FIRE RISKS FOR THE BLIND OR VISUALLY IMPAIRED 
OCTOBER 1999 

This publication was produced by TriData Corporation under subcontract to Ogilvy 
Public Relations Worldwide for the United States Fire Administration. 

Fire Risks for the Blind or Visually Impaired 

CONTENTS 

OVERVIEW OF THE 'FIRE RISKS' SERIES...... 1 
EXECUTIVE SUMMARY........... 3 
INTRODUCTION..... 5 
BLINDNESS AND VISUAL IMPAIRMENT IN THE UNITED STATES....... 7 
Causes of Blindness and Visual Impairment ....... 7 
Population Estimates .......... 10 
Demographics....... 11 
FIRE RISKS............. 13 
The Loss of Sight .. 13 
Public Fire Education.... 14 
Newly Blind or Visually Impaired People....... 16 
Residence..... 16 
FIRE SAFETY FOR SPECIAL-NEEDS POPULATIONS: TIPS FOR FIRE SERVICE 
PROFESSIONALS........ 19 
Recommendations for Assisting the Blind or Visually Impaired Population in an 
Evaluation of Their Fire Safety Needs....... 19 
Building Design and Codes ... 21 
Instructional Materials....... 23 
CONCLUSIONS......... 25 
APPENDIX: FIRE SAFETY TIPS FOR BLIND OR VISUALLY IMPAIRED 
PEOPLE.................. 27 
REFERENCES 

Fire Risks for the Blind or Visually Impaired 1 

OVERVIEW OF THE 'FIRE RISKS' SERIES 

This report is one in a series of four that discuss the increased fire risks for 
four groups of the general population: 

 Older adults 
 The mobility impaired 
 The deaf or hard of hearing 
 The blind or visually impaired. 

Older adults-those over 65 years of age- represent one of the highest fire risk 
groups in the United States, in large part because they are the fastest growing 
segment of the U. S. population. Of course, many older adults may also fall into 
the other three groups since the elderly suffer some or all of these impairments 
to a much greater degree than does the general population. 

People who are deaf or have hearing impairments, those who are blind or have 
vision impairments, and those with mobility impairments may face unique 
challenges in an emergency. Their ability to detect a fire or escape its effects 
may be hindered by their impairments. As a result, people with these impairments 
are at a greaterrisk of death or injury due to fire. 

As might be expected, many of the fire safety issues are of concern for all four 
groups. This commonality is reflected in the reports, particularly in the fire 
safety tips, most of which apply to all the groups. These safety tips are 
presented in an appendix at the end of each report, organized in three sections: 
before the fire, during the fire, and fire prevention. The tips that are common 
to all four groups are summarized here: 

Before the Fire 

 Identify the nearest fire exit 
 Install smoke alarms 
 Live near an exit 

Fire Risks for the Blind or Visually Impaired 2 

 Plan and practice escape plans 
 Involve the fire department 

During the Fire 

 Get out and stay out 
 Test doors before opening them 
 Stay low and go 
 What to do if you are trapped 
 Stop, drop, and roll 

Fire Prevention 

 Cooking 
 Electrical safety 
 Smoking 
 Space heaters 
 Heating 
 Fireplaces 

Fire Risks for the Blind or Visually Impaired 3 

EXECUTIVE SUMMARY 

Blind or visually impaired people are faced with many challenges, not the least 
of which is personal safety. Interaction with an environment one cannot see 
creates potential health and safety hazards. As a result, blind or visually 
impaired people are at increased risk of injury and death in the event of a 
fire. Depending on the severity of vision loss, they may be more likely to 
ignite a fire accidentally through common household activities, while they are 
less likely to extinguish or escape one. Further, a blind or visually impaired 
individual is highly vulnerable to sustaining burns by attempting to suppress a 
small fire. 

Practicing fire safety is the most effective means for a blind or visually 
impaired person to improve his or her chances of surviving a fire. For example, 
by planning and practicing an escape plan, a blind or visually impaired person 
can escape to safety, in the event of an actual emergency, with little time lost 
searching and feeling for an exit. The same general fire safety tips targeted at 
the seeing population address the needs of the blind or visually impaired. 
Unfortunately, blind or visually impaired people often have been overlooked by 
public fire education campaigns. Innovative mechanisms by which to disseminate 
these life-saving messages must be sought in order to raise awareness and foster 
fire safety practices in the blind and visually impaired community. 

The most important findings of this report are as follows: 

 During an emergency, the senses on which visually impaired or blind 
individuals depend may be overwhelmed. 
 High-decibel smoke alarms make it difficult for the blind individual to 
process audible clues and instructions effectively. 

Fire Risks for the Blind or Visually Impaired 4 

 Many buildings are not equipped with Braille or tactile signage for the 
visually impaired, hindering the individual's ability to escape because of lack 
of directions. 
 As they may not be able to process visual indicators of fire, individuals with 
visual impairments are at an increased risk for accidents involving fires and 
burn injuries. 
 Public fire education is not generally formatted for, nor directed to, the 
blind or visually impaired. 
 Practicing fire safety, rather than using improved fire technology, is the 
most effective means by which blind or visually impaired people can improve 
their chances of surviving a fire. 

