FIRE RISKS FOR THE DEAF OR HARD OF HEARING 
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 Deaf or Hard of Hearing 

CONTENTS 

OVERVIEW OF THE 'FIRE RISKS' SERIES......... 1 
EXECUTIVE SUMMARY........ 3 
INTRODUCTION ....... 5 
THE DEAF AND HARD-OF-HEARING POPULATION...... 7 
Estimates....... 7 
Hearing Loss.... 7 
Cultural Perceptions ........... 8 
Federal Laws and Regulations.......... 9 
FIRE RISKS ....... 11 
Residence...... 11 
Specialized Smoke Alarms ........ 11 
Public Fire Education.......... 12 
Educational Barriers ......... 13 
Communication Barriers ...... 14 
FIRE SAFETY FOR SPECIAL-NEEDS POPULATIONS: TIPS FOR FIRE SERVICE 
PROFESSIONALS....... 15 
Recommendations for Assisting Deaf or Hard-of-Hearing People in an Evaluation of 
Their Fire Safety Needs ...... 15 
Building Design and Codes...... 16 
Instructional Materials ....... 17 
CONCLUSIONS .............. 19 
APPENDIX: FIRE SAFETY TIPS FOR HEARING-IMPAIRED PEOPLE......... 21 
Before the Fire During the Fire 
Fire Prevention 
REFERENCES 

Fire Risks for the Deaf or Hard of Hearing 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 greater risk 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 
 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 Deaf or Hard of Hearing 3 

EXECUTIVE SUMMARY 

Fire safety is a much overlooked problem among people who are deaf or hard of 
hearing. They do not receive the same media, educational, or industry attention 
as the hearing population. Many advancements in fire injury and death prevention 
over the past century have not addressed the fire safety needs of the deaf 
community. The most significant of those inventions is the audible smoke alarm. 
Smoke alarms have been credited with saving thousands of lives from fires each 
year. Conventional alarms, however, work less well for those who cannot hear. 
Additionally, traditional fire safety messages do not address the unique needs 
of the deaf community. Fire safety messages more than likely will not reach this 
population due to the lack of effective distribution channels. 

By raising the level of fire safety awareness for the deaf and hard-of-hearing 
community, and for the surrounding population, we can eliminate many fire risks. 
Groups representing people with hearing impairments must collaborate with the 
fire service to educate each other and reduce the risks posed by fires to non-
hearing people. 

The principal findings of this study are summarized below: 

 Visual assessment is the primary means for people with hearing impairments to 
process information vital to everyday living. These individuals cannot rely on 
traditional audible smoke alarms. They require visual alarms equipped with 
strobe lights or vibration devices. 
 Vibrating beds and pillows have been developed to awaken people who are deaf 
or hard of hearing and alert them to the presence of a fire. These beds and 
pillows are wired to a smoke alarm and vibrate when the alarm is activated. 
 A portion of the deaf and hard-of-hearing population is also blind or visually 
impaired. Visual strobe lights are ineffective for this group. A vibrating bed 
and pillow alarm must be used instead. 
 While specialized detection and alarm devices are available, there is a dearth 
of information about how to obtain them. In addition, these devices are often 
prohibitively expensive. 
 Many people who are deaf or hard of hearing are not aware of provisions in the 
Americans With Disabilities Act requiring that appropriate smoke alarms be 
provided by landlords, public buildings, etc. 
 Public fire education is generally neither formatted for, nor directed to, 
people who are hearing impaired. 

Fire Risks for the Deaf or Hard of Hearing 5 

INTRODUCTION 

People who are deaf or hard of hearing face a high risk for fire and fire-
related injury. The hearing world dominates much of the way our society is 
physically and socially structured. Communication involves the free exchange of 
ideas, the receipt of such ideas, and reaching a mutual understanding about 
these ideas. This cannot be done when parties communicate through different 
media. Telephonic communication relies on the ability to speak and hear. 

