Risk Reduction

In the late evening hours of February 20, 2003, a fast-moving fire spread through
The Station nightclub in West Warwick, Rhode Island. At the time that the fire
began there were reportedly over 440 occupants in the club. This fire completely
destroyed the building and resulted in 100 fatalities and over 200 injuries,
becoming the fourth deadliest nightclub fire in U.S. history.
This fire immediately invoked memories of other tragic fires in assembly
occupancies, such as the Cocoanut Grove, the Rhythm Club, and the Beverly Hills
Supper Club. Many common factors can be found when analyzing these tragedies,
including combustible interior finish, overcrowding, and problems with egress.
Following several months of study and analysis, several changes to key NFPA
codes were completed resulting in new requirements that would help to mitigate
similar occurrences in the future. These changes were made to NFPA 101®, Life
Safety Code®, and NFPA 5000®, Building Construction and Safety Code®, relating to
Assembly Occupancies and included provisions for crowd managers, added further
restrictions on festival seating unless a life safety evaluation had been completed,
required facilities to conduct egress inspections before opening for business, and
added provisions that would require automatic sprinklers in existing nightclub-type
assembly occupancies with occupant loads of over 100 and in all new nightclubtype assembly occupancies. The Tentative Interim Amendments (TIAs), which were
approved by the NFPA Standards Council as interim requirements in July of 2003
became permanent provisions of the 2006 editions of NFPA 101, Life Safety Code,
and NFPA 5000, Building Construction and Safety Code, as well as NFPA 1,
Uniform Fire CodeTM.
Additionally, the 2006 editions of NFPA 101 and NFPA 5000 require the main
entrance/exit of new nightclub-type assembly occupancies to accommodate not
less than two-thirds of the total occupant load. Other exits must accommodate
not less than one-half the total occupant load. Thus, the total egress capacity
must accommodate 117% of the total occupant load.
This case study will review historic fires in assembly occupancies as well as
review The Station nightclub fire and the response of NFPA to this tragedy.
In addition, changes made by the states of Rhode Island and Massachusetts as
well as an investigation completed by the National Institute of Standards and
Technology are also summarized.
Historical Perspective
Fires resulting in large losses of life in assembly occupancies have been occurring
for hundreds of years. In the 19th century, theatres were the most common
assembly location where major fires resulting in large numbers of fatalities
occurred. Some examples are:
• Richmond Theatre, Richmond, VA – December 26, 1811 – 72 Fatalities
• Conway Theatre, Brooklyn, NY – December 5, 1876 – 295 Fatalities
• Ring Theatre, Vienna, Austria – December 8, 1881 – 794 Fatalities
• Comiqué Opera House, Paris, France – May 25, 1887 – 200 Fatalities
• Royal Theatre, Exeter, UK – September 4, 1887 – 187 Fatalities
As the 20th century began, the fire at the Iroquois Theatre in Chicago, IL, on
December 30, 1903, resulted in 602 fatalities, making it the deadliest fire in an
assembly occupancy in the United States.
Common contributing factors in these fires were lighting (candles, gas lamps, or
electric stage lights) igniting combustible materials on or near the stage; inadequate, blocked/locked, or poorly designed egress systems; and combustible interior finish. In each of the cases previously mentioned the fire began in the area of
the stage as a lighting fixture came in contact with combustible materials nearby
and spread rapidly, spreading heat and smoke over the audience, resulting in a
rush to the exits. In these examples, egress systems were often inadequate in
number or design, if not blocked or otherwise nonfunctional. These conditions led
to many occupants being overcome before they could reach an exit, resulting in
large losses of life. In the case of the Iroquois Theatre, the facility was touted as
“Absolutely Fireproof” as a way to ease the concerns of patrons. While the building
itself may have been noncombustible, the interior finish, contents, and other furnishings were not.
In the years that followed the Iroquois Theatre fire, deadly assembly occupancy
fires began to occur in clubs as these establishments became a popular form of
entertainment and socializing.
The following are some examples of fatal fires in club settings. The accounts are
taken from NFPA reports on the incidents.
NFPA CASE STUDY: NIGHTCLUB FIRES 3
© 2006 NFPA
Rhythm Club
Natchez, Mississippi
April 23, 19401
A fire in the Rhythm Club in Mississippi took
207 lives and injured over 200 more of the 700
people that were in the building that evening to
listen to a popular Chicago orchestra.
