FIRE RISKS FOR THE MOBILITY 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 Mobility Impaired 

CONTENTS 

OVERVIEW OF THE 'FIRE RISKS' SERIES.. 1 
EXECUTIVE SUMMARY......... 3 
INTRODUCTION ..... 5 
WHAT IS A DISABILITY? ..... 7 
Mobility Impairments....... 8 
Growing Disability Community....... 9 
FIRE RISKS ..... 11 
Limited Means for Escape...... 11 
Limited Mobility....... 11 
The Newly Disabled ...... 12 
Residence....... 12 
FIRE SAFETY FOR SPECIAL-NEEDS POPULATIONS: TIPS FOR FIRE SERVICE 
PROFESSIONALS....... 13 
Recommendations for Assisting Mobility-Impaired People in an Evaluation of Their 
Fire Safety Needs ..... 13 
Building Design and Codes...... 14 
Instructional Materials ......... 15 
CONCLUSIONS ... 17 
APPENDIX: FIRE SAFETY TIPS FOR MOBILITY-IMPAIRED PEOPLE... 19 
Before the Fire During the Fire 
Fire Prevention 
REFERENCES 

Fire Risks for the Mobility 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 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 Mobility Impaired 3 

EXECUTIVE SUMMARY 

People with mobility impairments are faced with many challenges in life. 
Personal safety, especially fire safety, is one challenge that many perceive as 
an obstacle. It does not have to be this way. By being aware of one's own 
special capabilities and fo llowing fire-safety practices tailored to certain 
needs, the mobility-impaired person can lead a fire-safe life. 

Mainstream fire safety education and fire protection devices are designed 
primarily with the able-bodied person in mind. Thus a scarcity of fire safety 
knowledge exists within both the mobility-impaired community and the fire 
service. Both groups must work to edu-cate each other to decrease fire-related 
losses and injuries. 

The principal findings of this study are summarized below: 

 People with mobility impairments represent a segment of the population with 
one of the highest risks of dying in a fire. 

 The fire safety needs of people with mobility impairments are not addressed 
through mainstream public fire and life safety education. 

 Fire safety engineering has not adequately addressed the capabilities of 
people with mobility impairments. 

 Typical home construction may present people with disabilities with unneces-
sary impediments to escape. 

 The mobility-impaired community is growing. 

 Mobility impairments hinder attempts by the disabled not only to escape fires, 
but also to confine or extinguish small fires. 

Fire Risks for the Mobility Impaired 5 

INTRODUCTION 

In 1990, the United States Congress passed the Americans With Disabilities Act 
(ADA), which extended civil rights protection to individuals with disabilities 
(Reference 1). Title III of the ADA is most applicable to fire safety, as it 
prohibits discrimination of disabled persons in places of public accommodation. 
The proprietors of such businesses are responsible for making their 
establishments more physically accessible to people with disabilities. The ADA 
requires the installation of emergency alarms in public places that serve both 
hearing and non-hearing patrons, the installation of entrance and exit ramps, as 
well as the widening of doorways to accommodate wheelchairs (Reference 1). 

Although Title III greatly improves provisions for the disabled, it does not 
specifically address fire and disaster evacuation needs in either public 
buildings or private homes. According to the accessibility guidelines for all 
new construction, each floor in a public building without a supervised automatic 
sprinkler system must contain an area of rescue assistance (i. e., an area with 
direct access to an exit stairway where people unable to use stairs may await 
assistance during an emergency evacuation) (Reference 2). This standard concedes 
the fact that some people with mobility impairments may not be able to exit a 
building in the same manner by which they entered. People with mobility 
impairments are limited by time and physical means for mobility when it comes to 
escaping a fire emergency. As a result of their inherent limitations, mobility-
impaired individuals must be particularly diligent when cultivating a fire 
escape plan in both public and private places. This plan may be as simple as 
living on the ground floor of one's home. 

