U.S. Fire Administration

TOPICAL FIRE RESEARCH SERIES

Volume 2, Issue 8

October 2001 (Rev. March 2002) 

Medical Facility Fires

FINDINGS

S An estimated 2,500 fires occur each year in medical facilities, resulting

in $8.7 million in property loss.

S Injuries per medical facility fire are four times greater than that of all

U.S. fires. Two-thirds of injuries are from smoke inhalation.

S The leading cause of medical facility fires is cooking, with the kitchen

as the leading area of fire origin.

S Most medical facilities are equipped with smoke alarms or sprinklers or

both.

Sources: NFPA and NFIRS

Each year in the United States, an average of 2,500 fires occur in medical facilities,

resulting in approximately 5 civilian fire deaths, 125 injuries, and $8.7 million in property loss.

1

Medical facilities include hospitals, clinics, infirmaries, and other facilities that provide care to the sick and injured. Fires in these facilities can be particularly dangerous

due to the presence of oxygen and other flammable substances and the challenge of evacuating patients who may not be ambulatory.
LOSS MEASURES

Figure 1 compares the loss measures for fires in medical facilities to those for all

fires and those in non-residential structures.

Figure 1. Loss Measures for Medical Facility Fires

(3-year average, NFIRS data 1996–98)

MEDICAL

FACILITY

LOSS MEASURE ALL FIRES FIRES

NON-RESIDENTIAL

STRUCTURE FIRES

Dollar Loss/Fire

Injuries/1,000 Fires

Fatalities/1,000 Fires

$5,619

15.7

2.4

$21,878

22.1

1.7

$4,286

59.2

2.2

Source: NFIRS only

WHERE FIRES START

Eighty-nine percent of medical facility fires occur in hospitals, and 10% occur in

clinics. Fires most often originate in the kitchen (20%); additionally, 11% begin in

patient rooms, and 9% in laundry rooms. This pattern resembles the pattern seen in residential structure fires, which is not surprising given that hospitals have characteristics

similar to residential structures. Fore example, both hospitals and residential structures

are occupied 24/7 and must support the activities of daily life (e.g., cooking, laundry).

CASUALTIES

Medical facility fires tend to be more injurious than other categories of fires, but

generally cause less damage. This pattern is likely because, although medical facility

fires tend to be small, their smoke is deadly. For civilian casualties (both injuries and

fatalities), the majority (66%) suffered from smoke inhalation; 44% percent of these

casualties were attempting fire control at the time of their injury. Overall, about half of

casualties were either intimately involved with the ignition of the fire or in the same

room; 40% were on the same floor as the fire.

Virtually all reported civilian fire injuries and 100% of reported civilian fire fatalities occur in hospitals. Patients in hospitals are more likely than patients in other facilities

to be incapacitated or otherwise unable to escape from a fire. Further, 48% of casualties

in hospitals either are intimately involved with the fire’s ignition (e.g., their clothing or

bedding ignites) or are in the room where the fire ignites.
CAUSES

Figure 2 displays the causes of medical facility fires. Cooking is the leading cause of

these fires, followed by appliances (including air conditioners) and other equipment. Factors influencing fire ignition include electrical short circuits (15%), leaving ignition

materials unattended (12%), and abandoning/discarding ignition materials improperly

(9%).

Figure 2. Leading Causes of Medical Facility Fires

(3-year average, NFIRS data 1996–98)

0 5 10 15 20 25

Cooking

Appliances, A/C

Other Equipment

Electrical Distribution

Incendiary/Suspicious

Smoking

Open Flame

Heating

Other Heat

Natural

Exposure

Adjusted Percent Source: NFIRS only
WHEN FIRES START

Figures 3 and 4 illustrate the occurrence of fires in medical facilities by month of the

year and day of the week, respectively. Fires peak in the first two months of the year and

occur more often during the workweek.

