Carbon Monoxide Prevention – Progress?

Need Constant Reminders for Carbon Monoxide Prevention

There is no one solution for carbon monoxide prevention. Stopping CO poisoning requires a large scale legislative, regulatory and standards changes requiring detectors in all indoor spaces and annual professional maintenance of all fuel burning appliances.

By Rebecca Martin

The prevalence of warnings about the potential sources of carbon monoxide poisoning, especially prior to the arrival of severe weather systems, in hopes of increasing carbon monoxide prevention, has been on the uptake. Across the country utility companies and fire departments routinely issue these warnings. Stories of injuries and deaths in the media usually contain a recap of warnings in connection with the suspected source at the center of each particular story.

Carbon monoxide prevention requires more than broader alarm requirements. As important as universal alarm requirments are, standards requiring annual preventive maintenance must be mandated as well.

There have also been a number of legislative measures proposed recently to address some of the most common issues associated with carbon monoxide injuries and fatalities.

In Pennsylvania, a bill requiring carbon monoxide detectors in childcare centers will be debated. This bill is in response to an incident at Happy Smiles Learning Center in Allentown last October in which 28 children and 4 adults were sent to the hospital for carbon monoxide exposure. The source of the exposure was later found to be a faulty furnace and blocked ventilation. https://www.wfmz.com/news/area/lehighvalley/pa-lawmakers-to-debate-bill-requiring-carbon-monoxide-detectors-in-child-care-centers-after-leak/article_c7d9cd40-d013-11ed-b831-a77f589ccc33.html

In Ann Arbor, Michigan, the City Council voted unanimously to give an initial go ahead for a new ordinance which would address renter safety.

 “The new law now awaiting final council approval April 3 would require carbon monoxide detectors in residential rental units and prohibit people from disabling them.” https://www.mlive.com/news/ann-arbor/2023/03/ann-arbor-aims-to-protect-renters-from-carbon-monoxide-poisoning-with-new-law.html

Legislation has been moving to address carbon monoxide prevention often through the mandatory use of carbon monoxide detectors in areas where such requirements did not exist or were not enforced. New legislation could not come at a better time.

A new report from the U.S. Consumer Product Safety Commission (CPSC) says that deaths from carbon monoxide poisonings are increasing in the United States.

“The report looked at carbon monoxide (CO) deaths from 2009 to 2019, finding 250 consumer product-related CO deaths in 2019, more than any other year.” https://www.usnews.com/news/health-news/articles/2023-03-30/report-finds-big-rise-in-u-s-carbon-monoxide-deaths

Carbon Monoxide Prevention Requires Alarms in all Indoor Spaces

Historically the focus has been on getting alarms in all places people sleep. First it was homes and apartments. Laws requiring CO alarms in hotels have lagged behind but are catching up. But that leaves too many other places that people can get poisoned while they are doing their day to day activities indoors. We were reminded last month that a two hour movie is long enough to cause a serious carbon monoxide poisoning. See the Marcus Theater poisoning event in Wisconsin. 

School and office buildings are another place where large numbers of people can be poisoned simultaneously.

Portable Electric Generator Death Season

Portable generators were the source of the greatest number of deaths at 40% of non-fire related carbon monoxide fatalities. Heating systems came in second at 28%. Spring and summer storms are always linked to these poisonings.

Earlier studies were hampered by death certificate coding which often did not identify the source of carbon monoxide exposure. One such study indicated a decline in carbon monoxide fatalities, most likely due to the fact that pre-1975 automobiles were no longer in service, and some states had adopted legislation requiring rentals and new construction to have carbon monoxide detectors.

