O2053: Pediatric Fire-Related Deaths and Environmental Risk Factors: An Ongoing Retrospective Review of National Fatality Review Case Reporting System (NFR-CRS) Data

Background: This ongoing study explores the National Fatality Review-Case Reporting System (NFR-CRS) as a data source to describe pediatric fire-related residential (FRR ) deaths among children aged 0-17 years during the period 2004 to 2020.

Methods: NFR-CRS data for 2004–2020 were used to identify FRR deaths. FRR deaths were selected from the NFR-CRS if the child’s primary cause of death was a fire that occurred at the child’s home, a relative’s home, or a friend’s home. Frequencies and percentages were calculated to describe child demographics, primary caregiver characteristics, incident circumstances, and family environmental characteristics.

Results: A total of 2,631 children died in residential fires These children were primarily male (55.0%) and White (57.3%); 34.4% were Black. Over three-quarters (77.7%) of children were under the age of 10 years, the highest proportion being aged 1 to 4 years (42.6%). Most incidents occurred at the child’s home (86.4%). The majority of affected homes were single-family houses (51.4%), followed by trailer/mobile homes (18.7%) and multi-unit dwellings (17.3%). Many of these tragic events occurred during the late hours, between 11 pm and 4 am (N= 927, 35.2%), and were predominantly accidental (83.9%). In 51.8% of FRR deaths, more than one child aged 0-18 years was known to have died from the fire. At the time of death, the child’s primary caregiver was typically the childbearing biological parent (75.3%), aged 25-34 (32.9%), female (81.0%), and English-speaking (75.7%).

Among children who died in a residential fire, 22.2% (N=584) had a history of maltreatment. Child death review teams determined that child abuse, neglect, poor/absent supervision, or exposure to hazards caused or contributed to 828 (31.5%) deaths. These deaths encompassed various scenarios: 28 instances (3.4%) of child abuse, 92 (11.1%) of child neglect, 331 (40.0%) of exposure to hazards, and 373 (45.0%) of poor/absent supervision.

Conclusion: This preliminary study explores the NFR-CRS as a data source to describe pediatric FRR deaths among children aged 0-17 years during the period 2004 to 2020.Certain limitations exist regarding the use of NFR-CRS data. The NFR-CRS only includes infant and child deaths reviewed by fatality review teams. Data quality presents another concern, encompassing issues such as inconsistent data, delayed data entry, and overuse of the “Other” specified field, which can impact the overall generalizability of the data.