For those who cannot hear, the external world is foreign, obstructive, and 
potentially dangerous. This is especially true in the case of audible alarms. 
For centuries, public and individual warning signs have typically been sound 
oriented. Paul Revere used his voice to warn of the impending British invasion. 
During the height of the Cold War, warning sirens were used in air raid 
exercises to alert Americans to the possibility of nuclear attack. These modes 
of communication were the most effective ways to reach the greatest number of 
people. Fire and smoke alarms are no different. However, these life-saving 
devices are of little use to an individual who is hearing impaired. Light-
equipped smoke alarms have been developed, but they are expensive and not widely 
available. 

Significant progress has been made in developing fire protection and alerting 
devices and in educating the public about fire prevention. However, much remains 
to be done if people who are hearing impaired are to benefit from these 
advances. 

Many deaf children receive targeted fire protection education in school. 
However, public service announcements disseminated through the mainstream media 
particularly television and radio- may not reach the people who are deaf or hard 
of hearing. 

This report is divided into three principal sections. In the first section, the 
cultural perceptions of deaf and hard-of-hearing individuals are discussed, 
along with the impact that hearing loss has on daily life. The current estimates 
of the deaf and hard-of-hearing population are also presented in conjunction 
with projected estimates of future populations. 

The second section focuses on the characteristics of deaf and hard-of-hearing 
people that places them at risk to injury, especially fire-related injury. The 
effectiveness of fire protection devices for deaf and hard-of-hearing people are 
discussed, as are educational programs. 

The final section of this report provides tips to fire service professionals for 
en-hancing 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 educa-tion activities. 

Fire Risks for the Deaf or Hard of Hearing 7 

THE DEAF AND HARD-OF-HEARING POPULATION 

Estimates 

The National Institute on Deafness and Other Communication Disorders (NIDOCD), a 
division of the National Institutes of Health, estimates that there are 28 
million deaf and hard-of-hearing individuals in the United States (Reference 1). 
The NIDOCD uses a higher estimate than traditional reporting agencies, such as 
the National Center for Health Statistics (NCHS), which estimates that deaf and 
hard-of-hearing persons number approximately 22 million in the United States 
(Reference 2). This discrepancy is worth noting due to the complexities in 
tracking and reporting mechanisms. 

Both the Census Bureau and NCHS use survey forms to derive their estimates, and 
due to the subjectivity of the participant's response, their results may not be 
entirely accurate. The definitions of deafness and hearing loss are not 
universal and are described in the surveys in the context of functional 
limitations. If hearing loss does not restrict daily activities, 
many individuals may not regard themselves as hard of hearing, even if they 
would benefit from a hearing aid. Furthermore, hearing loss may go undiagnosed 
for years, which is especially true for people of low socioeconomic backgrounds 
who may not be under a doctor's care and thus subjected to scheduled hearing 
tests (Reference 3). In other cases, people may be reluctant to admit to 
themselves that they have a hearing problem, or they may choose not to report 
it. Furthermore, populations in prisons, skilled nursing facilities, and 
retirement homes- as well as the homeless- are not screened (Reference 2). 
Consequentially, these cases are not reported and thus contribute to the 
discrepancies in the reporting agencies' estimates. To compensate for the lack 
of unreported cases, the NIDOCD estimates that 28 million Americans are deaf or 
hard of hearing- about one in nine people in the United States. 

Hearing impairment is extremely common in the older adult population. 
Presbycusis, a form of hearing loss in the elderly, is considered by some to be 
a normal part of aging (Reference 4). In fact, nearly 40 percent of the 
population over the age of 65 has experienced some degree of hearing loss 
(Reference 2). The subtleties of hearing loss do not make themselves immediately 
evident, and only when discrepancies are noted is hearing loss identified. 

Hearing Loss 

Hearing loss may be classified in many ways. It can be total, unilateral (one 
ear), or bilateral (two ears), and it may result from problems in sound 
conduction, nervous sensation, or both. Problems in sound conduction generally 
result from dysfunctions of the external or middle ear. That is, sounds do not 
get to the sensory structures of the ear. Disorders of nervous sensation 
(sensorineural problems) are usually related to deterioration of the cochlea, 
often from loss of hair cells in the Organ of Corti. With fewer hairs to 
vibrate, the ear's function is impaired (Reference 4). 