Fire Risks for the Blind or Visually Impaired 5 

INTRODUCTION 

People who are blind or visually impaired live in a world without images or, at 
best, unclear ones. For people with sight, the sense of vision is the primary 
means for assessing and interpreting clues in the external environment. As 
images are transferred to the brain, we react both physically and emotionally to 
what we see. Without sight, secondary senses evolve into the medium for 
assessing the external environment. Those who have been blind or visually 
impaired for several years generally learn to adapt and hone their remaining 
senses to allow for largely independent living in a society that sees. 

The Americans With Disabilities Act (ADA) mandates that employers and owners of 
public facilities provide reasonable accommodation to people of all disabilities 
(Reference 1). Federal regulations require that documents and public markings be 
made available in formats that can be used by people who are blind or visually 
impaired. Seeing-eye dogs are permitted in all public accommodations, and 
employers cannot discriminate against blind workers as long as they can perform 
the necessary duties with "reasonable accommodation" (Reference 1). 

There is little knowledge on the actual number of fire deaths and injuries among 
people with vision impairments, primarily because of lack of reporting and 
reporting mechanisms. Neither of the two national sources for fire death data- 
the National Center for Health Statistics (NCHS) and the National Fire Incident 
Reporting System (NFIRS)- provides for data collection of ancillary infor-mation 
on the deceased. The U. S. Fire Administration's NFIRS specifically provides a 
forum for both civilian fire death and fire injury data to be collected, 
analyzed, and interpreted; however, it does not contain an entry for the 
presence of physical disabilities. Available fire death and injury data 
regarding individuals with physical impairments must be viewed with this caveat 
in mind. 

Fire Risks for the Blind or Visually Impaired 6 

The blind and visually impaired must take extra precautions when it comes to 
health and safety, and especially fire safety. Few assistive devices will 
provide better protection to a blind individual than self-initiated life safety 
practices. This segment of the population must always be prepared to react 
swiftly in a fire emergency, for precious time may be lost if fire safety steps 
that compensate for their lack of sight are not taken. Recognition of, and 
subsequent planning for, the potential fire safety dangers that are unique to 
blind and visually impaired individuals can help to preserve a person's life in 
a fire emergency. 

This report is divided into three principal sections. The first section 
discusses the primary causes of vision loss along with current and projected 
estimates of the number of Americans who are blind or visually impaired. The 
demographic characteristics for blind and visually impaired populations are 
reviewed as well. 

The second section of this report focuses on the characteristics of blind and 
visually impaired individuals that place them at risk for injuries, especially 
fire-related injuries. 

The final section provides tips to fire service professionals for enhancing fire 
safety for people with disabilities. A reproduction-ready appendix presents fire 
safety tips. Fire service professionals may photocopy the appendix for use in 
public education activities. 

Fire Risks for the Blind or Visually Impaired 7 

BLINDNESS OR VISUAL IMPAIRMENT IN THE UNITED STATES 

Causes of Blindness and Visual Impairment 

Blindness and visual impairment result from a variety of causes, including 
traumatic eye injuries, pathogenic infections, and complications associated with 
progressive illness. Many people who have experienced vision loss initially feel 
anger, then grief, and finally depression (Reference 2). An individual who 
permanently loses use of any sense usually progresses through the same emotional 
stages as a person who has suffered the loss of a loved one. Moreover, lengthy 
depressions are not uncommon (Reference 2). 

Many causes of blindness are preventable through routine eye exams and early 
intervention. Four conditions- macular degeneration, cataracts, diabetic 
retinopathy, and glaucoma- are responsible for a significant portion of 
blindness and vision loss in this country (Reference 3). These conditions are 
often preventable or treatable, if diagnosed in their early stages. 

Macular degeneration is a degenerative disease commonly associated with the 
aging process that affects the macula, a small spot in the central area of the 
retina located at the back of the eye. The macula is responsible for sight in 
the center of the field of vision and is the most sensitive part of the retina. 
Macular degeneration is the leading cause of legal blindness in people over age 
50. Visual characteristics of the disease include the inability to see straight 
lines in the field of vision. Telephone poles, the sides of buildings and 
streetlight posts appear wavy; type in books, magazines, and newspapers appears 
blurry; and dark or empty spaces may block the center of the field of vision 
(Reference 4). 

A cataract is a clouding of the eye's lens. The role of the lens is to help 
focus images onto the retina at the back of the eye, which then transmit the 
images to the brain. Clouding blocks or changes 

Fire Risks for the Blind or Visually Impaired 8 

the passage of light needed for vision. If images cannot be trans-mitted through 
an ordinarily transparent lens, images received in the brain may become blurred 
(Reference 5). Cataracts are a leading cause of blindness among adults in the 
United States and account for nearly half of all cases of blindness worldwide 
(Reference 6). Although most prevalent in adults, cataracts can occur in young 
people and are sometimes even found in a baby's eyes at birth. As medical 
advances have succeeded in lengthening the human life span, more and more 
Americans will be entering the age group as-sociated with the development of 
cataracts. It has been shown that if we live long enough, most of us will 
develop a cataract (Reference 7). The symptoms of cataracts include blurred 
vision, double vision, and ghost images; the impression of a "film" over the 
eyes; problems with light, such as finding lights not bright enough for reading 
or near work, or being "dazzled" by intense light; and the need for frequent 
changes of eyeglass prescriptions, which may not improve vision (References 4 
and 8). 

