Abstract
Carbon monoxide (CO) poisoning is responsible for significant morbidity and mortality in the US. In response, a majority of states have passed legislation in recent years requiring the installation of residential CO alarms. There is, however, no published information evaluating compliance with such laws. Employees of a Seattle medical center were surveyed in 2008 regarding home use of CO and smoke alarms. Washington State enacted legislation requiring residential CO alarms by all residences by January 1, 2013. The survey was repeated in mid-2016 to evaluate compliance. In 2016, a total of 354 employees completed the survey and their responses were compared to an equal number of 2008 survey respondents matched by home ownership and ZIP code. Residential CO alarm use rose from 37% to 78% (p < 0.0001). Among homeowners, 78% had alarms while 80% of renters had them. Homeowners with the highest compliance (96%) had purchased their homes since January 1, 2013 while those with the lowest compliance (73%) had purchased them earlier. A majority (79%) of renters without alarms reported the reason was that their landlord did not provide one, a violation of the law. Only one-half to two-thirds of all equipped homes had the required number of either CO or smoke alarms. Use of residential CO alarms increased significantly in this study population three years after law required them. Areas for further improvement include education of landlords, tenants, and longtime homeowners about the law, as well as public education regarding the number of CO and smoke alarms needed.
Highlights
Carbon monoxide (CO) poisoning accounts for hundreds of deaths and thousands of emergency department visits in the US annually (Centers for Disease Control and Prevention, 2007, 2008; Hampson and Weaver, 2007; Hampson, 2016)
The subgroup of 2008 survey responders used as comparators with the 2016 survey results was not statistically different from the total 2008 survey population of 574 with regard to use of CO alarms (38.7% vs. 37.0%; p = 0.4518), or use of smoke alarms
Between 2008 and 2016, residential CO alarm use increased from 37% to 78% in the study population (p b 0.0001) (Table 2)
Summary
It is generally believed that most accidental CO poisonings are preventable through use of public education, emission controls, warning labels on consumer products, and residential CO alarms. In an attempt to reduce the public's risk for poisoning, many states have passed legislation requiring the installation of residential CO alarms over the past several years. As of January 1, 2016, thirty states had enacted statutes requiring installation of residential CO alarms in at least one category of domicile (National Conference of State Legislators). 2009), that state's legislature passed a law mandating phased-in requirements for residential CO alarms (City of Seattle). Beginning January 1, 2011, state law required CO alarm installation in all newly constructed single-family homes and other residences. As of January 1, 2013, alarms were required in all existing residences. Certain singlefamily homes occupied prior to 2008 are exempted but will be required to have alarms when they are sold
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