Ionization and photoelectric smoke alarms in rural Alaskan homes. (1/11)

OBJECTIVE: To compare rates of nuisance alarms and disconnection between ionization and photoelectric smoke alarms. DESIGN: A prospective cohort study. SETTING: Four Inupiat Eskimo villages in the Northwest Arctic Borough region of Alaska, 48 km (30 mi) above the Arctic Circle. SUBJECTS: Households in 4 communities with similar populations, number of homes, mean income, size of household, and square footage per home. INTERVENTION: Two villages had photoelectric alarms installed (58 homes), and 2 other villages had ionization alarms installed (65 homes) in standard locations. Follow-up household surveys were conducted after 6 months to determine rates of false alarms and detector disconnection. All of the households that could be contacted 104/123 agreed to participate in the follow-up surveys. Main outcome measures The proportion of households experiencing false alarms and the proportion of disabled alarms in households in each of the test communities. RESULTS: Homes with ionization alarms had more than 8 times the rate of false alarms as those with photoelectric alarms. Eleven of the ionization alarms (19%) were disconnected compared with 2 of the photoelectric devices (4%). CONCLUSIONS: In small rural residences, photoelectric smoke alarms have lower rates of false alarms and disconnection. Photoelectric alarms may be the preferred choice for dwellings with limited living space or frequent false alarms.  (+info)

Medicare and Medicaid programs; fire safety requirements for certain health care facilities. Final rule. (2/11)

This final rule amends the fire safety standards for hospitals, long-term care facilities, intermediate care facilities for the mentally retarded, ambulatory surgery centers, hospices that provide inpatient services, religious nonmedical health care institutions, critical access hospitals, and Programs of All-Inclusive Care for the Elderly facilities. Further, this final rule adopts the 2000 edition of the Life Safety Code and eliminates references in our regulations to all earlier editions.  (+info)

Reactive airways dysfunction syndrome caused by bromochlorodifluoromethane from fire extinguishers. (3/11)

Although the neurological and cardiovascular effects of Freons have been extensively described, the respiratory effects have been less well documented. We report four cases of occupational asthma following accidental exposure to bromochlorodifluoromethane (Halon 1211) due to release of the contents of a fire extinguisher. All subjects developed an irritative reaction of the upper airways and lower respiratory symptoms immediately after exposure. Non-specific bronchial hyperreactivity was present for at least two months in all subjects and was still present more than two years after exposure in one case. The diagnosis of reactive airways dysfunction syndrome can be adopted in at least three of these four cases.  (+info)

Surgical fires: perioperative communication is essential to prevent this rare but devastating complication. (4/11)

A fire on or within a surgical patient is a continuing risk in modern surgery. Unfortunately, the sensitivity of surgical and anaesthesia staff to this hazard has waned over the past 25 years with cessation of the use of flammable anaesthetic agents. Prevention of surgical fires requires understanding the risks and effective communication between surgical, anaesthesia, and operating nursing staffs. Preventive measures exist but have yet to diffuse sufficiently across professional boundaries. Based on a review of relevant databases, decades of experience from field investigations, and a review of the medical literature, this paper discusses the incidence of surgical fires, the responsibility for prevention in the perioperative setting, and the procedures for surgical fire prevention and extinguishment.  (+info)

Medicare and Medicaid programs; fire safety requirements for certain health care facilities; amendment. Interim final rule with comment period. (5/11)

This interim final rule with comment period adopts the substance of the April 15, 2004 temporary interim amendment (TIA) 00-1 (101), Alcohol Based Hand Rub Solutions, an amendment to the 2000 edition of the Life Safety Code, published by the National Fire Protection Association (NFPA). This amendment will allow certain health care facilities to place alcohol-based hand rub dispensers in egress corridors under specified conditions. This interim final rule with comment period also requires that nursing facilities install smoke detectors in resident rooms and public areas if they do not have a sprinkler system installed throughout the facility or a hard-wired smoke detection system in those areas.  (+info)

Grand rounds: outbreak of hematologic abnormalities in a community of people exposed to leakage of fire extinguisher gas. (6/11)

CONTEXT: Although there are ample data on the respiratory effects of exposure to fire extinguisher gas, the potential hematologic effects have not been fully documented. We conducted this study to determine the possible etiologic agent(s) for a decrease in red blood cells among community residents in Taipei, Taiwan, after they were exposed to leakage of mixed fire extinguishants containing bromotrifluoromethane (CF3Br, Halon 1301), bromochlorodifluoromethane (CF2BrCl, Halon 1211), and dichlorodifluoromethane (CCl2F2, CFC-12). CASE PRESENTATION: We studied 117 exposed residents who came into one hospital for physical examinations. We also selected age- and sex-matched referents for comparison from residents who came to the same hospital for health examinations. Nine months after the exposure to mixed fire extinguishants, 91 of the exposed residents came back for a second physical examination. In the first examination of the exposed residents, we found a significant reduction in red blood cell count and hemoglobin and a relationship between dose and response. DISCUSSION: After excluding iron-deficiency anemia, thalassemia, and other possible agents, we suspected that the hematologic effects might have resulted from pyrolytic products of CFC-12 and Halon 1211, which may contain phosgene, among other products. RELEVANCE TO CLINICAL PRACTICE: The acute transient hematologic effects observed in the exposed residents were associated with the incident of leakage of mixed fire-extinguisher gases and were most likely caused by a small amount of pyrolytic products, probably phosgene. Nine months after the exposure, we found a significant improvement in the abnormalities without any specific treatment.  (+info)

Medicare and Medicaid programs; fire safety requirements for long term care facilities, automatic sprinkler systems. Final rule. (7/11)

This final rule requires all long term care facilities to be equipped with sprinkler systems by August 13, 2013. Additionally, this final rule requires affected facilities to maintain their automatic sprinkler systems once they are installed.  (+info)

Updating fire safety standards. Final rule; affirmation. (8/11)

This document affirms as final, without changes, a provision included in a final rule with request for comments that amended the Department of Veterans Affairs (VA) regulations concerning community residential care facilities, contract facilities for certain outpatient and residential services, and State home facilities. That provision established a five-year period within which all covered buildings with nursing home facilities existing as of June 25, 2001, must conform to the automatic sprinkler requirement of the 2009 edition of the National Fire Protection Association (NFPA) 101. This rule helps ensure the safety of veterans in the affected facilities.  (+info)