“The potential value of residential CO alarms cannot be underestimated. They are a possible defense against furnace malfunctions, motor vehicles left running in attached garages, and even CO from an adjacent apartment in a multifamily dwelling. If their effectiveness is anywhere close to that of smoke alarms, they would be cost-effective. Now that so many states have enacted alarm legislation, more studies are needed to measure compliance with these regulations. If low, barriers to installation must be identified and resolved. Only when a high use rate has been achieved will it be possible to determine how effectively alarms impact accidental CO mortality.” https://www.atsjournals.org/doi/10.1513/AnnalsATS.201604-318OC

We can all agree that more research is needed and along with it; a careful reconsideration of measures to ensure that carbon monoxide detectors are in place in ANY place people are exposed to fuel-burning devices. Nowhere do we fall shorter in our search for solutions when considering the responsibility of negligent property owners and their legal or illegal tenants.

A story came out of Robbinsville, NJ on March 31, 2023, in which an EMT’s carbon monoxide alarm went off while treating a patient for a possible stroke. High levels of carbon monoxide were discovered. The home had been turned into an illegal boarding house for 33 BAPS Temple volunteers. BAPS is a Hindu-based faith based on personal growth. In this instance, safety of the occupants was not the primary concern.

“Specifically, it was observed that there were no carbon monoxide detectors, not enough smoke detectors, and many points of egress were blocked. Police noted in the report that a door was screwed shut to the frame, and another with two planks of wood mounted across it, preventing it from being opened. As a result, there was only one working point of exit for the occupants.” https://midjersey.news/2023/03/31/33-female-baps-temple-volunteers-evacuated-from-home-being-used-as-rooming-house-after-carbon-monoxide-incident/

The building had been issued a Notice of Unsafe Structure on March 16, 2023.

We have seen in past blogs other instances in which citations were issued and ignored in both legal rentals and illegal rentals. In some cases, lack of maintenance of fuel-burning devices has gone hand-in-hand with lack of carbon monoxide detectors. Lack of qualified inspectors, lack of consequences; these issues all come into question when dealing with negligent landlords. Ignored citations often come to light only after a tragedy occurs.

Public awareness is the other obstacle we face. Just as carbon monoxide fatalities dropped after auto makers complied with the environmental mandates of the 1970s, is it not probable that the major source of carbon monoxide deaths, generators, might require the same legislative mandates? Although legislation requiring carbon monoxide detectors in more and more situations is prudent, we are still relying on potential victims to protect themselves. And this in a society that because of increasing technology is less likely to understand the basics of combustion or the dangers thereof.

We continue to see stories like the recent incident in Fort Worth, Texas in which 6 people were hospitalized after the levels of carbon monoxide had built up in their home due to a car left running in the garage. A child answered the door and collapsed after informing responders that his mother was acting oddly. https://www.insurancejournal.com/news/southcentral/2023/03/31/714654.htm

Five firefighters were subsequently treated with oxygen after entering the home. A carbon monoxide alarm might have alerted responders to the danger as well as alerting the family.

These types of incidents are all too common. Have we achieved a meaningful level of public awareness? Has carbon monoxide detector legislation accomplished what we need it to accomplish? More importantly, how can we do better?

Carbon Monoxide Prevention a Complex Issue

It is a complex issue which encompasses public education, carbon monoxide detector availability, and effective legislation with enforcement and consequences. It also carries with it an appeal to manufacturers to examine costs vs human life and ideally address solutions such as cutoff switches for portable generators.

Some solutions may be simpler. We are all familiar with power cords wrapped with an electrical shock warning, we have yet to see a thermostat with a Do Not Operate Without A CO Detector. Twice a year we face changing our clocks with a reminder to check our smoke detector batteries, but what about the CO detector? We have a long way to go before carbon monoxide is the mainstream concern that it should be.

At the same time our understanding of the potential for long term injuries due to carbon monoxide poisoning are increasing due to a greater understanding of the human brain and medical advances. We have yet to fully grasp the impact that exposure to carbon monoxide has on the thousands who end up in the emergency room or who go undiagnosed.

What we do know is it is not a single solution problem. It is a multi-faceted issue that can improve for the general public with education and legislation. In cases of negligence that endangers the public, litigation is sometimes the only meaningful consequence.