Carbon monoxide (CO) is responsible for more than 400 deaths in the U.S. each year. Further, the U.S. Centers for Disease Control and Prevention (CDC) estimates that more than 4,000 hospitalizations and approximately 20,000 emergency room visits are related to CO poisoning each year. And, because the symptoms of CO poisoning are similar to those of the flu, it seems likely the numbers could be much higher.
Since CO is a byproduct of fossil-fuel combustion, the first line of defense against its harmful effects is to ensure that fuel-burning appliances operate properly. However, Safe Kids Worldwide and many fire service leaders argue that a CO alarm is the single most effective device available to reduce deaths and injuries caused by this poisoning. Then-U.S. Fire Administrator Kelvin Cochran testified before a Senate hearing in December 2009, “Carbon monoxide detectors provide a crucial early warning of elevated levels of carbon monoxide.”
Most, but not all experts agree that every home should have at least one properly installed CO alarm outside each bedroom. The National Association of Home Builders (NAHB) does not support state CO detector laws. Larry Brown, director of NAHB Codes and Standards, argues that because there is no way to know its dispersion pattern, there is no way to know where in a residence detectors should be installed. NAHB argues that detectors are not cost effective and that those dollars would be better spent on preventive maintenance.
Notwithstanding these arguments, fire service organizations endorse CO detector mandates. While the value of CO detectors may seem obvious to the fire service, the same cannot be said for the public. And, just as with seatbelts, smoke detectors and other safety initiatives, public education programs promoting their use can go only so far. Safe Kids cites a correlation between cities with CO alarm requirements and lower CO death rates, referencing numbers from Los Angeles and Chicago.
Safe Kids and a coalition of others concerned about CO poisoning have developed a model law to serve as a guideline for state legislatures. The model’s basic mandate requires installation in all homes, apartments of all sizes, hotels and similar facilities that use fossil-fueled appliances or have attached garages. The model specifies locations in a building where detectors should be installed, including provisions for larger buildings that have central heating units. Since many CO detectors are battery operated, it also includes a penalty for battery removal. Heather Caldwell, a spokesperson for Kidde Manufacturing, a producer of detectors, says laws should be at least consistent with International Codes Council (ICC) standards.
Advocacy efforts led by Safe Kids and others, including some fire service organizations such as the National Association of Fire Marshals (NAFM), have led 35 states to enact laws requiring the use of CO detectors. According to a summary of laws prepared by Kidde, there is wide variation among the states in the details, and many have significant gaps. Sixteen limit coverage to one- and two-family dwellings plus townhouses. Only 14 specify where in the structure detectors should be located (outside each bedroom or sleeping area). It appears four states require CO detectors in hotels, motels, dormitories and similar structures. That number may be uncertain since these types of buildings may be covered in a separate section of the law. According to Kidde, most state laws requiring residential alarms mandate that the detectors meet Underwriters’ Laboratories (UL) standards, but there is no uniform requirement.
One significant debate is whether the requirement should apply to all residential buildings or only new buildings. CO is just as dangerous in an older building (and perhaps more so in some cases), but asking homeowners and building managers to retrofit can be an expensive proposition. As a result, legislatures have been fairly evenly divided in their decisions. Only 11 states require detectors in all buildings, while 13 limit the requirement to only new construction. An additional nine states have taken some sort of combination approach, requiring installation in all structures of certain types, but only in newly constructed buildings of other types. For example, in Maine, installation is required in all multi-family and rental dwellings, but only in new single-family dwellings.
Fire service leaders interested in injury prevention should take a serious look at the Safe Kids policy recommendation. Although many states have laws, few are adequate.