Hearing loss can be caused by a number of factors, both biological and environ-
mental. Biologically, hearing loss can be as simple as impacted earwax or fluid 
behind the eardrum, or as complex as a congenital syndrome or a brain tumor. 
Certain drugs such as 

Fire Risks for the Deaf or Hard of Hearing 8 

nonsteroidal antiinflammatories, antibiotics, or heavy doses of aspirin can lead 
to a hearing impairment. Certain blood vessel and blood coagulation disorders- 
including hypertension and blood clots- can also lead to hearing loss (Reference 
4). The most common cause of hearing loss in infants and young children is 
chronic middle-ear infection, also known as otitis media (Reference 5). 
Otosclerosis is a chronic condition found in older people that restricts the 
vibration of the bone leading to the inner ear, causing hearing loss. It can 
usually be treated with antibiotics, surgery, hearing aids, and other techniques 
(Reference 6). Finally, age-related hearing loss (presbycusis) involves a 
progressive loss of hearing, beginning with high-frequency sounds, such as 
speech. It is believed that presbycusis is a result of long-term noise exposure. 
The disorder occurs in about 25 percent of people ages 65 to 75 years old and in 
50 percent of those over age 75 (Reference 4). 

Prolonged exposure to sound levels of 85 decibels or higher can lead to hearing 
loss. Normal conversation is approximately 60 decibels. Sounds that exceed the 
85-decibel level include lawnmowers (90 decibels), car horns (110 decibels), and 
rock concerts or jet engines (120 decibels). Individuals who are exposed to high 
noise levels can prevent hearing loss by wearing ear plugs or ear muffs. 
Exposure to atmospheric pressure changes can also cause hearing loss. Rapid 
changes in atmospheric pressure can occur during flying or diving (Reference 4). 

Some forms of hearing loss are treatable. In some cases, earwax removal or ear-
drum puncture repair may resolve a hearing deficit. Surgery can sometimes repair 
conductive-type hearing loss. Hearing loss caused by prolonged exposure to loud 
noise has been found to disappear when the noise is eliminated. Hearing loss 
caused by medications can oftentimes be corrected by changes in dosage or brand 
of medication. If hearing loss is found to be caused by other medical 
conditions, the treatment of that disorder can sometimes restore hearing 
(Reference 4). 

Of the common disabilities found among people in the United States, deafness and 
hearing impairments tend to lead to isolation and resulting psychological 
disturbances, as people are tempted to withdraw themselves socially because of 
their disability (Reference 7). Isolation may also increase communication 
problems and frustration as well as hinder social adjustment. Speech therapy and 
rehabilitation, sign language, and lip reading facilitate communication between 
hearing-impaired and hearing individuals and among people in the hearing-
impaired population. 

Cultural Perceptions 

To the hearing world, people who are deaf or hard of hearing are significantly 
impaired and at a disadvantage. However, many deaf and hard-of-hearing people do 
not perceive themselves as impaired. They communicate through a different 
language and medium- sign language or lip reading. The deaf community uses sign 
language- specifically American Sign Language, or ASL- to communicate. Instead 
of hearing spoken words, lip readers read words by watching the shape of the 
speaker's mouth as words are formed. Just as translators are required for 
individuals speaking a foreign language, the deaf and hard-of-hearing community 
feels its members deserve the same courtesy. Communication can be enhanced with 
modest accommodations. 

Fire Risks for the Deaf or Hard of Hearing 9 

As with other disabilities, deafness and hearing loss are not well accommodated 
in the hearing world. Until the Americans With Disabilities Act (ADA) (42 U. S. 
C. 12181) was passed in 1991, accommodations for people who are deaf or hearing 
impaired were neither customary nor required. 

