New Report: State-by-State Assessment of Carbon Monoxide Risks

Washington, D.C. — Today, UL Standards & Engagement released its inaugural U.S. State CO Risk Assessment Report, evaluating U.S. states’ preparedness to prevent CO poisonings. The report draws on multiple data sources across the last two decades to ensure a comprehensive assessment of health outcomes, regulatory and code strength, and public awareness and behavior.

“Carbon monoxide is a silent killer, but a preventable one if we take the right steps to reduce the risk,” said Jeff Marootian, president and CEO of UL Standards & Engagement. “Detection is the best — and sometimes only — means of prevention, but we found that a staggering number of people were leaving themselves unprotected and wanted to explore where and how we can save lives.”  

Last year, a ULSE report found that 36% of U.S. adults — an estimated 86.2 million Americans — have no means of CO protection in their homes. The report comes as hurricane season approaches and in the wake of several high-profile carbon monoxide poisonings in the news.

Evaluating 50 states and the District of Columbia, the assessment offers an overall weighted score out of 100 based on health outcomes, state-level mandates for indoor CO detector presence, and public awareness measures (weighted at 40%, 35%, and 25%, respectively) to balance each component’s relative impact on public health. 

States were classified by their scores into four categories: CO safety champion, CO safety leader, CO safety advocate, and CO safety starter. 

Carbon monoxide poisoning causes significant harm in the United States, and globally, each year. The U.S. Centers for Disease Control and Prevention estimates at least 430 Americans die annually from unintentional CO poisoning, and an estimated 50,000 people seek emergency care due to accidental exposure. Actual exposure numbers may be higher, as symptoms are often misdiagnosed.  

“Every day, we see the same alarming pattern — people unknowingly putting themselves at risk simply because they don’t recognize the danger,” said Charon McNabb, president and founder of the National Carbon Monoxide Awareness Association. “Carbon monoxide is invisible, odorless, and tasteless, making it incredibly easy to overlook without proper safeguards. And with safety requirements varying so much from state to state, far too many people are left unprotected. This report is here to change that. It offers states and territories a clear, research-backed roadmap to strengthen their protections and keep communities safe.”

The report includes recommendations for states to improve their CO risk readiness. The recommendations, put forward by NCOAA and ULSE, drive several principles of effective CO management, including:

• Improving detection through mechanisms like offering financial incentives for low-income and vulnerable populations to install CO alarms.
• Enhancing public outreach through campaigns that help promote awareness of symptoms and importance of working alarms in homes — particularly targeting vulnerable populations.
• Requiring CO alarms certified to UL 2034 in new and existing commercial and residential buildings and ensuring enforcement mechanisms create greater accountability.
• Training first responders and health professionals to recognize and treat CO poisoning cases effectively. 

“We want this assessment to be a resource to states in protecting their communities and identifying opportunities to strengthen awareness. With summer’s extreme weather around the corner, this is a critical moment to sound the alarm on carbon monoxide,” concluded Marootian.

Read the full report and see the breakdown by state here.

Methodology

State performance was evaluated using three key metrics: public health outcomes (sourced from CDC’s Environmental Public Health Tracking Network, spanning 2000 to 2022), state-level CO detector building code and regulatory strength (sourced from the National Fire Protection Association’s 2021 Carbon Monoxide Detection and Alarm Requirements publication), and public awareness levels (using survey data from ULSE’s nationally representative surveys of U.S. adults between August 2023 and August 2024, capturing CO alarm ownership, safe generator usage, and general knowledge of CO risks). These metrics were weighted at 40%, 35%, and 25%, respectively, ensuring a balanced assessment that accounts for the diverse factors influencing CO safety.

About UL Standards & Engagement

UL Standards & Engagement is a nonprofit organization that translates safety science into action through standards development, partnerships, and advocacy. Since 1903, we have developed nearly 1,700 standards and guidance documents for products ranging from fire doors to autonomous vehicles. ULSE enables innovation and grows trust by convening experts, and informing policymakers and regulators as we work toward a safer, more secure and sustainable future. Visit ulse.org for more information.

Contact

Catie Talenti
UL Standards & Engagement
Lead, Media Relations & Strategic Positioning
P: (607) 742-8766
catie.talenti@ul.org