A fire at a Moscow drug rehabilitation hospital has killed 45 women, most of them young addicts.

Officials say they are "90% certain" that arson caused the blaze at Moscow's Hospital 17, in the south-west of the city, early on Saturday morning.

All appeared to have died of smoke asphyxiation even before the first firefighters reached the building.

Recommendations earlier this year to close the hospital on fire safety grounds were reportedly ignored.

Fire safety officers visited the hospital in February and March, and called for its temporary closure after their second visit, said Russia's chief fire inspector Yuri Nenashev.

"Unfortunately this decision was not adopted," said Mr Nenashev.

Firefighters rescued 160 people from the building, and 10 are being treated in hospital for carbon monoxide poisoning. Moscow's chief fire inspector said their lives remained in the balance.

Forty-two people died at the scene, with others dying later in hospital. Two staff are among the dead.

'Windows barred'

The hospital had been slow to raise the alarm after the fire broke out in a second-floor cafeteria, said a spokesman for the Moscow fire brigade.

"Secondly, the hospital personnel worked very badly, they did not take steps to evacuate people in the early stages of the fire," said Yevgeny Bobylyov, the Associated Press news agency reported.

However, there were suggestions that staff had been overcome so rapidly by smoke that they had been incapable of taking action.

The walls were reportedly covered with plastic, making the fumes especially hazardous.

A further problem was the lack of exits.

"It was a very particular building with five storeys and only one exit and bars on the windows because it was a drug treatment hospital," said Irina Andrianova, a spokeswoman for Russia's Emergencies Ministry.

"Judging by the placement of the bodies, they really tried to get out," said Alexander Chupriyanov, the deputy emergency situations minister.

"Everyone who died as a result of this fire, died before the first fire engines came, and those were at the site four minutes after the call," he told Russia's Itar-Tass news agency.

Signs of arson

More than 20 fire engines were sent to the site, where they battled the flames and smoke for an hour before bringing the blaze under control.

"The fire was relatively small, only 100 square metres. But there was very thick smoke, and people got poisoned by smoke in their sleep," one rescue official told Itar-Tass.

Fire inspector Yuri Nenashev said that he was "90%" sure the fire was started deliberately.

"No technical means such as heaters, wires or such were found... there was only a wooden shelf, which was the fire's centre, and that indicates arson," he said.

Russia records about 18,000 fire deaths a year, the Associated Press reports, 10 times higher than in the US.

Last December seven people died in a fire at an institute for the mentally ill near Moscow.

And in 2003 36 students died and some 170 were hurt at a hostel for foreign students.

Photo caption

A body is removed from the scene of the fire