Federal Laws and Regulations 

Americans With Disabilities Act. The ADA prohibits discrimination against 
individuals with disabilities and requires that accommodations be made for these 
individuals. Almost all privately owned facilities that provide goods or 
services to clients, customers, or patrons must comply with the ADA. It 
prohibits private businesses such as restaurants, hotels, and retail stores from 
discriminating against individuals with disabilities. The ADA stipulates that 
the responsibility for providing interpreter services, adaptive equipment, or 
accessibility to other services or facilities rests with the proprietor of the 
building entity. The law contains four sections listing required services and 
programs for the hearing im-paired: mployment, government, public 
accommodations, and telecommunications (Reference 8). 

As a result of this legislation, people who are deaf or hard of hearing are 
entitled to assistive technology in public places. Such technologies include 
telecommunication devices for the deaf (TDDs), text telephones (TTYs), and 
visual smoke alarms, security system alarms, doorbells, ringers, and door locks. 
Many deaf and hard-of-hearing individuals have installed these devices in their 
private homes, although the ADA does not mandate doing so. These devices may be 
installed permanently or packaged for portable use when the ind ividual is away 
from home. 

Statutes and Regulations. Under Title II of the ADA, the Department of Justice 
certifies local building codes. All of the National Standard codes (BOCA, NFPA, 
etc.) are certified. As a result, most landlords are required to provide visual 
smoke alarms to their tenants (Reference 9). Several sections of the 1997 Code 
of Federal Regulations require landlords to provide and install high-intensity 
visual alarms for tenants who are deaf or hard of hearing. Landlords who benefit 
from a variety of federal government programs or other federal subsidies are 
required to provide visual fire alarms to their deaf and hard-of-hearing 
residents at no cost. The sections of the federal code that apply to landlords 
and building design are: 42 U. S. C. 4151- 4157, 7CFR1930- Subpart C (Management 
and Su-pervision of Multiple Family Housing Borrowers and Grant Recipients), and 
24CFR570.614- Section 570.614 (Architectural Barriers Act and Americans With 
Disabilities Act). 

Fire Risks for the Deaf or Hard of Hearing 11 

FIRE RISKS 

Residence 

People who are deaf or hard of hearing place great value on living 
independently. These individuals are widely dispersed in many communities and 
clustered together in others. 

They live in apartments, dorms, group homes, and single-family homes. In many 
cases, deaf or hard-of-hearing people reside with hearing family members and 
relatives. Despite their specific needs, these individuals assimilate in the 
environment that suits the hearing members of their family. The most pressing 
fire safety issue for people who are deaf or hard of hearing is whether they 
will be alerted to the danger in time to escape. Many rely on their family 
members to notify them when a doorbell chimes, a phone rings, or an alarm 
sounds. Other people may not be a reliable alerting mechanism in the event of a 
fire. Smoke and toxic fumes are nondiscriminating killers. A hearing family 
member or caregiver overcome by fumes may not be able to alert a sleeping deaf 
person in time for both to escape. 

Apartment living may represent equally challenging fire safety issues for deaf 
and hard-of-hearing people. High-rise buildings pose significant threats to 
timely egress in the event of a fire. Smoky hallways, long and dark corridors, 
and multiple flights of stairs are among some of the characteristics that make 
efficient building exit difficult. Once again, early detection and warning are 
key to survival. If a fire occurs outside an apartment, a localized fire alarm 
will sound, alerting the building occupants. Deaf occupants will not hear this 
audible warning and may remain in the building until escape is no longer 
possible. Even if the smoke alarms in the hallways are equipped with flashing 
lights, they are of little help to a deaf person behind the closed door of his 
or her apartment. 

Apartments for deaf and hard-of-hearing people should be equipped with special 
smoke alarms for alerting residents. Smoke alarms installed in the apartments 
and equipped with lights or vibration devices must be linked to smoke alarms 
located in the common areas of the building (hallways, lobby, service rooms). 
The centrally located alarms will then trigger the alarms in the occupants' 
apartments, even if there is no fire or smoke in the apartments. 