The Rhythm Club was a single-story, woodframed building measuring 120 ft (36.6 m) x 38
ft (11.6 m). (See Figure 1.) The roof and sides
of the converted garage building were covered
with corrugated metal sheets. The structure
contained approximately 24 windows (most of
which apparently were shuttered or nailed shut
at the time of the fire).
The club had only one exit, a door measuring 38
in. (0.9 m) wide. This door opened inward.
Inside the main entrance foyer was a pair of
doors measuring 6 ft (1.8 m) wide, which also
opened inward. These doors opened into a
lobby area. Proceeding through the lobby one
would enter the dance floor, which constituted
the majority of the floor space. At the far end of
the club, opposite the entrance, were the
orchestra platform and the bar.
The interior of the club was decorated with
dried Spanish moss, which was hung on wires
from the ceiling joists above the dance floor.
The interior walls were constructed of wooden
shiplap boards up to 5 ft (1.5 m) from the floor.
The floor was composed of wood planks over
concrete.
At the time of the fire, 700 patrons and staff
and musicians were reportedly in the building.
At approximately 11:15 p.m., a fire started near
the hamburger stand, which was located adjacent to the only exit from the building. The fire
quickly involved the Spanish moss, spreading
the fire rapidly throughout the building, and
above the crowd.
Patrons in the vicinity of the entrance were able
to escape. However, those beyond the lobby
area were quickly trapped by the fire, as pieces
of the burning moss began to drop onto the
fleeing occupants, igniting their clothing. The
fire forced those who remained inside deeper
into the building toward the orchestra platform.
FIGURE 1 Layout of Rhythm Club (NFPA)
4 NFPA CASE STUDY: NIGHTCLUB FIRES
© 2006 NFPA
It was in this location where the majority of the
victims’ bodies were found.
The fire department was notified and responded, extinguishing the fire quickly. During the
overhaul of the fire, they made the grisly discovery of dozens of victims within the charred
remains of the building.
The contributing factors leading to the loss of
life in this incident were the lack of required
exits and the highly combustible interior decorations. Less than three years later, these factors would again contribute to a large loss of
life in another tragic fire.
Cocoanut Grove
Boston, Massachusetts
November 28, 19422
The Cocoanut Grove nightclub was a popular
destination in Boston in 1942. The club offered
entertainment in a nightclub on the street level
as well as more intimate surroundings in a
small lounge on a lower level. In the months
leading up to the fire, another lounge (Broadway
Lounge) had been opened adjacent to the club
on the main level by renovating several adjacent buildings and adding them to the club’s
footprint. This renovation gave the facility the
shape of two overlapping rectangles.
FIGURE 2 Layout of the Cocoanut Grove (NFPA)
The original building was constructed of concrete in 1916. In the years prior to its transformation into a nightclub, the building was used
as a garage and film storage facility. It was bordered on three sides by Piedmont Street,
Shawmut Street, and Broadway.
The building measured 100 ft x 90 ft (30.5 m x
27.4 m) in an irregular shape. (See Figure 2.)
The building was mainly a single story (with a
partial lower level), except for a small upper
level above the new lounge that contained
dressing rooms and restrooms.
The lower level contained the Melody Lounge as
well as the kitchen and liquor storage for the
club.
The main club area measured approximately 60
ft x 60 ft (18.3 m x 18.3 m). The Broadway
Lounge measured 40 ft x 40 ft (12.2 m x 12.2
m), and the Melody Lounge measured 55 ft x 35
ft (16.8 m x 10.7 m).
Exits from the facility were located on the
Piedmont Street, Shawmut Street, and
Broadway sides of the building. The main
entrance was through a revolving door arrangement on Piedmont Street. This entrance opened
into the lobby of the club. Access to the Melody
Lounge was via a single set of stairs from the
lobby. There were no other means of egress
from this portion of the club. The Shawmut
Street exit was located approximately halfway
along the wall in the main club area. Another
door on the Shawmut Street wall, adjacent to
the stage, was locked. The Broadway exit was
located in the new cocktail lounge. A single
door, in the lounge, leading to the outer doors
on Broadway opened inward.
All other doors within the building that would
have provided access to the outside were
locked or obscured at the time of the fire. One
of these locked doors was located on the
Piedmont Street side, to the left of the marquee
over the main entrance. Had this door been
unlocked at the time of the fire, it would have
provided a means of egress for the patrons in
the Melody Lounge, without them having to
travel into the lobby and use the revolving door.
