In the past 15 years the U.S. civilian fire death rate dropped 40%. This brought the United States to where the British were 15 years ago. Since then, the British have dropped another 40%, which is a huge achievement, because progress becomes more difficult the lower overall number gets. What did they do to achieve that, and can America do it, too?

The National Center for Injury Prevention and Control, a branch of the Centers for Disease Control and Prevention, and the leaders of the Department of Homeland Security's Assistance to Firefighters Grant program wanted the answers. To this end, a three-year program has been started to identify best practices in home fire safety in three parts of the globe: Europe, the Pacific Rim nations, and Latin America. The TriData division of System Planning Corp. has undertaken international research on fire protection for over two decades, and was asked to assist.

The British fire service has undergone sweeping changes to emphasize prevention much more than it did in the past. It used to do prevention similar to how it is done in the United States, but have introduced new practices that are worth emulating. Some of these practices are based in part on U.S. research on the effectiveness of fire-prevention programs and reaching those who are hard to reach. So it is only fitting to borrow back the more fully developed and tested ideas.

The United Kingdom does not have a national fire service, rather it is run by local authorities. There are 56 consolidated, autonomous fire brigades serving the nation. All British firefighters now are required by contract to do prevention work when asked. And much of the new prevention work is carried out by line firefighters. To make this work the national standards of cover for response times and weight of attack were dropped to allow more time for prevention activities. Prevention is considered a line service, not a support service, and usually reports to the chief of operations. Targeting these prevention activities is based on local risk analysis.

The British fire service is using a combination of line firefighters and prevention specialists to visit a large percentage of high-risk homes. The researchers say this is the most important fire-prevention practice they discovered. The national and local fire authorities feel this is a key to their success in reducing fire deaths over the past decade. Each fire brigade has a somewhat different implementation approach for its home-visit programs, but they are all reaching many high-risk households. These high-risk households must agree to the visit and most do, based on publicity about the program, word of mouth, and that it is free.

Home visits are scheduled via fire brigade call centers that are separate from the dispatch centers and staffed with friendly, marketing-type personalities. Most home visits are scheduled by direct contact from the household, but some come from referrals from social services, other agencies or from households already visited. The brigades make home visits in selected morning, afternoon, and evening periods. The times are based on a combination of considering when emergency calls are relatively low and when someone is likely to be home.

Each home visits takes about an hour. Activities in the home include testing and installing smoke alarms, inspecting for visible hazards and mitigating visible hazards. There also is one-on-one education, which ideally leads to changing safety-related behaviors. During the visits, data are collected on the risks found in the household. The home will be revisited anywhere from one week to eight years after the initial visit, depending on the perceived risk at the end of the visit.

Community safety specialists, called advocates, join firefighters in visiting many ethnic and high-risk households. Their specialties include knowledge of foreign languages and problems of the elderly, alcoholics, and the hearing or mobility impaired.

In most brigades, the home-safety visit program has involved hundreds of thousands of households. A significant percentage of high-risk households have been reached and more are planned.

For example, the Merseyside Fire and Rescue Service, which includes Liverpool, protects about 540,000 households. By the end of 2006, it had visited 300,000 of them and had installed 400,000 smoke alarms. Its goal is to visit 250,000 households in the next five years. The home-safety visits are divided among 42 fire units. Each station has 100 home inspections assigned per month. With four shifts, this breaks down to 25 home inspections per shift per month, a manageable number. Even the busiest stations find time to participate in the household visits.

West Midlands, which includes Birmingham, plans to conduct about 80,000 home visits and install 40,000 smoke alarms per year among its approximately 1 million households. That brigade has been conducting 50,000 home visits per year, focusing on the areas with highest fire risk. It too, divide the visits among stations and shifts.

To leverage resources and increase efficiency, local fire brigades use risk-analysis software that links fire data with socioeconomic data to estimate areas of high risk and to target fire-safety programs. Nationally developed risk models have been disseminated to all local fire brigades. The local fire brigades conduct integrated risk analysis to decide the best mix of prevention and suppression for their communities.

The local brigades are also using marketing-related software such as Mosaic to analyze the groups at risk from a marketing perspective. This information helps to determine the most effective way to promote prevention activities to specific populations.