Diabetic retinopathy is an eye disease in which the small blood vessels in the 
retina become weak and break down or become blocked (Reference 5). The longer a 
person has diabetes, the greater the risk of developing this condition. In fact, 
diagnosis of diabetic retinopathy is often the first clue that an individual has 
developed diabetes. More than 40 percent of those who have had diabetes for 15 
or more years have some blood vessel damage in the retina (Reference 9). The 
most serious result of the disease is severe vision loss or blindness. However, 
the disease is not limited to long-term diabetics; it can appear within the 
first year or two after the onset of the disease. Early treatment of diabetic 
retinopathy often improves the potential for saving sight (Reference 9). 

Glaucoma is a condition in which the optic nerve is damaged by increased 
pressure within the eye. This pressure causes damage that progressively worsens, 
leading initially to the loss of peripheral vision, then the diminution of 
central vision, and eventually blind-

Fire Risks for the Blind or Visually Impaired 9 

ness. An estimated 15 million Americans have glaucoma, a leading cause of 
blindness- 150,000 new cases per year in the United States (Reference 4). The 
disease may not produce any noticeable symptoms; thus, individuals may not even 
be aware they have it. African Americans are four to five times more likely than 
Cauca-sians to develop glaucoma; other risk factors include genetics (being 
related to someone with glaucoma), age (over 50 if Caucasian and over 35 if 
African American), nearsightedness, and diabetes (Reference 10). Treatments are 
available to reduce the risk of glaucoma resulting in blindness (References 5 
and 10). 

Changes in the tissue of the eye make individuals more sus-ceptible to diseases 
of the eye as they age. As a result, vision loss is often considered to be a 
normal function of the aging process- a misperception that is reinforced by the 
prevalence of vision prob-lems in the elderly (Reference 5). Studies have shown 
that these problems are not unique to the aged and are usually treatable 
(References 11 and 12). Common problems encountered as a result of the aging of 
eye tissues include (Reference 13): 

 Requiring more light to see. 
 Difficulty distinguishing between some colors, particularly shades of blue and 
green. 
 Difficulty focusing on things that are near. 
 Difficulty adjusting to glare and darkness. 

The leading causes of blindness will have a greater impact in the coming years 
as the Nation's baby boomers reach retirement age. The expected dramatic 
increase in age-related eye disease threatens to diminish the quality of life 
for millions. In fact, by the year 2030, twice as many people will be blind as 
there are today (Reference 13); macular degeneration will continue to be the 
leading cause of blindness, and there will be a near doubling of the total cases 
of glaucoma (Reference 13). 

Fire Risks for the Blind or Visually Impaired 10 

Population Estimates 

Estimates of the numbers of people who are either visually impaired or legally 
blind vary greatly. For example, the American Foundation for the Blind estimates 
that there are between 10 and 12 million persons with visual impairments, while 
the American Council of the Blind's estimate is 19 million. According to the 
CDC, there are approximately 8 million Americans with visual impairments 
(Reference 14). 

Legal blindness indicates a degree of loss of visual acuity that prevents an 
individual from performing work that requires eyesight. In the United States, 
this is defined as corrected visual acuity of 20/ 200 or less, or a visual field 
of 20 degrees or less in the better eye (Reference 4). 

Estimating the exact size of the blind and visually impaired population is 
difficult and depends on a number of factors. The majority of estimates are 
derived from the results of the National Center for Health Statistics' National 
Health Interview Survey. This survey samples American households, and results 
are dependent on individual interpretation and participation. Since vision 
impairment statistics are usually collected though surveys, and are thus highly 
subjective, many agencies are reluctant to accept them fully. The definition of 
legally blind is the only widely accepted definition for blindness; however, 
most surveys do not rely on this quantitative measurement. Surveys often use a 
time limit or duration of vision loss that does not reflect transient 
disturbances in vision. As a result, temporary vision loss as a result of an 
accident, surgery, or medication may be erroneously recorded as long-term vision 
loss or not recorded at all. Vision disturbances may go unnoticed and ignored 
for several years (Reference 15). Many individuals of lower socioeco-nomic 
status cannot afford vision care or regular eye examinations that may detect 
subtle changes in vision (Reference 16). 

Fire Risks for the Blind or Visually Impaired 11 

Demographics 

Age, race, and economic standing appear to play significant roles in progressive 
visual impairments. Age factors predominantly in the incidence of blindness and 
vision loss (Reference 17). Approximately 70 percent of the population over the 
age of 65 have a severe visual impairment (Reference 17), while only about 4 
percent of the people with visual impairments are under the age of 18 (Reference 
18). Most cases of juvenile blindness are the result of congenital defects, 
premature birth, or febrile illnesses (Reference 18). They make up a small 
portion of the blind and visually impaired population in comparison with older 
adults who naturally ex-perience deteriorating eyesight (Reference 18). 

