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Fire and Burn Injury Interventions
Flammable Fabrics Act (Legislation)
Background
Children 0-14 years of age are the group
at risk for clothing ignition burns. Fabric type and garment style affects flammability.
Children’s sleepwear can catch on fire from a spark from the fireplace,
open flames or contact with space heaters. Laboratory tests results show that
non-retardant sleepwear can be engulfed in flames in 10 seconds after exposure
to a single small ignition source such as a match, stove, or candle.20
Girls are more at risk for sleepwear burns if
they wear wearing full flowing nightgowns. Beginning in 1953 the U.S. government
passed standards regulating flammability of general wearing apparel, carpets,
rugs, mattresses and children’s sleepwear.20 The Flammable
Fabrics Act was passed in 1972 and is monitored by the Consumer Products Safety
Commission.21 New Zealand passed legislation regulating
children’s nightwear in 1977.22,23
Review of the Flammable Fabrics
Act:
Author | Laing and Bryant, 1991 |
Study design and target population | Interrupted time series
Children ages 1 to 14 years in New Zealand
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Intervention | Legislation: New Zealand’s Children’s
Nightclothes Act., 1977; implemented, 1980.
Additional evaluation for time
period 1980-1988.
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Outcomes | Hospitalizations for burns resulting from clothing
ignition using nationwide data base |
Results | Downward trend for all clothing ignition 1979-88
(p<0.001) and stronger downward trend for nightwear (p<0.001). Rate
of decrease in events involving nightwear is greater than decrease for all
clothing. 80% decrease in rate per 100,000 children (1988 vs. 1979).
Shift in type of night clothes with decrease in
nightdresses (to 29%) and increase in pajamas (68%).
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Study quality and conclusions | Legislation was less restrictive for pajamas fabric
than for nightdress fabric.
Decrease in injuries from nightclothes
ignition due to several factors:
mandatory controls on nightclothes,
increased use of pajamas, decrease in use of open fires and portable electric
heaters.
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Author | McLoughlin et al., 1986 |
Study design and target population | Interrupted time series
Children ages 1 to 14 years in New Zealand
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Intervention | Legislation regulating clothing flammability (New
Zealand’s Children’s Nightclothes Act, 1977).
Regulated manufactured garments only, not home-sewn
garments.
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Outcomes | Hospitalizations for burns resulting from clothing
ignition using nationwide data base |
Results | Slight decrease in burn injuries. Between 1981
and 1984 there was a linear downward trend for all clothing ignition burns
(p<0.04) and suggested trend for nightwear (p<0.06). |
Study quality and conclusions | Good effort made to evaluate intervention.
Methodological problems include:
incomplete case ascertainment;
E code-misclassification; could not distinguish between home sewn and
manufactured clothing (44% of nightwear home sewn).
Recommended fiber content labeling
for all children’s nightwear and fabrics.
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Author | Knudson, 1980 |
Study design and target population | Interrupted time series.
Admissions to Shriners Hospital burn unit
in Galveston Texas, 1966-1977.
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Intervention | Legislation: Children’s Sleepwear Flammable
Fabrics Act, 1972. Effective for sizes 0-6x in July, 1973 and for sizes
7-14 in mid-1975. |
Outcomes | Admissions and severity of sleepwear related burns
pre-standard period, 1966-1973 vs. post-standard period, 1974-1977. |
Results | Percentage of sleep-wear related burns decreased
following legislation (12% of all admissions vs. 3%) with no change in other
clothing related burn admissions.
No significant difference found for burn severity.
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Study quality and conclusions | Flame-resistant sleepwear seems to be responsible
for reduction in burn admissions.
Study corroborates findings of McLoughlin
in Boston.
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Author | McLoughlin, 1977 |
Study design and target population | Interrupted time series studies.
Flame burns from a single ignition source.
Shriners Burn unit, Boston. Compared
sleepwear to other types of clothing
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Intervention | Legislation: U.S. government standards regulating
sleepwear for children 1-14. Flammable Fabrics Act, 1972. |
Outcomes | Change in admissions to the burn unit pre-legislation
(1969-74) and post-legislation (1975-76). |
Results | The risk of sleepwear burn admission after the
law compared to risk of injury pre-law was reduced by 75% (OR=0.25, 0.13-0.48).
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Study quality and conclusions | Legislation regulating flammability of sleepwear
is effective in reducing burn injuries.
Injury reduction also due to education
and style changes from nightgowns to pajamas.
Possible that some injuries treated
in local hospital and not referred to burn unit.
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Summary of the Flammable Fabrics
Act
Legislation regulating flammability of sleepwear is effective in reducing burn
injuries. McLoughlin’s study24 found a 75% reduction in burn unit admissions
due to sleepwear following passage of the Flammable Fabrics Act of 1972. Studies
from New Zealand were unequivocal and indicate some of the methodological problems
of evaluating an injury prevention strategy using a nationwide database.
Recommendations on the Flammable
Fabrics Act
Clearly, nationwide legislation requiring flame retardant sleepwear coupled
with CPSC enforcement has been successful in removing dangerous materials from
the marketplace. Additional interventions which should be considered for regulation
are sources of ignition (stove elements, matches, cigarette lighters). Physical
barriers for stoves and space heaters, child safe lighters, and safety matches
are all potential area for legislative action.
Recommendations for future
research
Standards should be reviewed an updated as technological advances occur to
make certain that the safest (non-carcinogenic) and least flammable fabrics
are used for children’s sleepwear.
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