Few data are available on the actual number of fire deaths and injuries among 
people with disabilities. This is true 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)- indicate whether the deceased was disabled. 
Although 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, it does not contain an entry for the presence of physical or mental 
disabilities. This civilian casualty report does contain a segment that 
describes theoretical reasons as to why an individual did not escape the fire. 
In the entry entitled condition preventing escape, the reporting fire service 
representative may postulate as to whether a physical impediment prohibited the 
victim's escape, whether the victim "moved too slowly," or whether the victim 
was "incapacitated." Although these last two descriptions may technically cover 
a wide range of disabilities, they also cover a victim under the influence of 
drugs or alcohol. Any available fire death and injury data regarding individuals 
with physical disabilities must be viewed under this caveat. The numbers of 
fire-related deaths and injuries sustained by the disabled are no doubt 
underreported and underemphasized in public fire education and fire prevention 
efforts. 

This report focuses on disabilities that impair or alter the mobility of an 
individual in a fire emergency. It is directed to those people who depend on 
artificial means for mo ving about, including wheelchairs, walkers, and 
assisted-walking devices. 

The report is divided into three principal sections. The first section defines 
the term disability and discusses the impact of disabilities. Also discussed are 
the current and projected population estimates of people with mobility 
impairments. 

Fire Risks for the Mobility Impaired 6 

The second section of this report focuses on the characteristics of people with 
mo-bility impairments that place them at risk for injuries, especially fire 
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 Mobility Impaired 7 

WHAT IS A DISABILITY? 

To the general public, a disability is some type of physical impairment that 
prohibits one from performing the normal activities of daily life. People with 
disabilities, however, view themselves in an entirely different light. To the 
disabled community, the disabilities that they experience stem not from physical 
impairments but from the way others perceive disabilities and the conscious or 
unconscious decision to construct an environment that does not meet their needs. 
From this paradigm, true disability stems from the social response to bodies 
that fail to meet social expectations and is reflected in both the social and 
built environments (Reference 3). By providing reasonable accommodations in 
public areas for people with disabilities, the design community is merely 
compensating for the unacknowledged benefits that the existing environment 
provides to those who are free from disability. 

There are wide variations in the definition of disability. Equally wide are the 
variations in the reporting mechanisms that gauge the size of this population. 
According to the Americans With Disabilities Act, a disability is defined as (1) 
a physical or mental impairment that substantially limits one or more of the 
major life activities of such an individual; (2) a record of such an impairment; 
or (3) being regarded as having such an impairment. Major life activities refer 
to functions such as caring for oneself, performing manual tasks, walking, 
seeing, hearing, speaking, breathing, learning, and working. As a result of its 
legal implications, the ADA requirements for having a qualified disability are 
broad. The ADA was passed to prohibit discrimination toward individuals with 
real or perceived disabilities, as either may have detrimental effects in the 
social and business worlds (Reference 4). 

Individuals with disabilities are also entitled to federal benefits and 
supplemental income. In 1999, 6 million people received disability benefits 
under either the Supplemental Security Income program or the Old-Age, Survivors 
and Disability Insurance program (Reference 5). 

According to the U. S. Census Bureau's Survey of Income and Program Participa-
tion (SIPP), 20 percent of noninstitutionalized Americans had some form of 
disability (Reference 6). The SIPP is the most current source of periodic data 
on the prevalence and characteristics of disabilities in the United States. The 
SIPP incorporates variables such as income, employment, health insurance 
coverage, and the receipt of program benefits. The definitional criteria used to 
describe the two levels of disability are as follows (References 6 and 7): 

Disability 

 Uses a wheelchair or is a long-term user of a cane, crutches, or walker. 
 Has difficulty performing one or more functional activities- seeing, hearing, 
speaking, lifting/ carrying, using stairs, or walking. 
 Has difficulty with one or more activities of daily living (ADL)- getting 
around inside the home, getting in or out of a bed or chair, bathing, dressing, 
eating, or toileting. 