Large numbers of individuals can be reached with consistent, clear messages through national and local public safety campaigns. The British use paid, prime-time television and radio spots, print media and the Internet. They do not rely on free public service announcements shown late at night. Selected local radio stations and newspapers are used to reach ethnic populations. Television and radio advertisements are run when people are implementing the behavior addressed, such as cooking safety at dinnertime.

The fire-safety campaigns also include getting coverage of the targeted issues on news and talk shows. Fire brigade personnel may call into or be interviewed for talk shows. This is particularly effective to reach elderly residents who are shut-in. Besides encouraging use and maintenance of smoke alarms, national campaigns call for household members to do bedtime fire-safety checks. Students are encouraged to do this if their parents do not. This bedtime check is especially important in homes where a parent is an alcoholic. Some national fire-safety campaigns also are targeted to alcoholics; dramatic television spots show how they endanger their children. Additional strategies include reminders about fire safety being posted above urinals in pubs both in England and Scotland, and pop-up fire safety ads on the Internet to reach children and youths.

Strategic partnerships between fire and other local government agencies such as health, social services and police are used to develop, fund and deliver fire-safety programs. These partnerships provide access to more resources and more ways to get safety information disseminated. The fire services have long realized that the fire problem is linked to many other social problems — alcoholism, infirmities from aging, disabilities, anti-social behavior of youths, public attitudes about government, discrimination, language problems of immigrants and asylum seekers, among others. One-third of fire-death victims in the United Kingdom come to the attention of social services prior to their demise, so the prospect of reaching more of the hard-to-reach through partnerships is potentially of great importance.

The fire service works with health and social service agencies on what they should check when they visit a household, especially a household where shut-in elderly individuals reside. The providers test smoke alarms and look for fire hazards. The agencies are asked to alert the local fire brigade if a fire service visit is needed. In return, the fire service alerts social service agencies after safety visits to households if the household wishes aid it is not receiving, or if an imminent danger is found such as an abused child or elderly person needing medical assistance. In Scotland, it is now mandatory for fire, police, health and social-service agencies to meet regularly to plan for safety.

A relatively new prevention approach in England is to design fire stations as community fire-safety centers, especially stations in high-risk areas or areas with populations that have been hard to reach. The concept is to entice people to visit the fire service and receive fire-safety information. The fire station becomes known as the place to obtain literature on a variety of subjects and in a variety of languages. The station also serves as a place for non-fire-related meetings of clubs, groups, and classes, such as English or computer trainings. The station personnel often use these meetings to pass on fire-safety information to these groups and to solicit volunteers from them to help with community safety programs.

Previously, most fire stations had their doors closed day and night. Now many are kept open, at least in daytime. By mingling with firefighters at the station and observing their activities, the community sees the firefighters more as people and not just helmeted figures.

The West Midlands brigade has an outstanding example of the new generation of fire stations. Its community fire station clocked more than 95,000 visitors since it opened. The station was built with areas from which the visiting public can watch firefighters train and respond to calls. The viewing area is a small, glass-walled hallway bordering the main apparatus hall.

Embedded in the fire station is a fire-safety house with unique features. The most startling innovation is a glass-walled observation area in front of which the firefighters can discuss fire safety in the home and perform a live-fire demonstration. They can show a pot cooking on the stove, then flames shooting up from the pot as if left unattended, then fire spreading to the surrounding flat areas and cabinets around the stove, and finally — the most striking part of the demonstration — the room flashing over. This is done with controllable propane jets. Seeing the live fire and feeling its heat through the glass makes a huge impression. Visitors can feel the blast of heat when flashover occurs, something few outside the fire service experience and live to tell about it. The corridors of the station lead to rooms with fire-safety video displays and interactive computers. These demonstrations are especially effective with children, but work for virtually all audiences.

The West Midlands station's reception area is open to the public and displays fire-safety literature in several languages. A receptionist provides literature, guides people to events, and records requests for meeting space, presentations and home visits.

Advances in fire-safety consumer products and their wider use has contributed to the United Kingdom's success in reducing the number of home fire deaths. The fire service is installing 10-year, tamper-proof, battery-powered smoke alarms; these also can be purchased by the general public. The batteries cannot be taken out and used for other purposes. The tamper proofing is especially important for households with children. The long-lasting batteries are especially important for the elderly. The fire service also provides portable home-sprinkler systems for extremely high-risk households.