Race may indirectly affect the incidence of visual disturbances by predisposing 
an individual to an illness or disorder that commonly leads to vision loss. For 
example, African Americans have high incidence rates of hypertension and Type II 
diabetes (Reference 5). Consequently, the rate of vision impairment related to 
glaucoma and diabetic retinopathy is also high (Reference 19). However, there is 
no evidence of a direct link between race and poor vision. 

Socioeconomic standing may be the most easily modified risk factor for diseases 
of the eye and subsequent blindness. Individuals of low income and poor 
education cannot afford or gain access to the same health and medical benefits 
that more affluent Americans enjoy. They are less likely to have insurance and 
even less likely to participate in preventative checkups that help to diagnose 
debilitating conditions early in their progression- as evidenced by the 
association of vision loss with systemic chronic conditions often unrecognized 
in poor populations (Reference 16). Race may appear to be an independent factor 
in conditions causing blindness; however, studies have shown that the 
association between minorities and low 
socioeconomic standing may be more relevant (Reference 15). 

Fire Risks for the Blind or Visually Impaired 13 

FIRE RISKS 

The Loss of Sight 

Sight is the primary sense for processing information contained in the 
environment. Loss of this sense may predispose an individual to ignite a fire 
accidentally or sustain an injury from an already lit fire. Further, people who 
are blind or visually impaired may be more susceptible to cooking accidents or 
leaving a heater too close to a flammable object. 

To a blind or visually impaired person, the first indication of a fire will 
usually be the smell of smoke and accompanying sense of heat emanating from the 
fire. Unable to see exactly where the fire has originated, the visually impaired 
individual is less likely to be able to extinguish even a small fire. Otherwise 
easily extinguished flames can quickly become a serious threat. 

Also dangerous is the impact that the loss of sight has on the ability to escape 
a fire. Relying heavily on auditory clues, the blind or visually impaired 
individual must be able to react and respond to a sounding smoke alarm. If the 
individual has planned and practiced two escape routes from each room in the 
home, the chances of surviving a fire are improved. Complications arise, 
however, when the blind or visually impaired individual is in a foreign 
environment, such as a hotel, hospital, or new nursing facility. Tactile or 
high-contrast markings designating exits are not always available. Inability to 
locate an escape route can waste the few precious minutes before smoke and toxic 
fumes can overcome an individual. 

The same can be true for individuals who have only recently lost their sight. 
Unaccustomed to relying primarily on their sense of hearing, these individuals 
have not yet perfected the ability to process auditory clues quickly. Reverting 
to basic tactile assessment of the environment, an individual could come into 
contact with a hot door or even an open flame hidden around a corner. Continuous 

Fire Risks for the Blind or Visually Impaired 14 

high-decibel smoke alarms may inhibit the blind person's ability to hear and 
process auditory clues from rescue personnel, neighbors, or others close by. 

Visually impaired individuals are at risk from injuries from fires that would 
not necessarily harm sighted individuals. The most common cause of residential 
fires is cooking (Reference 20). Many of these fires start when food cooking on 
the stove or in the oven ignites. Cooking fires on the stove are often easily 
extinguished by removing the pan from the heat source or by placing a lid over 
it. Oven fires can often be extinguished by reducing or eliminating the heat or 
by simply closing the oven door to restrict the flow of oxygen. Because visually 
impaired persons may not be able to recog-nize the early signs of a fire, his or 
her response to the danger may be slowed. 

Public Fire Education 

Public fire education has made great strides in this country and in nations 
around the world. Fire is a universal problem that can be reduced and even 
prevented through concerted educational efforts. Although fire affects all 
people, certain groups are more vulnerable and subsequently at higher risk of 
injury and death than others. Young children and older adults are the two groups 
with the greatest risk of dying in a fire. Accordingly, they are the target of 
much public fire education and attention. Through widespread educational 
campaigns, various fire service advocacy groups and public safety agencies 
disseminate vital fire safety tips to these groups as well as their caregivers. 
These efforts have resulted in increased fire safety awareness in these 
populations. 

Although people who are blind or visually impaired have high risk of injury or 
death from fire, they are not typically targeted by fire education. Typically, 
the presence or degree of disability of a fire victim is not reported and, 
consequently, not recorded in the datasets. Therefore, it is hard to assess the 
degree to which a per-

Fire Risks for the Blind or Visually Impaired 15 

son's disability plays a role in his or her becoming a casualty. Since these 
correlations are not readily available, targeted programs may not be delivered 
when and where they should be. 