Fire Risks for the Mobility Impaired 8 

 Has difficulty with one or more of the instrumental activities of daily living 
(IADL)- going outside the home, keeping track of money or bills, preparing 
meals, doing light housework, taking prescription medicines in the right amount 
at the right time, or using the telephone. 
 Has one or more of the following conditions: learning disability, mental 
retardation, or another developmental disability (Alzheimer's disease or some 
type of mental or emotional condition). 
 Is limited in the ability to do housework. 
 Is 16 to 67 years old and limited in the ability to work at a job or business. 
 Is receiving federal benefits based on an inability to work. 

Severe Disability 

 Uses a wheelchair or is a long-term user of a cane, crutches, or walker. 
 Is unable to perform one or more functional activities. 
 Needs personal assistance with an ADL or an IADL. 
 Has a developmental disability or Alzheimer's disease. 
 Is unable to do housework. 
 Is 16 to 67 years old and unable to work at a job or business. 
 Is receiving federal disability benefits. 

The SIPP covers in great detail many conditions that alter or hamper functional 
activities. The estimates derived from the SIPP are based on individual 
interpretation of the criteria for disabilities and are subjective in nature. 
The federal guidelines under the ADA have been intentionally left broad and 
vague to allow for the widest possible interpretation of the term disability 
(Reference 4). As a result, the SIPP data include a large number of people who 
would not be considered "disabled" by the lay person. Nevertheless, the SIPP is 
considered by many to be the best estimate of the number of individuals with 
disabilities. For the purpose of this report, the mobility-impairment guidelines 
outlined in the SIPP will serve as the criteria for defining mobility 
impairments. 

Mobility Impairments 

People with physical disabilities rely on a variety of artificial means for 
mobility. Such devices range from canes and walkers to motorized wheelchairs. 
Approximately 1.8 million people in the United States use a wheelchair, and 5.2 
million people have used a cane, crutches, or a walker for longer than 6 months 
(Reference 6). The most prevalent causes of mobility impairments are orthopedic 
in nature, the result of paralysis or other deformities, such as the absence of 
a limb. Others are organic in nature, stemming from birth defects, illness, and 
degenerative nerve disorders. Organic causes also include cerebral palsy, 
muscular dystrophy, multiple sclerosis, Parkinson's disease, polio, epilepsy, 
and stroke (Reference 8). 

Fire Risks for the Mobility Impaired 9 

Growing Disability Community 

According to the NCHS's National Health Interview Survey, nearly 20 percent of 
the U. S. population, or 54 million people, have some type of disability. Of 
this group, almost half (48 percent) are classified as having a severe 
disability. The number of disabled persons has risen dramatically over the past 
20 years and is expected to continue to increase. While some of this growth may 
be attributed to the expanding government definitions of what constitutes a 
disability, much of it is the result of the demographic shift of the elderly 
population. Of the 54 million disabled people in this country, 13.4 percent are 
males over the age of 65, and 20.4 percent are females over the age of 65 
(Reference 9). With people living longer, the number of disabled people can be 
expected to rise. While it is difficult to quantify how many of these 
individuals would be mobility impaired, it would be reasonable to assume that 
the "graying of America" will result in more mobility impairments. 

Fire Risks for the Mobility Impaired 11 

FIRE RISKS 

Individuals who have lived with a mobility impairment for a number of years, or 
even a lifetime, have, for the most part, adapted extremely well to their 
environments. Those who are newly or temporarily disabled may find it difficult 
to adapt, even in familiar surroundings. This "inexperience" may increase their 
risk for starting a fire and at the same time may reduce their chances of safely 
escaping a fire. Traditional routes of escape may no longer be viable to the 
individual who is temporarily in a cast or wheelchair. A disabled individual's 
chances for escape are further limited if the person lives alone and cannot 
receive immediate assistance or does not live on the ground floor. 

