was most strongly associated withliving in a house versus a flat (apartment) (odds ratio (OR) 3.2, 95%CI 1.1 to 10.0), having two resident adults versus one (OR 2.8, 95% CI1.2 to 6.5), and recognising stills from a Home Office television smokealarm campaign (OR 2.4, 95% CI 1.1 to 5.5). CONCLUSIONS—Fires area leading cause of child injury and death, particularly among thoseyounger than 5 years of age and those in social classes IV and V. Smokealarms are associated with a significantly reduced risk of death inresidential fires, and are more protective in households with youngchildren. Few council properties in a multi-ethnic, materially deprivedurban area had any installed, functioning smoke alarms, despite a highrisk of residential fires and fire related injuries in such areas.Effective methods to increase the prevalence of installed andfunctioning alarms must be identified.
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