There’s No Place Like Home… for Carbon Monoxide Poisoning

Since CO exposure occurs primarily in the home, the installation of battery-powered or battery-backed CO alarms—both in the home and garage—can prevent poisoning. These detectors are inexpensive and available at common retail stores. Unfortunately, despite the easy availability and access to CO detectors, only 39 states currently have legislation mandating their use, and approximately two-thirds of the states with existing legislation only require CO detectors in newly built structures.⁸

In 2010, the state of New York enacted legislation known as “Amanda’s Law,” (named after a teenaged girl whose death was caused by CO poisoning from a defective boiler) mandating CO detectors in all one- and two-family homes with heating sources that may emit CO or have attached garages. However, an industry survey in 2011 found that nearly half of New York families were not aware of this law.⁹ The two largest surveys on home CO detector use—those conducted by the US Census Bureau and CDC—estimate the national rate of having a working CO detector in a home is 32% to 40%, with a lower prevalence among those living in manufactured housing, renting a home, or living below the poverty level.¹⁰

What is the utilization of CO detectors by ED patients?

The United States Consumer Product Safety Commission, the National Fire Protection Agency, and most CO detector manufacturers recommend that CO detectors be installed in close proximity to sleeping areas. A convenience cross-sectional survey in Connecticut found that less than half of residents polled had CO detectors installed, and only 17.2% had a detector installed in the proper location.¹¹ Interestingly, nearly 98% of the 1,000 people surveyed had smoke detectors installed.¹¹ The authors of the survey noted a direct, near linear relationship between household income and CO detector installment with rates of low-income and high-income CO detector use of 27% and 82%, respectively (Figure 4).¹¹ The reasons survey participants gave for lack of CO detector use were varied, yet all were consistent with a lack of understanding CO poisoning and an awareness of the importance of CO detection.¹¹