Limited Means for Escape 

As noted earlier, almost 2 million people in the United States are confined to a 
wheelchair, and over 5 million use a cane, crutch, or a walker (Reference 6). 
This physical limitation requires various accommodations for moving safely into, 
through, and out of a building. Even under normal circumstances, moving about 
may be time consuming. In the event of a fire, some accommodations used to move 
about in a building- elevators, for example- may pose a grave risk to users. 
When first introduced, elevators were extolled as a safe and effective means for 
moving throughout a structure. They quickly gained popu-larity and are used in 
nearly every building with multiple stories. In conjunction with ramps, they 
allow many existing structures to be retrofitted to comply with ADA standards. 
In the event of a fire, however, elevators are anything but safe. In fact, they 
can trap people inside a burning building. During a fire, elevator shafts act as 
chimneys, funneling smoke and toxic fumes to floors above (Reference 10). In 
addition, heat emanating from a fire may activate the button to call the 
elevator, thereby bringing elevator riders directly to the floor of the fire. 
Fire emergencies necessitate alternative means for egress. 

ADA accessibility guidelines dictate that public buildings contain areas where 
persons with disabilities may wait until further help or instructions arrive 
(Reference 1). While private, multiresident homes are not subject to the same 
standards, current trends in fire safety design are beginning to include this 
feature. Rescue areas must be directly accessible to an exit and fire resistant 
for at least 1 hour. Refuge areas must be able to hold 10 percent of the 
occupants on the floor, with 15 square feet allotted to each occupant. Two such 
areas must be provided on each floor, and ductwork must be designed to prevent 
the passage of smoke (Reference 2). 

Limited Mobility 

Individuals with mobility impairments have a diminished capacity to deal with 
fire. Fires grow rapidly and may quickly overpower a person who is not readily 
equipped with an extinguishing device. If clothing or flammable materials near a 
disabled person have caught fire, traditional methods of extinguishing the 
flames are not applicable. "Stop, Drop, and Roll," a popular message directing 
the proper method for extinguishing burning clothing, may not be a viable option 
for persons with severe mobility impairments. 

Fire Risks for the Mobility Impaired 12 

The Newly Disabled 

Traumatic injuries occur every day in this country. In fact, trauma is the 
leading cause of death for people between the ages of 1 and 40 (Reference 11). 
In addition to claiming lives, unintentional injuries may permanently or 
temporarily alter an individual's mobility. Such "newly disabled" people may be 
at greater risk for reinjuring themselves than individuals who have lived with a 
physical disability all of their lives. A substantially limiting injury forces 
an individual to adapt to a new way of life= one with new dimensions, obstacles, 
and setbacks. Suddenly an individual's own home may become a hazardous 
environment filled with potentially dangerous items. Walking, cooking, driving, 
and working- activities that were previously taken for granted- suddenly become 
challenges. 

During the reacclimation phase following an injury, such activities pose a risk 
for further injuries. Cooking is a prime example. Unaccustomed to limited 
mobility, an individual suddenly confined to a wheelchair, or to the use of just 
one limb, can easily get burned on the stove or have a garment catch fire. Even 
fires common among the nondisabled are more dangerous. A grease fire can quickly 
grow out of control if the newly disabled person cannot promptly extinguish it. 
Learning to live with a disability means ac-knowledging the vulnerability to 
dangers inherent in the environment. 

Residence 

A mobility impairment may require an individual to reside in a long-term care 
facility or a group home to receive assistance with ADLs. Fire emergencies in 
these facilities place these residents at significant risk for a variety of 
reasons. Due to their impairments, these residents are most in need of staff 
assistance when evacuating to escape a fire. There are typically fewer staff 
than patients, and the ratio may become unfavorable at night (fewer staff 
generally work at night) (Reference 12). During a fire emergency, at least two 
staff members are required to evacuate a bedridden or wheelchair-bound person, 
further depleting staff resources and leaving those with less severe 
disabilities or mobility impairments with less assistance available. 

Another risk is the construction of nursing and group homes. These facilities 
are often designed with open ceilings that facilitate the passage of smoke 
throughout upper levels (Reference 13). During the time it takes to evacuate 
people needing assistance, residents as well as staff members can easily succumb 
to smoke inhalation (Reference 14). Moreover, many of these facilities were 
built before current fire codes were enacted and thus have limited means for 
egress, combustible interior finishes, and a lack of automatic sprinkler systems 
(Reference 13). 