Public education efforts seeking to modify the behavior of an individual are the 
best means for the blind and visually impaired to decrease their chances of 
injury in a fire. In contrast to fire technology and engineering practices that 
address the needs of other disabilities, such as hearing loss and mobility 
impairment, relatively few devices currently exist to improve the safety of 
people who are blind or visually impaired. Awareness of the unique risks posed 
by the loss of sight and the importance of fire safety practices is the best way 
to diminish the fire risk posed to the visually impaired population. 

Most fire safety technology is based on the assumption that an individual has 
the ability to hear- a sharpened sense in the blind population. In fact, smoke 
alarms were designed on the premise that visual warnings are not the most 
effective means to alert someone of a fire. Furthermore, heavy smoke emanating 
from a fire has the potential to reduce or eliminate visibility. Not being able 
to see should not hinder hearing an audible smoke alarm, crawling low on the 
floor, and escaping to safety. More important, committing these actions to 
memory will serve as an instinctual map to safety. 

Public education efforts through the mainstream media may not always reach the 
blind and visually impaired populations. Through market research and discussions 
with focus groups (Reference 21), it has been found that radio is the most 
effective medium for disseminating public safety messages to the blind and 
visually impaired. Consequently, public service announcements (PSAs) should be 
created for, and disseminated to, those radio stations that are only available 
to people who are blind or visually impaired and who have special FCC decoders. 
PSAs may also be included in audio tapes of books and newspapers used by this 
population (Reference 21). 

Fire Risks for the Blind or Visually Impaired 16 

Blind children do not always have access to the same educational materials that 
sighted children do. Certain fire safety messages are applicable to all 
populations, regardless of the presence of a disability. Special editions of 
children's public education materials (such as Smoky the Bear, Sparky the Dog, 
and E.D.I.T.H.) should be produced for blind and visually impaired children. 
Those materials stressing escape drills are especially important to these 
children. 

Newly Blind or Visually Impaired People 

Those who have recently lost either all or a significant portion of their sight 
must undergo a long and arduous process of learning to live with limited (or no) 
sight. A world that was once familiar is now foreign. These individuals must 
relearn basic activities of functional life, such as cooking, eating, dressing, 
and even reading the newspaper (Reference 22). Many therapists and trainers for 
disability and blindness organizations offer assistance throughout this process. 
One area often overlooked is fire safety practices. Developing and practicing a 
fire escape plan is more important to a newly blind or visually impaired 
individual than to someone who has been blind or visually impaired since birth 
or for many years. 

Residence 

The majority of visually impaired persons live in standard private residences or 
with their families in the community. Approximately 30 percent of nursing home 
residents are visually impaired (Reference 23). Board and care facilities and 
nursing homes present significant fire risks, especially to those requiring 
assistance in an emergency. The majority of these facilities are staffed with 
medical personnel; the residents, however, typically greatly outnumber the staff 
(Reference 24). 

A fire emergency places residents of nursing facilities at significant risk for 
a variety of reasons. Any one of these hazards can foster fire growth: 

Fire Risks for the Blind or Visually Impaired 17 

 Nursing and group living homes are often designed with large, open-air living 
spaces that can facilitate the spread of smoke and toxic gases (Reference 25). 
In a study of fires occurring in nursing home facilities, most of the injuries 
and deaths were attributed to relatively small fires that produced toxic fumes 
before the detection or suppression devices 
were activated (Reference 26). 
 Many older nursing homes have been built with limited means for egress, 
combustible interior finishes, and a lack of automatic sprinkler systems 
(References 25 and 26). 
 Nursing homes typically have other fire hazards such as oxygen, flammable 
liquids and gases, electrical equipment, and careless smokers. 

The residents of nursing homes outnumber the staff, and this ratio may increase 
at night (fewer staff are used at night) (Reference 21). Many people with visual 
impairments live in nursing homes because they need assistance with everyday 
activities. Residents who are bedridden or incapacitated depend solely on the 
assistance of staff to evacuate them in the event of a fire. Those with less 
severe disabilities may lack staff assistance that is directed toward those with 
more pressing needs. 

While most fires can be prevented, people with visual impairments must pay 
special attention to fire safety. Hazards that might be obvious to a sighted 
person can have catastrophic consequences for those who are visually impaired. A 
visually impaired individual living alone must be able to recognize the fire 
hazards found in his or her immediate surroundings. For this reason, it is 
recommended that people who are blind or visually impaired reside in homes 
equipped with automatic fire sprinkler systems or retrofit their residence with 
such protective devices. 

Fire Risks for the Blind or Visually Impaired 19 

FIRE SAFETY FOR SPECIAL-NEEDS POPULATIONS: TIPS FOR FIRE SERVICE PROFESSIONALS 

You have been asked to provide advice on the fire safety needs of a blind or 
visually impaired individual. Where do you begin? There are the "generic" fire 
safety tips routinely given out to all who ask, but how do you tailor your 
recommendations to those with special needs? The first thing to remember is that 
the generic fire safety tips still apply. Individuals with physical impairments 
or disabilities are still people and still benefit from the years of 
conventional wisdom that created existing fire safety programs. 

