Case Reports

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

Emergency Medicine. 2014 March;46(3):113-122

References

Centers for Disease Control and Prevention. Carbon monoxide-related deaths—United States, 1999-2004. MMWR Morb Mortal Wkly Rep. 2007;56(50):1309-1312.
Centers for Disease Control and Prevention. Carbon mononoxide exposures—United States, 2000-2009. MMWR Morb Mortal Wkly Rep. 2011;60(30):1014-1017.
Iqbal S, Law HZ, Clower JH, Yip FY, Elixhauser A. Hospital burden of unintentional carbon monoxide poisoning in the United States, 2007. Am J Emerg Med. 2012;30(5):657-664.
Centers for Disease Control and Prevention. Nonfatal, unintentional, non-fire-related carbon monoxide exposures—United States, 2004-2006. MMWR Morb Mortal Wkly Rep. 2008;57(33):896-899.
Hampson NB. Residential carbon monoxide poisoning from motor vehicles. Am J Emerg Med. 2011;29(1):75-77.
Centers for Disease Control and Prevention. Average annual number of deaths and death rates from unintentional, non-fire-related carbon monoxide poisoning, by sex and age group—United States, 1999–2010. MMWR Morb Mortal Wkly Rep. 2014;63(3):65.
Mott JA, Wolfe MI, Alverson CJ, et al. National vehicle emissions policies and practices and declining US carbon monoxide-related mortality. JAMA. 2002;288(8):988-995.
Carbon monoxide detectors: state statutes. National Conference of State Legislatures Web site. http://www.ncsl.org/research/environment-and-natural-resources/carbon-monoxide-detectors-state-statutes.aspx. Accessed March 11, 2014.
Survey results: New York homeowners and the risk of carbon monoxide poisoning. Kidde Web site. http://www.kidde.com/PressRoom/Pages/SurveyResultsNYHomeownersCORisks.aspx. Accessed March 11, 2014.
Iqbal S, Clower JH, King M, Bell J, Yip YF. National carbon monoxide poisoning surveillance framework and recent estimates. Public Health Rep. 2012;127(5):486-496.
Johnson-Arbor K, Liebman DL, Carter EM. A survey of residential carbon monoxide detector utilization among Connecticut Emergency Department patients. Clin Toxicol (Phila). 2012;50(5):384-389.

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

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

References

What is the utilization of CO detectors by ED patients?

Pages

Recommended Reading