Install smoke alarms, and add a carbon monoxide alarm if you burn coal or use gas for indoor heating
A working smoke alarm can lower the risk of death in a house fire by about 60%. Around four in ten victims were asleep when the fire began; smell alone will not reliably wake you. If you burn coal or use gas indoors in winter, add a carbon monoxide alarm. China recorded about 11,500 carbon monoxide deaths in 2018; in the three winter months, roughly 70% occurred at home.
What it takes
In China, a smoke alarm costs RMB 30–100 and a carbon monoxide alarm RMB 50–150. Replace the batteries yearly after installation.
What you may gain
A case-control study of residential fires in North Carolina compared households retrospectively. A working smoke alarm was associated with about 60% lower death risk: OR 0.39, 95% CI 0.18–0.83. In fatal fires in occupied US residential buildings in 2018–2020, 24% of homes had no smoke alarm, and 41% of victims were asleep when the fire started. China reported 11,523 carbon monoxide poisoning deaths in 2018. Of deaths in December, January and February, respectively, 72.59%, 67.42% and 66.48% occurred at home.
Context & considerations
Grade B because the smoke-alarm evidence here is one retrospective case-control study, not a randomized trial. There is no study here demonstrating that carbon monoxide alarms themselves reduce mortality. That benefit is inferred from the concentration of poisoning deaths at home in winter.
Research & references
Marshall SW et al. (1998). Fatal residential fires: who dies and who survives? JAMA. https://doi.org/10.1001/jama.279.20.1633 ; USFA (2022). Fatal Fires in Residential Buildings (2018-2020), Topical Fire Report Series 22(2). https://www.usfa.fema.gov/downloads/pdf/statistics/v22i2.pdf ; You J et al. (2020). Number of Deaths due to Carbon Monoxide Poisoning by Month and by Place of Death — China, 2018. China CDC Weekly. https://doi.org/10.46234/ccdcw2020.008