Recommendations for Assisting the Blind and Visually Impaired Population in an 
Evaluation of Their Fire Safety 

Needs 

Focus groups found that being identified as "special" or "needy" was a concern 
for individuals with visual impairments (Reference 21). This mirrors the 
findings of a 1981 fire safety report from the National Center for a Barrier 
Free Environment. That study concluded that impaired individuals often feel that 
official concern for fire safety can restrict their freedom of choice- for 
example, denying an impaired student a bedroom on the upper floor of a college 
dormitory (Reference 27). These opinions also reflect those expressed at the 
Solution 2000 Conference, held by the U. S. Fire Administration and the North 
American Coalition for Fire and Life Safety Education in April of 1999. In 
addition, individuals in the focus groups also worried about falling victim to 
crime if their home was marked for fire department recognition of their needs. 
The key to dealing with individuals with a visual impairment is to acknowledge 
their ability to help themselves, while guiding them to recognize their 
limitations in an emergency situation without drawing undue attention to them as 
impaired individuals. 

Fire Risks for the Blind or Visually Impaired 20 

The importance of exit drills should be stressed to assist blind or visually 
impaired individuals in recognizing their physical limitations in crisis 
settings. If the individual lives on an upper floor or requires other special 
assistance, it is important for the fire service to be involved in these drills, 
if at all possible. Blind or visually impaired individuals may have an 
unrealistic view of the capabilities of the fire department. There may be 
unforeseen obstacles or barriers to exit or rescue. These should be identified 
and addressed before a fire o ccurs. 

The use of smoke alarms must be strongly advocated. The U. S. Fire 
Administration considers smoke alarms to be the single most important piece of 
fire safety technology employed today. The importance of early recognition of a 
fire cannot be stressed enough in populations where physical limitations may 
increase the time needed to safely exit a burning building. 

If you are called upon to assess the needs of an individual with visual 
impairment, the Center for Fire Research at the National Institute of Standards 
and Technology (formerly the National Bureau of Standards) recommends assessment 
of the following seven risk factors (Reference 28): 

 The risk that the individual will resist leaving the structure. For example, 
is the individual fearful of leaving with a stranger; unwilling to leave pets, 
belongings, and cherished items; or exhibiting confusion or other symptoms 
consistent with possible mental impairments? 
 The individual's response to fire drills. For example, does the individual's 
escape plan work during drills? 
 The individual's response to instructions. For example, are there language or 
other communication barriers? 

Fire Risks for the Blind or Visually Impaired 21 

 The individual's mobility impairments (and the resources necessary to overcome 
them). For example, is the individual capable of reasonably safe self-rescue 
from a burning structure? How much can the person assist his or her rescuers? 
 The need for extra help. This may be related to the actual egress or the 
period immediately following. For example, a ventilator-dependent quadriplegic 
may require medical resources once outside the structure involved. 
 The individual's waking response to alarms. Will there be a difference between 
the daytime and nighttime fire safety needs of the individual concerned? 
 The probability that the individual will lose consciousness in an emergency. 
For example, is the individual dependent on specific equipment for life support? 
Is there adequate backup to provide for emergency situations? 

Note the emphasis on performance-based assessment. The risk assessment cannot be 
based on an individual's impairment, but rather on his or her demonstrated 
abilities to evacuate a structure in an emergency. 

Building Design and Codes 

The following recommendations are based on Design for Ac-essibility, a guide for 
architects on designing barrier-free environments (Reference 29). They should 
provide some insight into the role of building design in the fire safety needs 
of the population. 

 Provide exit signs set to flash (less than 5 hertz) when a fire alarm sounds. 
Connect these signs to the emergency power system. 

Fire Risks for the Blind or Visually Impaired 22 

 Provide audible fire alarms that exceed the average ambient sound level by a 
minimum of 15 decibels (15 phones). These alarms should exceed a noise of 30 
seconds' or less duration by a minimum of 5 decibels (5 phones). The maximum 
audible emergency signal should not exceed 120 decibels (120 phones). 

 Provide visual/ light alarm signals in all areas occupied by individuals who 
are deaf or hard of hearing. 

 Provide under-pillow vibrating alarm signals in bedrooms for deaf or hard-of-
hearing individuals. 

 Provide a minimum of two accessible exits or horizontal exits for all 
accessible areas of all buildings. 

 Where there is only one accessible exit, provide a minimum of one fireproof 
refuge area (fire-rated enclosed elevator lobby preferred, or enlarged landing 
area in a fire-rated stair enclosure). The fire refuge area should be a minimum 
of 16 square feet (1.5 square meters) outside of exit circulation paths. Provide 
an occupancy/ call system from refuge areas 
to fire department enunciator location or entrance vestibules. 

 Cover open fireplaces with tempered glass doors and guard them by a 9-to 18-
inch (23-to 46-cm) raised hearth. 