Some stronger legal requirements in the United Kingdom also improve fire safety. Hard-wired smoke alarms are required in all new residential premises and major residential refurbishments. Flame- and cigarette-resistant upholstered furniture and bedding are required by national law, which also applies to the sale of used furniture.

School children are given safety education not only to improve their own safety now and as future adults, but also to serve as a means to bring safety information home to their parents. Most British school children are reached with a fire-safety program at least once in their elementary-school years. The brigades with school programs typically target children in the third grade either with an assembly program or meeting with a few classes at a time. Significant numbers of students in secondary schools also are being reached, and some brigades have programs in pre-school or nursery-level education.

The school programs in the United Kingdom are conducted mostly by firefighters but sometimes by teachers or prevention bureau personnel, uniformed or civilian. Firefighters who deliver this education in schools receive special training. In some brigades firefighters gradually take on responsibility for program delivery. They start as an observer, then are allowed to deliver part of the program under guidance and finally conduct the full program on their own. This approach eases then into a new role. Additional programs are targeted at youths who have demonstrated anti-social behavior such as fire-setting, attacks on firefighters or vandalism.

In London, the school program is not mandatory. The brigade asks schools to participate through a direct mailing. They classify schools as being in areas with five different levels of fire risk, from very high to very low, and work hard to get schools in the high and very high-risk areas to accept the programs. Not all of London is the same, and deployment of resources is not equal across the board. If the brigade cannot cover all the schools, they do those in the high-risk areas first.

London has a somewhat different approach to staffing its school program from most other brigades. The London program is conducted by the brigade's school team, which is comprised of about 15 school officers who are not firefighters. Most of them have experience in sales, not teaching, which the brigade has found to be a more suitable background for delivering safety messages. The sales-oriented school officers have a style of reaching out to children that is less preachy and less parental than teachers. Each school officer works five days a week exclusively on school fire-safety instruction. Their assignments to schools are centrally scheduled, so all their time is available for in-person outreach. Each school officer reaches about 10,000 to 12,000 students a year.

The elderly are at the highest risk of dying from fires in the United Kingdom, as they are in the United States, and thus are an important target population for prevention.

Partnerships with various social-service agencies increase resources and provide more ways to disseminate safety information to the elderly. While homes of high-risk elderly can be visited by the fire service, social-service caretakers also can be trained on fire-safety practices that they can implement or advocate during home visits. Home visits include testing or installing smoke alarms. However, that alone is not enough. The elderly sometimes feel safe if they have a working smoke alarm, so another focus has been to instruct them on the need to have an escape plan, too, since an alarm does not extinguish a fire.

Seventy-five percent of fire deaths occurring in Merseyside are to elderly people. Merseyside considers the elderly in two groups that require different approaches. The fire brigade reaches the fit elderly by visiting places where they go, such as supermarkets, bingo halls, clubs, flu clinics, and events arranged by organizations working with the elderly. The more vulnerable elderly often are housebound, more difficult to contact, and harder to influence. The fire service works with various caregivers and organizations that have built relationships with the elderly and are often their only contacts.

The United Kingdom succeeded in changing its fire service culture over the past decade, and transferring practices from a few innovative brigades to many. The results have been nothing short of spectacular: a sharp reduction in the deaths and injures, especially among the highest-risk households — low-income, minority, immigrant and elderly. Although it is sometimes difficult to transfer good practices from one culture to another, the above practices all can be used in the United States. In fact, most already are used here and there. The big difference is that the United Kingdom uses these best practices more regularly and on a much wider scale.

American fire chiefs and fire prevention community should seriously consider adapting and applying these best practices in their own communities. The fire-death rate in the United States has been relatively flat during the past several years, and implementing these best practices may help reduce the fire-injury and -death rates in American homes.

The full report can be downloaded free of charge at www.sysplan.com/TriData/Publications/International.

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Philip Schaenman is the president of the TriData Division of System Planning Corp. Schaenman previously was associate administrator of the U.S. Fire Administration in charge of the National Fire Data Center and the Fire Technology Program. He holds advanced engineering degrees from Stanford University and Columbia University.

Dr. Mick Ballesteros of the U.S. Centers for Disease Control and Prevention contributed to this story.