(See Figure 2.)
Exits from the dressing rooms on the upper
level were via stairs that terminated at the
locked Shawmut Street door.
Windows on the Piedmont Street and Shawmut
Street sides of the building were covered so as
not to be visible from the inside of the building.
The interior of the nightclub was decorated with
numerous fabrics and materials. These included
artificial leather on walls and the bars, and cloth
on the ceilings. Suspended ceilings and false
walls throughout the facility covered the original
construction features of the building. Artificial
palm trees were placed in the club and in the
Melody Lounge. Lighting and the associated
wiring were incorporated into these trees. The
Melody Lounge also contained rattan wood wall
coverings.
Many of the furnishings within the club and
lounges were covered in artificial leather material, as well.
Reportedly, just eight days before the fire, fire
department inspectors found “no flammable
decorations” and sufficient exits and fire extinguishers. The only deficiency the city building
inspector found in an inspection just prior to the
fire was the lack of a steel fire door between
the Broadway Lounge and the main dining area.
After the addition of the Broadway Lounge, the
club had applied for a license as a restaurant
with a capacity of 490 patrons. The reported
capacity of all areas was approximately 600. On
the night of November 28, 1942, the Cocoanut
Grove was well over capacity, with estimates of
over 1,000 occupants in the building at the time
of the fire.
The fire began in the area of an artificial palm
tree in the Melody Lounge. A popular account
was that a busboy used a match to provide light
as he investigated a faulty light bulb within the
tree. Within seconds the tree had ignited. The
smoke, heat, and flames spread rapidly
throughout the lounge, forcing patrons to flee,
using the only exit passage toward the stairs
and the lobby. Many were overcome before they
could reach the exit.
The first indication of trouble for occupants on
the main floor was when a young woman ran
screaming through the lobby with her hair on
NFPA CASE STUDY: NIGHTCLUB FIRES 5
© 2006 NFPA
fire, immediately followed by a wave of smoke
and heat from the stairwell. Many headed
toward the exit on Piedmont Street, having
entered the club earlier through the revolving
door at that entrance. The revolving door quickly
became jammed as patrons pushed toward the
door.
Others within the main club headed toward the
door on Shawmut Street. Many were able to
exit through this door until smoke and toxic
fumes, along with the tangle of hundreds of
tables and chairs, overcame those remaining in
the building.
Those in the Broadway Lounge were the last to
know of the fire, being the most remote from
the lobby area. Approximately 4–6 minutes from
ignition, occupants from the main club area
began to rush into the Broadway Lounge seeking an exit from the building. The smoke, heat,
and fumes followed rapidly. The only remaining
viable exit from the building was quickly
jammed as the inward-opening door was forced
closed by the crush of people attempting to exit.
The fire department, which had several units on
the block for an automobile fire, was alerted by
a passer-by to the commotion at the Cocoanut
Grove. Arriving within seconds, fire fighters
immediately went to work rescuing patrons
near the entrances. Additional alarms were
sounded as the magnitude of the situation
became apparent. Windows were broken on the
Shawmut Street side in an attempt to gain
access to the building and as a means of
removing victims. Fire fighters and civilians
began to pull bodies from the building through
any accessible point. Victims, suffering burns
and smoke inhalation injuries, were transported
by all available means to city hospitals.
At this point the fire had consumed the combustible interior finish and furnishings and was
extinguished rapidly by the fire department.
Once fire fighters were able to gain access to
the interior of the building they were met with a
horrific sight: bodies piled several feet high at
the revolving door and near the exit in the
Broadway Lounge. Approximately 200 bodies
were found at the revolving door and 100 more
were found at the Broadway entrance. The
remaining fatalities were found throughout the
facility, many at their tables, overcome so rapidly that they were unable to make an effort to
escape.
In the days and weeks following the fire, the
death toll became a staggering 492, making the
Cocoanut Grove the deadliest nightclub fire in
U.S. history.
In the months following the Cocoanut Grove fire,
changes were made to building codes across
the country. The most notable advances were
made in the areas of exits, combustible materials, emergency lighting, and automatic sprinklers. The definition of places of public assembly was also expanded. Before the fire at the
Cocoanut Grove, many jurisdictions did not consider restaurants and nightclubs to be places of
public assembly. Notably, the 1942 edition of
the NFPA Buildings Exit Code (the early version
of today’s Life Safety Code) did consider nightclubs to be essentially places of public assembly, in the same class as a theatre, but having a
greater possibility of fire.3
Today it is recognized that all assembly occupancies should have at least two separate and
remote means of egress, and the necessary
number, width, and types of reliable exits based
on the expected occupancy should be available.