 Provide fire detectors, especially in institutions, in accordance with the 
recommendations presented in the table below: 

Fire Risks for the Blind or Visually Impaired 23 

Recommended Smoke Alarms 

Area of Residence in Which To Install Alarm Type of Smoke Alarm Rate of 
Temperature Rise Fixed Temperature, Adjustable Fixed Temperature, Permanent 
Setting 175  to 240  F (79  to 116  C) Smoke/ Products of Combustion 

Kitchen Preferred 
Basement Preferred Acceptable 
Storage Preferred Acceptable 
Trash Preferred Acceptable 
Garage Preferred 
Accessible Attic Preferred 
Sleeping Area Preferred 
Hallways Acceptable Preferred 

Source: Based on Robert James Sorensen, Design for Accessibility (New York: 
McGraw- Hill Book Company), 1979. 

Instructional Materials 

In addition to the reproduction-ready fire safety materials available at the end 
of this booklet, other materials, such as "Emergency Procedures for Employees 
With Disabilities in Office Occupancies," is available from the United States 
Fire Administration Publications Office or on its web site at 
http://www.usfa.fema.gov. 

Fire Risks for the Blind or Visually Impaired 25 

CONCLUSIONS 

Fire safety is a vital but often overlooked aspect of health and safety for 
people who are blind or visually impaired. The inability to see creates a 
greater risk and subsequent challenge in preventing fire injuries; however, the 
blind or visually impaired individual can overcome this challenge. Just as a 
blind individual must learn basic skills for living using senses other than 
sight, a blind person can learn and hone fire safety skills through repeated 
practice. 

Public fire education messages address the needs of blind or visually impaired 
individuals in a contextual manner, but not from the standpoint of delivery. 
Escape planning and smoke alarm maintenance are equally applicable to both 
seeing and non-seeing individuals. The general public is inundated with these 
messages beginning at a very early age in hopes of influencing behavior before, 
during, and after a fire. People who are blind or visually impaired are often 
not exposed to these messages with the same frequency and thus may be unaware of 
their content or value. As a rule, educational campaigns neither highlight the 
potential fire risks specific to blindness and visual impairment nor direct the 
fire safety messages to this population. 

Public education efforts that seek to change behavioral prac-tices are the most 
effective means for people who are blind or visu-ally impaired to increase their 
chances of surviving a fire. Whereas a specialized smoke alarm may greatly 
benefit someone who is deaf or hard of hearing or a fire-safe elevator may 
benefit people with mobility impairments, improved fire technology is not 
necessarily the most appropriate means to combat the fire problem in the visu-
ally impaired community. The only thing the visually impaired in-dividual cannot 
do is see. He or she is capable of hearing an audible smoke alarm and crawling 
low on the floor to escape to safety. The loss of sight should not be hindrance 
if the individual is aware of these steps and practices them on a regular basis. 
In fact, heavy 

Fire Risks for the Blind or Visually Impaired 26 

smoke can impair the vision of a seeing individual to the point of simulated 
blindness. Therefore, sight does not have to be a vital component to escaping 
from a fire; rather, memory will help the victim of a fire to envision the path 
to safety. The meaning of traditional fire safety messages increases 
dramatically for people who are blind or visually impaired. Good fire safety 
procedures are the most important steps these individuals can take to improve 
their chances of surviving a fire. 

Fire Risks for the Blind or Visually Impaired 27 

APPENDIX: FIRE SAFETY TIPS FOR BLIND OR VISUALLY IMPAIRED PEOPLE 

The following fire safety tips are organized in three sections: before the fire, 
during the fire, and fire prevention. While these tips represent many fire 
safety approaches, the use of smoke alarms and exit planning should be 
considered the most crucial. According to the U. S. Fire Administration, smoke 
alarms are the single most important piece of fire safety equipment in use 
today. Exit planning is also extremely important, especially for individuals who 
may have difficulty exiting a burning building. 

These fire safety tips are reproduction ready. They may be used as education 
material by fire service, life safety, or health educators. Permission to 
reproduce them for that purpose is granted. Proper credit should be given to the 
United States Fire Administration and the Federal Emergency Management Agency. 

Fire Risks for the Blind or Visually Impaired 

Before the Fire 

Identify the Nearest Emergency Exit. Whether you are at home or elsewhere, you 
should always know the location of the nearest exit. This could save your life 
in an emergency. 

Install Smoke Alarms. A working smoke alarm can make a vital difference in the 
event of a fire; it has the potential to reduce the risk of death in a fatal 
fire by 60 percent. A properly functioning smoke alarm can alert you to the 
presence of deadly smoke while there is still time to escape. Place alarms next 
to each sleeping area and on every floor of your home. Test batteries monthly, 
and replace them annually. If you cannot do this yourself, ask a family member, 
neighbor, building manager, or someone from the fire department to assist you. 
Clean smoke alarms by vacuuming them regularly, or ask someone to do it for you. 
Install high-decibel smoke alarms to alert you to the presence of a fire. If 
your smoke alarms are hardwired (connected to the electric circuitry of your 
residence), make sure they are also equipped with battery backups. 

Live Near an Exit. If you live in an apartment building or condominium, try to 
get a unit on the ground floor. If this is not possible, know where the exit 
stairwell is located and how to get there. Plan to wait there for help if you 
also have an impairment that prevents you from taking the stairs. If you live in 
a multistory house, try to sleep on the ground floor. Make sure a phone is next 
to your bed within arm's reach along with emergency telephone numbers. 

