UCSF

Abstract: Objective: To assess the evidence underlying the Centers for Disease Control and Prevention (CDC) indoor safety guidance for lightning storms. Design: Systematic Review of peer-reviewed literature. Setting: Google Scholar, PubMed, and Web of Science (through 2023). Participants: Reports of indoor death or injury from lightning strike. Main outcome measures: The number of deaths and injuries from lightning-related activities. Results: A majority of the 15 articles identified were retrospective reviews of data from death certificates, medical records, and newspaper reports; 5 articles were based on single case reports. Reports of injuries from lightning while indoors are exceedingly rare; death from lightning while indoors is essentially non-existent in modern times. No evidence exists that supports the given advice. Conclusions: Current U.S. lightning avoidance tips may inadvertently portray indoor spaces as unsafe, despite their protective advantage. Guidelines should place less emphasis on indoor situations and highlight controllable risks, such as behavior in outdoor and recreation situations.