Transcript CDC Presentation

Review of state-level laws requiring carbon
monoxide alarms in residential settings
Presented by: Fuyuen Yip, PhD, MPH
Air Pollution and Respiratory Health Branch, NCEH, CDC
Co-authored by: J. Clower, S. Kershner, T. Boehmer, L. Caucci, S. Iqbal, Y. Wing
Council of State and Territorial Epidemiologist’s Annual Conference
June 5, 2012
National Center for Environmental Health
Division of Environmental Hazards and Health Effects
Carbon Monoxide (CO)

Colorless, odorless gas

Produced due to incomplete combustion of
hydrocarbons

Common sources:
 Home heating & cooking appliances
 Gas powered equipment
 Motor vehicles

A leading cause of poisoning in the US
Epidemiology of Unintentional,
Nonfire-related CO Exposures

Mortality & morbidity
 >20,000 emergency department visits
 ~2,300 hospitalizations
 ~450 deaths

Populations affected
 Non-fatal: Children (<5 years), Females
 Fatal: Elderly (>65 years), Males

Season
 Winter

Region
 Midwest
 Northeast
CO Poisoning Health Effects & Prevention

Non-specific flu-like symptoms:
 Fatigue, dizziness, headache, confusion, nausea, vomiting
 Collapse, coma, cardio-respiratory failure, & death

15%−49% develop neuro-cognitive sequelae

Most cases occur in residential settings

Preventable with installation of CO alarm

37% of U.S. households report having a
CO alarm (2009 NHIS, National Household Interview Survey)
CO Alarm Guidance





Underwriter’s Laboratory (UL) approved
Battery-operated or have battery-back up
Located outside of sleeping areas in homes
In homes with fuel burning appliances
In homes with attached garages/parking
Public Health Law

Law can be an important tool to affect public health
outcomes

States have powers to enact legislation and
promulgate regulations to protect the public health,
welfare, and morals, and to promote the common
good

State laws include
 Statutes that are adopted by legislature
 Regulations that are promulgated by executive agencies
CO Alarm Laws

Sometimes adopted in response to CO poisoning
events

CO alarm provision can be adopted as part of
 Public health and safety laws
 Landlord/tenant laws

More recently, through state adoption of large national
or international code(s):
 International Code Council (ICC) building, residential, and fire
codes
 National Fire Protection Agency (NFPA) codes and standards
International Code Council (ICC)




Nonprofit organization that develops
comprehensive, coordinated building safety
and fire prevention model codes (I-Codes)
I-Codes updated every 3 years
CO alarm provisions first included in 2009 IRC
I-Codes relevant to CO alarms:
 International Residential Code (IRC)
 International Building Code (IBC)
 International Fire Code (IFC)

I-Codes must be adopted by state or local
governments through statute or regulation
2009 IRC
SECTION R315 – CARBON MONOXIDE ALARMS
** IRC applies to detached one- and two-family dwellings and
townhouses not more than three stories
 R315.1 Carbon monoxide alarms. For new construction, an
approved carbon monoxide alarm shall be installed outside of
each separate sleeping area in the immediate vicinity of the
bedrooms in dwelling units within which fuel-fired appliances are
installed and in dwelling units that have attached garages.
 R315.2 Where required in existing dwellings. Where work requiring
a permit occurs in existing dwellings that have attached garages
or in existing dwellings within which fuel-fired appliances exist,
carbon monoxide alarms shall be provided in accordance with
Section R315.1.
 R315.3 Alarm requirements. Single station carbon monoxide
alarms shall be listed as complying with UL 2034 and shall be
installed in accordance.
Objectives

Describe state-level laws that require CO alarms in
residential dwellings

Assess provisions of CO alarm laws pertaining to public
health guidance for CO poisoning prevention
Methods

Collaboration between Air Pollution and Respiratory
Health Branch/NCEH and Public Health Law Program

CDC attorneys conducted search to identify state laws:
 WestlawNext database
 International Code Council (ICC) website
 Individual state legislative and building code websites

Inclusion criteria
 State-level statute or regulation
 Adopted as of December 31, 2011
 Address CO alarms in traditional residential dwellings
Methods

Collected important provisions of laws:




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Applicable building types
Responsibility for installation and repair
Alarm type, operation, and installation specifications
Penalty and compliance issues
Data abstraction
 Two researchers independently abstracted each law and resolved
inconsistencies in coding
 Coding reviewed by an attorney for accuracy

Data analysis
 Frequency of states with specific CO alarm law provisions
 Percentages calculated using the number of states with CO alarm
laws as the denominator
Number of CO Alarm Laws