Several deaf or hard-of-hearing people in focus groups reported experiences with 
a fire erupting in their building. These respondents claimed to have had no 
knowledge of the fire and had not been made aware of it until the fire 
department broke in and evacuated them (Reference 10). The estimated time from 
the first alarm until the occupants were evacuated was 30 to 60 minutes. None of 
these respondents had specialized smoke alarms installed in their apartments. 

Specialized Smoke Alarms 

Places of public accommodation and employment are required to provide 
specialized smoke alarms and other assistive devices to their deaf and hard-of-
hearing patrons. The Americans With Disabilities Act requires hotels, 
businesses, and recreation facilities to install and make these items available 
(Reference 8). As a result, deaf individuals can reserve a hotel room with a 
light-flashing smoke alarm, specialized communications 

Fire Risks for the Deaf or Hard of Hearing 12 

devices, and other accommodations. They can also eat in restaurants, go to the 
movies, or work in an environment where the appropriate smoke alarms are 
installed. 

Under its rule on Title II of the ADA, the U. S. Department of Justice has 
chosen to require the provision of appropriate smoke alarms by certifying local 
building codes. As these codes are brought into compliance with the ADA, 
landlords will be forced to provide strobe light fire alarms to their residents 
(Reference 9). Several deaf and hard-of-hearing participants in market research 
groups discussed their attempts to obtain specialized smoke alarms from their 
building managers (Reference 10). More often than not, the building managers 
were non-cooperative, evasive, and difficult to work with. Many hearing-impaired 
individuals gave up out of sheer frustration at the problems they encountered 
simply in trying to communicate with their managers. Others claimed their 
managers refused to cooperate or ignored their requests. Some settled for the 
conventional alarms already installed. Only one respondent reported success in 
obtaining a specialized alarm from his building manager. Many of the respondents 
indicated that they were not aware of how and where to purchase specialized 
smoke alarms. They also stated that they had not received any information on 
specialized alarms from local disability support organizations. 

To an individual unable to hear, conventional smoke alarms are of limited use. 
Manufacturers have responded to this need by developing specialized smoke alarms 
that use flashing lights or vibrating materials to alert hearing-impaired 
occupants of a fire. Because of the small potential market, such ventures are 
modest at best. Furthermore, these developments have received very little 
publicity and are thus largely unknown to the populations most in need of them. 
Market research in a sample of deaf and hard-of-hearing individuals revealed 
that, while they recognized the importance of specialized smoke alarms, only a 
small percentage actually has one installed at home (Reference 10). The most 
common reasons cited for not having a visual or vibrating smoke alarm were the 
high cost and relative unavailability of such products. Still others were 
unaware of the very existence of such smoke alarms. 

Flashing lights are only useful if they are installed where a hearing-impaired 
person can see them. A properly functioning flashing alarm does no good if the 
hearing-impaired person is asleep in a room without one. To combat this issue, 
certain manufacturers have devised an alarm that vibrates the bed or pillow to 
rouse a sleeping individual. While this is a good idea, it is not a complete 
solution. In some cases, the individual may not be sleeping in a bed so equipped 
(e. g., a fire may erupt when the individual is napping on the couch). In any 
case, more than one alarm would be most beneficial. Ideally, all alarms in the 
home would be interconnected so that if an alarm in one part of the house 
detected a fire, all alarms would activate. 

Public Fire Education 

Public fire education has made great strides in this country and around the 
globe. 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 for fire-related 
injuries and death than others. 

Deaf and hard-of-hearing people are at high risk from fires and fire-related 
injuries. Unfortunately, they are a much-overlooked community for a variety of 
reasons. There is a 

Fire Risks for the Deaf or Hard of Hearing 13 

lack of quantifiable measures of fire deaths and injuries in the deaf and hard-
of-hearing community. Neither the National Center for Health Statistics nor the 
U. S. Fire Administration's National Fire Incident Reporting System includes 
data on the presence or degree of disability of a fire victim. When left up to 
the fire service, reporting agencies may only speculate as to whether the 
individual was impaired. Such impairments can range from physical disabilities 
to alcohol and drugs. The legal implications of false assumptions and 
theoretical reasons deter many in the fire service from ascertaining whether 
such impair-ments existed. In many scenarios, the fire service simply cannot 
determine whether an auditory, visual, mental, or physical disability prohibited 
the victim from escaping the fire based on the evidence at hand. Of these 
disabilities, deafness and hearing impairments may be the most difficult to 
detect. 