Figure 3. Medical Facility Fires by Month of Year

(3-year average, NFIRS data 1996–98)

0 6 10 12

January

February

March

April

May

June

July

August

September

October

November

December

Adjusted Percent

Source: NFIRS only

2 4 8

Figure 4. Medical Facility Fires by Day of Week

(3-year average, NFIRS data 1996–98)

0 9 12 15 18

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Adjusted Percent

Source: NFIRS only

3 6
-

WHAT IS IGNITED

Figure 5 lists the leading types and forms of materials ignited in medical facility

fires. Given the high incidence of cooking and various electrical fires as major causes of

such fires, the prominence of fabrics, plastics (including wire insulation), and cooking

materials (including grease) is not surprising.

Plastic

Fabric

Paper

Volatile Solid (including

food, grease)

27.9

19.5

17.3

10.7

Electrical Wire

Cooking Materials

Rubbish

Bedding

Figure 5. Materials Ignited in Medical Facility Fires

(3-year average, NFIRS data 1996–98, adjusted percentage)

TYPE OF

MATERIAL IGNITED

PERCENT

OF FIRES

PERCENT

OF FIRES

23.5

18.4

8.0

5.7

FORM OF

MATERIAL IGNITED

Source: NFIRS only

SUPPRESSION/ALERTING SYSTEMS

Figure 6 compares the performance of sprinklers and smoke alarms during medical

facility fires. A smoke alarm was present and activated in 63% of medical facility fires, a

higher percentage than is found in other property types.

Fire too small to activate system

No equipment present

Equipment operated

Equipment should have operated,

but did not

63

29

6

2

In room of origin, operated

In room, fire too small to activate

Not in room or origin, operated

None present

Not in room, did not operate

In room, did not operated

Figure 6. Smoke Alarm and Sprinkler Performance in Medical Facility Fires

(3-year average, NFIRS data 1996–98, adjusted percentage)

SPRINKLER

PERFORMANCE

PERCENT

OF FIRES

PERCENT

OF FIRES

53

15

10

9

7

7

DETECTOR

PERFORMANCE

Source: NFIRS only

Even though sprinkler systems operated in only 6% of medical facility fires, sprinklers were installed in 94% of the structures.

The presence of built-in suppression and alerting systems in medical facilities is

tightly regulated, so it is not surprising that a preponderance of such properties are

equipped with alarms and sprinklers. (For further information, see NFPA 99, Standard

for Health Care Facilities, and NFPA 101 Life Safety Code, or contact the USFA.)
-

EXAMPLES

S In June 2000, 16 people (6 patients and 10 staff members) were evacuated from a

medical facility when a lighting fixture caused smoke to enter the facility’s HVAC

vents.

2

S In January 2001, a two-alarm basement fire at a New York hospital caused the

temporary relocation of 32 patients. The fire’s cause was not determined.

3

S In August 2001, an electrical fire at Walter Reed Army Medical Center caused the

relocation of 80 patients to medical facilities throughout District of Columbia, Virginia, and Maryland.4

S In December 1994, a patient smoking in his room ignited a small fire, which

extended somewhat into an adjacent corridor. The fire generated heavy smoke,

which killed four patients and injured several firefighters.

5

NOTES:

1. National estimates are based on data from the National Fire Incident Reporting System (NFIRS)

(1996–1998) and the National Fire Protection Association’s (NFPA’s) annual survey, Fire Loss in the

United States.

2. “Smoke Causes 16 To Flee Medical Facility,” The San-Diego Union Tribune, June 22, 2000.

3. Cuza, Bobby. “Fire in Flushing Hospital’s Basement,” Newsday, January 3, 2001.

4. “Fire, Power Outage Evacuates Hospital,” Associated Press, August 29, 2001.

5. Hospital Fire Kills Four Patients, Southside Regional Medical Center, Petersburg, Virginia, Major

Fires Investigation Project, U.S. Fire Administration, FEMA, 1995.

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