After the fire, Robert Moulton, NFPA’s Technical
Secretary and the secretary of the NFPA
Committee on Safety to Life, indicated in a
newspaper interview: “The most glaring feature
of this tragedy was the lack of proper exits.
Revolving doors have long been considered by
the National Fire Protection Association
Committee on Safety to Life as a menace under
fire and panic conditions.”4
That same edition of the Code required that
“decorations of theatres and assembly halls
shall be of fire-resistive or nonflammable materials. Fabrics and papers used for such purposes shall be treated with an effective flameproofing material.” A cautionary note warned:
“Paper and cloth decorative materials should be
kept to a minimum in places of assembly since
such flimsy materials increase the hazard of the
kindling and spread of fire.”
Largely as a direct result of the Cocoanut Grove
fire, the Building Exits Code was adopted by
many more jurisdictions across the country, due
6 NFPA CASE STUDY: NIGHTCLUB FIRES
© 2006 NFPA
in large part to the efforts of the fire service.
The Committee on Safety to Life reported on
that increased usage at the 1945 NFPA Annual
Meeting.
It was during the 1945 NFPA Annual Meeting
that the Committee on Safety to Life also recommended a change in the method of exit
measurement, clarification of the need for stairway enclosure, provisions regulating loose
chairs in nightclubs, and changes in lighting and
signs. Those changes were incorporated into
the 1946 edition of the Code, as was a special
note on interior finish.5
NFPA CASE STUDY: NIGHTCLUB FIRES 7
© 2006 NFPA
FIGURE 3 Beverly Hills Supper Club Layout (NFPA)
Beverly Hills Supper Club
Southgate, Kentucky
May 28, 19776
On Saturday, May 28, 1977, approximately
2,400 to 2,800 people were attending several
functions within the Beverly Hills Supper Club,
an expansive banquet and nightclub facility. By
the end of the night, 164 patrons and employees would die when a fire that began in an
unattended room, and quickly spread throughout the facility, trapped many before they could
exit the complex.
The Beverly Hills Supper Club was a mostly
one-story facility that covered over 65,000 sq ft
(6,039 sq m) of total floor space [ground level:
240 ft x 260 ft (73.1 m x 79.3 m)] and contained numerous function and meeting rooms
as well as a large showroom (the Cabaret
Room, which could seat over 1,200 people).
(See Figure 3.) A second level was located
above the Main Bar in the original portion of the
complex and a partial basement was located
beneath the south portion. The original facility
was constructed in 1937 and several additions
and renovations were completed in the next 33
years until a major rebuilding project was
undertaken after a fire in the complex in 1970.
The construction of the facility was classified as
noncombustible (steel framing, masonry walls,
poured concrete floors, and a built-up roof system on a steel deck). Throughout the facility,
there were suspended ceilings of mineral tiles
installed beneath the original plaster and fiber
tiles. Wood framing was utilized for interior partitions in several areas in the complex, and floor
joists in the two-story section (above the Zebra
Room) were constructed of plywood and lumber.
The interior of the facility was decorated with
wood paneling, draperies, and carpeting, among
other combustible finishes.
Fire protection within the facility consisted only
of portable fire extinguishers. The building was
not equipped with automatic sprinklers or
8 NFPA CASE STUDY: NIGHTCLUB FIRES
© 2006 NFPA
FIGURE 4 Exit Locations in the Beverly Hills Supper Club (NFPA).
standpipe systems. The complex did not contain
an alarm system or fire/smoke detection
devices.
There were eight exit discharge points from the
complex. (See Figure 4.) However, one located
in the Viennese Room (C), was “disguised” as a
window, even though there was an exit sign
installed above the door. Another door adjacent
to the Cabaret Room was reportedly locked at
the time of the fire (H). This door was adjacent
to another exit, equipped with a double door (G).
At approximately 8:45 p.m. on the evening of
May 28, a fire was discovered by a staff member in the Zebra Room, which had been unoccupied since a wedding party had left sometime
before 8:00 p.m. Employees alerted managers
to the fire, as other staff attempted to battle the
fire using portable fire extinguishers. As they
continued to fight the fire, other employees
began to assist patrons in exiting the building.