Deaf and hard-of-hearing people are often underserved in public fire education 
efforts. Market research revealed some disturbing findings about public 
education directed toward the deaf and hard-of-hearing communities (Reference 
10). Respondents were asked their opinion on the availability, applicability and 
appropriateness, and frequency of public fire education messages addressed to 
the population as a whole versus those addressed specifically toward their 
community. The vast majority of respondents felt that their fire safety needs 
were not being addressed through mainstream media messages. They felt that 
current public safety announcements (PSAs) are directed at children and do not 
apply to them. Most of them indicated that they have never designed or practiced 
a fire escape plan, as the idea had never been introduced to them. Furthermore, 
the group of respondents were unaware of the existence of specialized smoke 
alarms or how to obtain them.

Clearly, this sample does not represent the entire deaf and hard-of-hearing 
population. Nevertheless, respondents felt confident that they speak for the 
majority of the nation's deaf and hard-of-hearing individuals. 

Educational Barriers 

Some of the most effective fire safety education for children comes in the early 
school years, yet the vast majority of the school programs are designed 
exclusively for the hearing community. The programs address not only fire drills 
at school, but also fire and injury prevention and fire safety in the home. The 
fire safety messages for the home environment are very important since this is 
where children are more likely to be alone or asleep. At school, a deaf or hard-
of-hearing child will likely be able to follow his or her classmates to safety, 
observe an activated fire alarm affixed with a strobe light, or even see flames 
or smell smoke. At home, however, these children must be made aware of fire 
prevention and safety measures in case they encounter a fire emergency when they 
are alone. They should know how to dial 9-1-1 without supervision and how to 
execute the "Stop, Drop, and Roll" procedure. 

Increasing numbers of deaf and hard-of-hearing children are being mainstreamed 
into traditional school settings. It is imperative that they are not overlooked 
in any aspect of their education, but especially in fire safety programs. 
Schools and fire departments must ensure sure that the deaf and hard-of-hearing 
children know how to react in a fire emergency independent of a hearing 
individual. 

Fire Risks for the Deaf or Hard of Hearing 14 

Communication Barriers 

Deaf and hard-of-hearing people rely on unique means for communicating with each 
other and the outside world. These mechanisms vary with the degree of hearing 
loss. To the individual with only partial hearing loss, something as simple as a 
hearing aid may make it possible to communicate with others. For individuals 
with complete hearing loss, verbal communication may not be possible. Many deaf 
people cannot utilize auditory clues to process information in their 
environment; they must rely entirely on visual clues to understand messages 
being sent. Sign language and lip reading are the primary means by which deaf 
individuals communicate, and their effective use is dependent on the person's 
ability to see. In the event of a fire, a person's line of sight may be hampered 
by smoke, making it difficult or impossible to see to read a person's lips or 
hands. Instructions from firefighters may be obscured, which may interfere with 
rescue attempts. In addition, firefighters may be wearing breathing apparatus 
that cover their faces, making lip reading impossible. The same may hold true 
for the individual who is not entirely deaf but does not use a hearing aid or 
has temporarily removed it. In the often chaotic environment of a fire, voices 
and sounds tend to be muffled, further contributing to failure to recognize 
instructions and escape in time. 

Fire Risks for the Deaf or Hard of Hearing 15 

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 deaf or 
hard-of-hearing 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 people first and foremost, and will benefit from the years 
of conventional wisdom that created existing fire safety programs. 

Recommendations for Assisting Deaf or Hard-of-Hearing People in an Evaluation of 
Their Fire Safety Needs 

Focus groups found that being identified as "special" or "needy" was a concern 
for individuals who are deaf or hard of hearing (Reference 10). 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 11). 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 deaf or hard-of-hearing persons 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. 