Plan and Practice Escape Plans. Knowing your escape plan is one of the most 
important steps you can take to save your life in a fire. Plan your escape 
around your capabilities. Know at least two exits from every room. Make sure you 
can unlock all your doors and windows. Be sure you know how to open your 
windows. If security devices, such as bars, are installed across the windows, 
ensure that they release from the inside. 

Fire Risks for the Blind or Visually Impaired 

Exit Indicators. The confusion and disorientation of a fire in the home can be 
difficult to overcome. You may be forced to crawl along the floor to avoid 
smoke. As it can be very disorienting to crawl where you are used to walking 
(especially if you count steps to locate doors and hallways), it is recommended 
that you place tactile markers along the baseboard of exit routes inside your 
home. These will help to identify where to go in case of a fire. 

Involve the Fire Department. Ask the fire department to help you plan an escape 
route, and inform them of your special needs. Ask the fire department to help 
identify fire hazards in your home and explain how to correct them. Any areas 
you plan to use as a rescue area must be identified and agreed upon by you and 
officials from the fire department. Learn the fire department's limitations, and 
make fire officials aware of yours. 

During the Fire 

Get Out and Stay Out. Leave your home as soon as possible. Do not try to gather 
personal possessions or attempt to extinguish the fire. Do not use the elevator. 
Once out, do not go back inside. 

Test the Doors Before Opening Them. Using the back of your hand, reach up high 
and touch the door, the doorknob, and the space between the door and the frame. 
If anything feels hot, keep the door shut and use your second exit. If 
everything feels cool, open the door slowly and crawl out low to the ground if 
smoke is present. 

Stay Low and Go. Crawl low and keep under the smoke if you can. If not, try to 
cover your mouth and nose to avoid breathing toxic fumes and make your way to 
safety as quickly as possible. What To Do If You Are Trapped. Close all the 
doors between you and the fire. Stuff cracks in doors and cover all vents with a 
damp cloth to the best of your ability to keep smoke out. If possible, call the 
fire department and tell them where you are located. Signal 

Fire Risks for the Blind or Visually Impaired 

rescuers from a window with a light-colored cloth that you keep in a 
predesignated place for this purpose. 

Stop, Drop, and Roll. If any part of you catches fire, do not run and do not try 
to extinguish the flames with your hands. Cover your face with your hands. Drop 
to the ground, rolling over and over. If you have another disability preventing 
these actions, try to keep a flame-resistant blanket or rug nearby to smother 
any flames. 

Fire Prevention 

Cooking. Never leave the stove unattended while cooking. If you need to step 
away from the stove, turn it off. Wear tight-fitting clothing when cooking over 
an open flame, and keep towels and potholders away from the flame. If food or 
grease catches fire, smother the flames by sliding a lid over the pan and 
turning off the heat. Do not try to use water to extinguish a grease fire. When 
deep-frying, never fill the pan more than one-third full of oil or fat. Never 
put foil or other metals in the microwave. Make sure the stove is kept clean and 
free of grease buildup. Turn pot handles away from the front of the stove so 
they cannot be knocked off or pulled down. 

Electrical Safety. Electric blankets should conform to the appropriate standards 
and have overheating protection. Do not wash blankets repeatedly as this can 
damage their electrical circuitry. If an appliance begins to smell suspicious or 
emit smoke, unplug it immediately. Replace all frayed or broken electrical 
cords. Never use an appliance with exposed wires. Never overload extension 
cords, and keep them out of traffic areas. Use only tested and UL-listed 
electrical appliances. 

Smoking. Never smoke in bed. Make sure that you are alert when you smoke. If a 
gas stove or oxygen source is nearby, do not smoke. Place signs stating that 
oxygen is in use and warning visitors to refrain from smoking. Do not smoke 
while under the influence of alcohol or if you are taking prescription drugs 
that can cause drowsiness or confusion. Never leave smoking materials unat-

Fire Risks for the Blind or Visually Impaired 

tended, and collect them in large, deep ashtrays. Check around furniture, 
especially upholstered furniture, for any discarded or smoldering smoking 
materials. Before discarding them, soak the materials in the ashtray. 

Space Heaters. Give space heaters space. Keep heaters at least 3 feet from any 
combustible material, including people. Follow the manufacturers' directions 
regarding operation, fueling, and maintenance of your space heater. Do not use 
heaters or other heating devices to dry clothing. 

Heating. Have your heating systems and chimneys checked and cleaned annually by 
a professional. Never store fuel for heating equipment in the home. Keep fuel 
outside or in a detached storage area or shed. 

Fireplaces. Open fireplaces can be hazardous; they should be covered with 
tempered glass doors and guarded by a raised hearth 9 to 18 inches high. 

For more information, contact: The United States Fire Administration Office of 
Fire Management Programs 16825 South Seton Avenue Emmitsburg, MD 21727 
Or visit the USFA website: www.usfa.fema.gov 

Fire Risks for the Blind or Visually Impaired 

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