People with mobility impairments living in private residences may receive little 
or no help in the event of a fire. Whether the disabled person is living alone 
or with friends and family members, a house fire can trap him or her inside a 
room. Often the door is the only exit, and escape through a window may not be 
possible. Such individuals must create a contingency plan for this type of 
situation. When escape is not an option, fire protection devices such as 
sprinkler systems, fire-safe compartmentation walls, and flame-resistant 
blankets must be used. Fire hazards unique to people with disabilities can be 
circumvented with the appropriate behavior and fire protection technology. 

Fire Risks for the Mobility Impaired 13 

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

Recommendations for Assisting Mobility-Impaired People in an Evaluation of Their 
Fire Safety Needs 

Focus groups found that being identified as "special" or "needy" was a concern 
for individuals with mobility impairments (Reference 15). 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 16). 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 mobility impairment is to acknowledge 
their ability to help themselves, while guid-ing 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 mobility-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. Mobility-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 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 an individual with mobility 
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 17): 

Fire Risks for the Mobility Impaired 14 

 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 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 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 18). They should 
provide some insight into the role of building design in the fire safety needs 
of the mobility-impaired 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 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. 

Fire Risks for the Mobility Impaired 15 

 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 
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 Mobility Impaired 17 

CONCLUSIONS 

Individuals with mobility impairments have unique needs and capabilities that 
put them at risk for fire injuries. These limitations, ranging from wheelchair 
confinement to walking with a cane, may also subsequently increase the chance 
that the individual will accidentally start a fire. Traditional fire safety 
messages are designed with the capabilities of the non-disabled population in 
mind. A disabled individual may have difficulty performing even the most basic 
of these fire safety practices. 

When designing fire safety programs and fire-safe structures for the mobility 
impaired, it is important to look at the nature of the impairments, the types of 
residences (single-family homes, high-rise buildings, boarding homes, nursing 
homes, group assisted-living facilities), and the social setting or the degree 
of assistance one can expect from others. Each variable contributes to the level 
of risk and degree of assistance to which people with mobility impairments may 
be exposed. 

Mobility impairments may restrict the individual's ability to take swift action 
when faced with a small fire or to escape a larger fire. As a result, people 
with mobility deficits require construction alterations that help facilitate 
their timely exit in the event of a fire. This varies by occupancy type. Single-
family homes, apartment buildings, and group assisted-living facilities each 
pose unique challenges to escaping a fire. In a private home, the mobility-
impaired individual is most likely to incorporate modifications, such as 
installing exit ramps and living on the ground floor. In an apartment setting, 
the mobility-impaired individual may reside several floors from the ground and 
far from the exit stairs. Elevators that are convenient and safe during normal 
conditions are not viable escape mechanisms in the event of a fire. Group 
assisted-living homes present risks because the number of residents requiring 
assistance often greatly exceeds the number of staff available to provide it. 
Construction elements and design, as well as hazardous medical supplies and 
equipment, create additional dangers in the event of a fire. 

The degree of support that a mobility-impaired individual receives from family, 
friends, or neighbors affects his or her ability to lead a fire-safe life. 
Clearly, individuals living alone and without support are more susceptible to 
fire risks. They are also less likely to perform basic fire prevention practices 
due to physical limitations. Outside assistance may be necessary for installing 
and maintaining smoke alarms, cleaning grease buildup around the stove, or 
replacing worn or frayed electrical wiring. 

Fire safety education, engineering, and legislation must adapt to accommodate 
the needs of the mobility impaired. Awareness through educational campaigns can 
encourage people with mobility deficits to practice techniques that will 
decrease their chances of accidentally starting a fire. Accessibility 
improvements will provide construction that dramatically eases the mobility-
impaired person's ability to escape a fire. Enhanced fire safety technology, 
such as a fire-safe elevator, can help ensure the disabled individual's safe 
egress from a burning building. By cultivating programs that approach the 
problem from multiple dimensions, fire safety no longer has to be an 
insurmountable challenge. 