The importance of exit drills should be stressed to assist deaf or hard-of-
hearing 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. Deaf or hard-of-hearing 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 occurs. 

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 someone who is deaf or hard of 
hearing, 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 12): 

Fire Risks for the Deaf or Hard of Hearing 16 

 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? 

 The individual's mobility impairments (and the resources necessary to over-
come 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 must be based 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 Accessibility, a guide for 
architects on designing barrier-free environments (Reference 13). 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. 
These signs should be connected to the emergency power system. 

 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 maxi-mum 
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. 

Fire Risks for the Deaf or Hard of Hearing 17 

 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 loca-
tion 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 
recom-mendations presented in the table below: 

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 provided in the 
appendix at the end of this report, other materials, such as "Emergency 
Procedures for Employees With Disabilities in Office Occupancies," is available 
from the U. S. Fire Administration Publications Office or on its web site at 
http://www.usfa.fema.gov . 

Fire Risks for the Deaf or Hard of Hearing 19 

CONCLUSIONS 

Deaf and hard-of-hearing people are just as capable as the hearing community 
when it comes to fire safety. Early detection and escape are the most important 
keys to surviving a fire. Smoke alarms provide an urgent message that demands an 
immediate response. Because hearing-impaired people communicate through special 
means, they require specialized warning devices. Flashing lights and vibrating 
smoke alarms are essential fire protection devices for people who are deaf or 
hard of hearing. These alarms complement, rather than compensate for, the 
inability to hear. 

Fire safety messages that are meant to help the hearing population also apply to 
people who are deaf or hard of hearing. The difference in providing public fire 
education lies not in content modification, but in packaging. It is not easy to 
reach the hearing-impaired through the mainstream media, which is addressed 
principally to hearing people. As a result, hearing-impaired people do not 
usually benefit from the life-saving advice that fire prevention and protection 
messages provide. 

With the right knowledge and tools, deaf and hard-of-hearing people can help 
save their own lives, as well as those of their loved ones, in the event of a 
fire. By instituting behavioral practices as well as engineering modifications, 
hearing-impaired people may no longer have to be at greater risk. Fire 
protection and prevention have grown by leaps and bounds over the past several 
decades, helping to decrease fire death rates in the United States by 
exponential numbers. Public education and advancements in fire safety 
technologies have contributed greatly to this trend. The same benefits can 
accrue to deaf and hard-of-hearing people by delivering programs that address 
the unique fire safety needs of this community. 

Fire Risks for the Deaf or Hard of Hearing 21 

APPENDIX: FIRE SAFETY TIPS FOR HEARING-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 existing 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 
replicate them for that purpose is granted. Proper credit should be given to the 
U. S. Fire Administration and the Federal Emergency Management Agency. These 
tips are printed in large font to enable people with vision impairments to read 
them more easily. 

Fire Risks for the Deaf or Hard of Hearing 

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. The single most important step you can take to save your 
life during a fire is to install a smoke alarm that suits your needs. A working 
smoke alarm can make a vital difference in the event of a fire and may reduce 
the risk of dying in a fire by as much as 60 percent. A properly functioning 
smoke alarm can alert you to the presence of deadly smoke while there is still 
time to escape. Place visual alarms inside each sleeping area, and connect them 
to other alarms on every floor of your home. Keep smoke alarms clean by 
vacuuming or having someone vacuum them regularly. Test batteries monthly, and 
replace them annually. Ask friends, family members, building managers, or 
someone from the fire department to install and test the batteries of a smoke 
alarm if it is hard to reach. Be aware that the ADA may require your landlord to 
provide an appropriate alarm. If your smoke alarms are hardwired (connected to 
the electric circuitry of your residence), make sure they are also equipped with 
battery backups. 

A number of companies manufacture strobe lights or vibratory smoke alarms for 
hearing-impaired people. Many of the companies producing these special alarms 
already offer communication and other assistive devices to people who are deaf 
or hard of hearing. If you have any questions about how to obtain an alarm, 
contact the fire department or the U. S. Department of Housing and Urban 
Development (HUD). If you live in an apartment building, the owner may be 
required to provide you with a specialized smoke alarm. Make sure you place 
appropriate alarm devices in every room in which you may sleep (e.g., living 
room, den, bedroom). 