71 CO alarm laws identified as of Dec. 31, 2011
36 states (72%) have a CO alarm law
 Number of laws per state ranged from 1 to 6
 17 states have 1 law; 11 states have 2 laws; 8 states have 3+ laws
Type of CO Alarm Laws (n=71)
Number
of Laws
% of
Laws
I-Codes, modified or verbatim
34
48%
Independent State Building Codes
8
11%
Landlord/Tenant laws
7
10%
Public Health or Safety laws
22
31%
CO Alarm Law Type by State (n=36)
Number
of States
% of
States
I-Code only, verbatim or modified
12
33%
I-Code plus another law
15
42%
2
6%
7
19%
Independent State Building or Fire
Code only
Landlord/Tenant or Public Health
or Safety laws only
Effective Date of First CO Alarm Law per State,
1998–2011 (n=36)
10
Number of states
8
6
4
2
0
Year first CO alarm law became effective
Alarm Requirements by Dwelling Characteristics
Construction Status
6%
New construction and
existing dwellings
8%
31%
New construction and
renovations with permit
New construction only
55%
Rental properties only,
new and existing
Alarm Requirements by Dwelling Characteristics
Residence Type
All residential dwellings
1- and 2-family homes, townhomes
Occupancy Status
Owner- and Renter-occupied
Owner-occupied only
Renter-occupied only
6%
31%
25%
75%
64%
Alarm Requirements by Dwelling Characteristics
Presence of CO Source
35
86%
89%
Garage/carport
present
Fuel burning
appliance present
Number of states
30
25
20
15
10
20%
5
0
Any CO source
present
Alarm Location within Dwelling
35
89%
Number of states
30
25
20
15
10
5
19%
6%
0
No location specified Outside of sleeping
area
Near fuel burning
appliance
Alarm Type, Installation, and Power Source
35
92%
89%
Number of states
30
25
20
15
28%
10
5
0
UL approved (or
comparable)
Install according to Battery operated or
manufacturer or
backup
NFPA
Additional Alarm Installation Requirements
Number
of States
(n)
%
Specifies who is responsible for
installation (e.g., owner, landlord)
15
41.7
Alarm required upon new lease
10
27.8
Alarm required upon sale/transfer
7
19.4
Provision
Compliance and Penalty Issues
Number
of States
(n)
%
Installation compliance check
29
80.6
Penalty for not installing
11
30.6
Prohibit tampering or disabling
12
33.3
Penalty for tampering or disabling
8
22.2
Provision
Summary

36 states adopted a CO alarm law as of Dec. 31, 2011

14 (28%) states do NOT have a state-level CO alarm law
 Local jurisdictions within these states may have CO alarm laws

Addition of CO alarm provision to 2009 IRC
substantially increased the coverage of CO alarm
requirements across US
 25 states adopted the IRC since 2009
 12 states only address CO alarm requirements via the IRC
Summary: CO Alarm Guidance

Provisions of public health CO alarm guidance:
92%
UL approved
89%
Installed outside of sleeping areas
89%
In homes with fossil fuel burning appliances
86%
In homes with attached garages/parking
28%
Operates on battery or has battery backup



7 states included all five provisions
2 states included zero provisions
Some state laws included provisions about installing
CO alarms near fossil fuel-burning appliances, which is
against manufacturer’s instructions
Summary: Compliance

CO alarm law compliance is complicated and can vary
widely from state to state

New and renovated dwellings
 CO alarm requirements that are a part of the state building code
entail a compliance check for permitting purposes

Existing dwellings
 Several (7) states made the alarm requirement contingent upon
the sale of the dwelling to increase compliance
Limitations

Only used legal resources available in the public
domain

Did not address how law interpreted and used

Understanding content and provisions of law doesn’t
reflect how it is being used

States without state-level CO alarm laws might have
local laws
Next Steps

Increase awareness of public health guidance for CO
alarm installation

Work with ICC and NFPA to
 revise model, national building codes
 incorporate aspects of public health guidance
 decrease variability among CO alarm laws

Possible future efforts
 Work towards building model legislation
 Examine effectiveness of state CO alarm laws in the reduction of
CO exposures and poisonings
Thank you.
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected] Web: http://www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the
Centers for Disease Control and Prevention.
National Center for Environmental Health
Division of Environmental Hazards and Health Effects
National Fire Protection Association

NFPA provides and advocates consensus codes and
standards, research, training, and education

NFPA develops, publishes, and disseminates more than
300 consensus codes and standards aimed to minimize
the possibility and effects of fire and other risks

NFPA 720: Standard for the Installation of Carbon
Monoxide(CO) Detection and Warning Equipment
Example Modifications to IRC

Limited code to “new construction” only (less
comprehensive)

Added provisions about location of alarms
 “one on each story including basements and cellars”

Added provisions allowing use of combination
smoke/CO detectors

Added provisions about alarm power source
Discussion

Impact of public health laws varies depending on:





breadth of the law
funding
implementation
Enforcement
Laws of narrower scope may:
 limit the ability to prevent CO poisonings
 may be the result of industry resistance

Recent adoptions and revisions provide opportunity to
strengthen existing laws and bring them into alignment
with public health guidance