A high percentage of injuries and fire deaths are from fires caused by smoking. Indicators of fire risk associated with smoking include:

• Burns on carpets, furniture, bedding and clothing
• Evidence of smoking in bed
• Carelessly discarded cigarettes or matches
• Overflowing ashtrays
• Lighters of matches within the reach of children

A person with a physical impairment or limited mobility is not necessarily at greater risk unless a fire occurs. If a fire should occur, they may be slow or unable to vacate the property in a safe and timely manner. Reduced manual dexterity may increase the likelihood of a fire, particularly from smoking or other household activities. For individuals who are bed dependent or bariatric, in the event of a fire, escape may not be an option. The biggest risk to these individuals is from smoke inhalation.

Drug and alcohol dependency or misuse may increase the likelihood of a fire particularly from smoking or other household activities such as cooking as it affects the ability to make safe decisions. It also affects the ability to recognise and respond appropriately in the case of a fire.

Prescription medication can increase the risk of a fire starting, particularly if the individual is a smoker. It can inhibit the ability to vacate the property in a safe and timely manner. This is because it is either designed to, or has side effects, that relax or create calmness, and to help people to sleep.

Mild mental illness with minimal medical intervention does not necessarily increase the risk of fire. More serious diagnosed conditions may lead to stronger medication, and more propensity to consume alcohol, non-prescription drugs and smoking. In some more serious conditions symptoms can include fire setting behaviours.

Dementia is a progressive brain disease that means a person’s ability to make rational cognitive decisions will become more challenging the further along the journey they are. Some of the specific risks and vulnerabilities to fire that the condition creates are:

• Leaving cooking unattended or putting items on cookers or in microwaves that shouldn’t be there
• Understanding the sound of the smoke detector in the event of a fire and taking appropriate action
• Not recognising the property they live in can inhibit an individual’s ability to exit in a safe and timely manner in the event of a fire

Hoarders generally increase fire loading within a property. The hoard can block exit routes which would reduce the ability to exit in a safe and timely manner. It can also affect the firefighter’s ability to tackle the fire because it makes the fire more intense and makes it more difficult to rescue those within the property. The content of the hoard may include hazardous or highly inflammable materials and may be located close to ignition sources such as gas fires or cookers.

Warwickshire Fire and Rescue Service is aware of a number of injuries and fire deaths relating to inappropriate use of portable heaters and/or poor regard to being in close proximity to an open fire, (gas, electric or solid fuel).

The risk factors are similar to those who live with dementia:

• The disability may inhibit their ability to make safe decisions
• They may not remember or retain safety information which could affect their ability to respond to fire and exit in a safe and timely manner
• Due to their vulnerability, they may have inappropriately befriended individuals who undertake risky activities such as taking drugs, smoking and setting fires

A person’s hearing impairment does not, in isolation, make them more at risk of fire. Should there be a fire without the correct type of smoke detection they are more likely to die or be injured. Smoke detection should, where possible, include low frequency sounders, flashing strobes and vibrating pillow pads. Where the individual resides in sheltered type accommodation, consideration should be given to how the alarm system links to the individual’s smoke detector. A visual impairment in isolation does not make an individual more at risk of fire. With appropriate adaptations everyday household tasks can be carried out safely for a person with a visual impairment. However, as they are unable to see smoke, a working smoke detector and escape plan is particularly important, along with the need for clear escape routes.

There is a greater risk of fire from damaged or overloaded electrical sockets. Faulty electric blankets can also be a common cause of fire. Use of cheap electrical chargers and appliances which do not comply with British/European safety standards increases the risk of fire. Always use the correct charger for the equipment/appliance. Risk is also associated with combustibles such as clothing or newspapers/magazines being placed over, or too close to, electrical equipment and sockets.

Dynamic-flow pressure relieving mattresses (and overlays placed on top of standard mattresses) are provided for the prevention and treatment of pressure ulcers for people who spend extended periods of time in bed. The mattresses/overlays are filled with air via a pump. These systems use dynamic controlled air pressure cells to constantly adjust the mattress/overlay in response to the person’s needs. If the mattress is punctured and loses air, the pump reacts by increasing the flow of air produced which increases the risk of death or injury as it fuels a fire. The mattress pump also contains a battery back-up, so if the electricity supply fails, the pump continues to discharge compressed air.

Emollient creams are applied to the skin to treat conditions such as eczema and psoriasis. Their use is common for people who spend extended periods of time in bed due to illness or impaired mobility. Many emollient creams are paraffin based and the use of such creams can result in bedding, dressings and clothing becoming impregnated with paraffin. These items can easily ignite when bought into contact with naked flames i.e., smoking, candles, gas fires and cookers. Non-oil or paraffin based emollient creams should be considered.

Older people and those with severely reduced mobility are at greater risk due to the flammability of incontinence care products. This could also affect the ability to exit a fire incident in a safe and timely manner.

Oxygen is highly explosive when exposed to a naked flame or dirt and grease. Use of medical oxygen if often associated with smoking related lung diseases and users often continue to smoke. The oxygen rich atmosphere stays within clothing and furnishings creating an increased risk of rapid fire spread which is a particular risk for smokers. The presence of medical oxygen cylinders poses a risk to fire fighters and the user in the event of a fire because the heat from the fire may cause the cylinders to explode.

Analysis of accidental house fires shows that people who live alone are more at risk from fire (this is likely to be because one or more of the risk and vulnerability factors above are present).

Smoke detectors do not prevent a fire from occurring. They provide the earliest possible warning, in the event of a fire, to give the best possible chance of exiting the property safely. Fire and Rescue Services recommend that all homes have a working smoke detector on each level.