Keep a Telecommunication Device Nearby. Make sure a TTY/ TDD or phone (if you 
use one) is next to your bed, within 

Fire Risks for the Deaf or Hard of Hearing 

arm's reach. Keep emergency telephone numbers and hearing aids (if necessary) 
handy as well. 

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. Make any necessary accom-modations to 
facilitate escape. 

Involve the Fire Department. Ask the local fire department to help you plan an 
escape route, and inform them of your special needs. Ask your fire department to 
help identify any 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 the 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 a 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 exit as low to the ground as 
possible if smoke is present. 

Stay Low and Go. Crawl low and keep under the smoke, if you are physically able. 
If not, try to cover your mouth and nose to avoid breathing toxic fumes, and 
make your way to safety as quickly as possible. 

Fire Risks for the Deaf or Hard of Hearing 

What To Do If You Are Trapped. Close all the doors between you and the fire. 
Fill cracks in doors and cover all vents with a damp cloth to keep smoke out. If 
possible, call the fire department and tell them where you are located. Signal 
rescuers from a window with a light-colored cloth. 

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 that 
prevents your taking 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 

Fire Risks for the Deaf or Hard of Hearing 

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 unattended, and collect them in large, deep ashtrays. 
Check around furniture, especially upholstered furniture, for any discarded or 
smoldering smoking materials. Soak the ashes in the ashtray before discarding 
them. 

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 mainte-nance 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 Deaf or Hard of Hearing 

REFERENCES 

1. Department of Health and Human Services, National Institute on Deafness and 
Other Hearing Disorders, National Strategic Research Plan of the National 
Institute on Deaf-ness and Other Hearing Disorders, 1996. 

2. Department of Health and Human Services, Centers for Disease Control and 
Preve n-tion, National Center for Health Statistics, Vital and Health 
Statistics, Series 10, No. 199, October 1998. 

3. K. J. Cruickshanks, T. L. Wiley, T. S. Tweed, B. E. Klein, R. Klein, J. A. 
Mares-Perlman, and D. M. Nondahl, "Prevalence of Hearing Loss in Older Adults in 
Beaver Dam, Wisconsin: The Epidemiology of Hearing Loss Study," American Journal 
of Epidemiology, Vol. 148, No. 9, November 1, 1998. 

4. J. LaDou, Occupational and Environmental Medicine, Second Edition (Stamford, 
CT: Appleton & Lange), 1997. 

5. C. Mutlu, A. O. Odabasi, K. Metin, S. Basak, and G. Erpek, "Sensorineural 
Hearing Loss Associated With Otitis Media With Effusion in Children," 
International Journal of Pediatric Otorhinolaryngology, Vol. 46, No. 3, December 
15, 1998. 

6. K. L. McCance and S. E. Huether, Pathophysiology: The Biologic Basis for 
Disease in Adults and Children (St. Louis: Mosby), 1994. 

7. R. W. Weitz, The Sociology of Health, Illness, and Health Care (New York: 
Wads-worth Publishing Co.), 1996. 

8. Department of Justice, Final Rule on Title III of the Americans With 
Disabilities Act of 1990 (42 U. S. C. 12181). 

9. Department of Justice, Final Rule on Title II of the Americans With 
Disabilities Act of 1990 (42 U. S. C. 12181). 

10. United States Fire Administration, Federal Emergency Management Agency, Fire 
Stops With You- Special Population Campaign: Fire Risks for the Visually 
Impaired, Deaf and Hard of Hearing, and Older Adults, 1999. 

11. B. Levin, R. Paulsen, and J. Klote, "Fire Safety," Access Information 
Bulletin, National Center for a Barrier Free Environment, 1981. 

12. J. Kuns, "Public Education," Proceedings of the 1980 Conference on Life 
Safety and the Handicapped, National Bureau of Standards, NBS-GCR Series 
(Washington DC: GPO), 1981. 

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