Fire Risks for the Mobility Impaired 19 

APPENDIX: FIRE SAFETY TIPS FOR MOBILITY-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. The U. S. Fire Administration considers smoke 
alarms to be the single most important piece of fire safety equipment available 
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 
mate-rial 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 Mobility 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. 

Heed Fire Safety and Design Guidelines. Walkways and doorways should accommodate 
any mobility impairment the individual may have. For example, doorways should 
accommodate a wheelchair's width, and flooring material should accommodate 
artificial limbs or canes. 

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 
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. 
Keep smoke alarms clean by vacuuming or having them vacuumed 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. If your smoke alarms are 
hard-wired (connected to the electric circuitry of your residence), make sure 
they are also equipped with battery backups. 

To accommodate wheelchair users in public buildings, manual alarm pull stations 
should be mounted no higher than 48 inches from the floor. If manual alarms are 
mounted higher than 48 inches, these devices should be retrofitted with 
attachments that make them accessible to a wheelchair user. 

Have a Fire Extinguisher- and Learn How To Use It. If you are confined to a 
wheelchair, consider mounting (or having some-one mount) a small "personal use" 
fire extinguisher in an accessible place on your wheelchair, and become familiar 
with its use. Then, if 

Fire Risks for the Mobility Impaired 

you cannot "stop, drop, and roll" during a fire, you should "pull, aim, squeeze, 
and sweep." 

Live Near an Exit. If you live in an apartment building, try to get an apartment 
on the ground floor. If this is not possible, know where the exit stairwell is 
and plan to wait there for help if you can-not take the stairs in the event of a 
fire. 

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. Keep emergency telephone numbers 
handy as well. If necessary, construct an exit ramp for emergency exits. It is 
recommended that ramps be at least 36 inches wide. Guardrails and handrails 
should be 44 to 48 inches high and 34 to 38 inches wide. 

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 accommodations 
(such as installation of exit ramps) to facilitate an emergency escape. 

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 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 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 a fire. Do not use the elevator. 
Once out, do not go back inside. 

Fire Risks for the Mobility Impaired 

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. 

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 a 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. 

Fire Risks for the Mobility Impaired 

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 
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 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. 

Fire Risks for the Mobility Impaired 

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 Mobility Impaired 

REFERENCES 

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

2. U. S. Department of Justice, Architectural and Transportation Barriers 
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Buildings and Facilities (Washington: GPO), 1991. 

3. R. W. Weitz, The Sociology of Health, Illness, and Health Care (New York: 
Wadsworth Publishing Co.), 1996. 

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

5. Social Security Administration, Office of Research, Evaluation and 
Statistics, High-lights of Social Security Data- June 1999. 

6. U. S. Department of Commerce, Economic and Statistics Administration, U. S. 
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1994- 95, Current Population Reports, Number P70- 61 (Washington: GPO), 1997. 

7. U. S. Department of Commerce, Economics and Statistics Administration, U. S. 
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1994. 

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9. U. S. Department of Commerce, Economics and Statistics Administration, U. S. 
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19910 92, Number P70-33 (Washington: GPO), 1994. 

10. E. Mahoney, Fire Suppression Practices and Procedures (Englewood Cliffs, NJ: 
Prentice-Hall), 1992. 

11. U. S. Department of Commerce, Economics and Statistics Administration, 
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(Washington: GPO), 1993. 

12. R. L. Cherry, "Agents of Nursing Home Quality of Care: Ombudsmen and Staff 
Ratios Revisited," Gerontologist, June 3, 1991. 

13. P. Blye and J. P. Yess, "Fire Safety in Elderly Housing," NFPA Journal, 
November/ December 1987. 

14. J. S. Petraglia, "Fire and the Aging of America," NFPA Journal, March/ April 
1991. 

15. 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. 

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

Fire Risks for the Mobility Impaired 

17. 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. 

18. Robert James Sorensen, Design for Accessibility (New York: McGraw-Hill Book 
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