Customers in the rooms closest to the Zebra
Room (Viennese, Empire, and Café) became
aware of the fire first, as smoke traveled down
the corridors and as the staff began to notify
them to exit immediately.
The fire department was notified of a fire at the
complex at 9:01 p.m.
Patrons in the Crystal Rooms on the second
floor above the Zebra Room became aware of
the fire when smoke and heat began to travel
up the open stairway from the first level. All but
two of the occupants on the second level
escaped by using an unblocked stairwell into
the kitchen. The remaining two were overcome
and perished in the dressing room area on this
level.
Those in the Cabaret Room were notified to exit
by a staff person at approximately 9:06 p.m.
Smoke and heat quickly began to fill the room,
as the fire began to travel down the corridor
from the Zebra Room. The smoke and flames
rapidly filled the Cabaret Room and Garden
Room, trapping many of the patrons before they
could reach an exit. Two of the exits from the
Cabaret Room (B and H) became blocked by
smoke and heat, rapidly forcing almost all of
the patrons (estimated at 1,200 to 1,300) in the
room to attempt to reach the only remaining
exit (A).
As the initial fire department units were
responding to the scene, smoke was visible
from a distance. Upon arrival, the Southgate fire
chief reported smoke issuing from the main
entrance, several injured people gathered near
the building, and occupants still exiting the
complex. The magnitude of the situation quickly
became apparent and the chief requested additional resources. Several hose lines and aerial
streams were put in service as more and more
apparatus arrived. Rescue efforts concentrated
on those victims still in the complex, as personnel attended to those who had exited or had
been removed and were lying injured outside
the complex.
A decision was made at approximately 11:30
p.m. to evacuate all fire personnel from the
building as the fire continued to spread
throughout the massive complex.
Eventually the incident involved every fire
department in the county. Twenty-four fire
departments responded with ambulances or
rescue units from surrounding counties as well.
In total, approximately 522 fire fighters
responded to the fire.
The fire was placed under control at approximately 2:00 a.m. on May 29. The search for victims began again at daylight.
The fire was not declared completely extinguished until Monday, May 30.
The majority of the victims were removed from
the Cabaret Room on the night of the fire. They
included 99 victims that were located in the
vicinity of Exit A, the double swinging doors to
the left of the stage. Another 34 victims were
located in the vicinity of Exit B, to the right of
the stage, near the dressing rooms. An additional 26 victims were recovered after the fire from
the area around Exit A. Two victims were located in the Viennese Room after the fire. Three
injured victims eventually died at the hospital,
resulting in a total of 164 fatalities.
The complex was completely destroyed by the
fire. The vast majority of the roof structure collapsed into the building as a result of the fire
damage.
The team conducting the investigation of the
fire determined that the most probable cause of
the fire was an electrical malfunction in the
NFPA CASE STUDY: NIGHTCLUB FIRES 9
© 2006 NFPA
concealed space at the ceiling of the Zebra
Room. The exact fixture or appliance could not
be determined due to the damage in the area of
origin.
The NFPA report on the Beverly Hills Supper
Club fire found that the following factors contributed to the loss of life:
• Delayed discovery of fire in the Zebra Room
• Attempts by employees to extinguish the fire
before notifying occupants
• No Emergency/Evacuation Plan to train
employees in proper actions in the event of a
fire
• Overcrowding: At the time of the fire the
Cabaret Room contained almost three times
the number of occupants that the space could
safely accommodate. At the time of the fire
the entire facility contained almost twice the
number of occupants that the facility could
safely accommodate.
• The capacity of the means of egress for the
facility and especially the Cabaret Room was
not adequate for the occupant load when calculated based on the square feet per person
or the actual number of occupants.
• The interior finish in the main north-south
corridor exceeded the flame spread allowed
for assembly occupancies in the Life Safety
Code and contributed to the rapid fire spread
from the Zebra Room to the Cabaret Room.
• The complex was not provided with automatic
sprinkler protection as would have been
required by the building code and fire codes
in effect at the time.
In the next edition of the Life Safety Code
(1981) following the fire, changes were made in
the following areas:
• Both new and existing assembly occupancies
with occupant load exceeding 300 were
required for the first time to have a fire alarm
system, complete with a voice message form
of occupant notification. Therefore, a large
facility such as the supper club (new or existing) in this case, would be required to have a
fire alarm system

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