Understanding risk behaviors for storm- and disaster-related carbon monoxide poisoning

Background: Unintentional, non-fire-related carbon monoxide (CO) poisoning causes 500 deaths and more than 15,000 injuries in the U.S. annually. A variety of fuel-burning appliances emit CO, a toxic, colorless, and odorless gas. The incidence of CO poisoning spikes after major storms and disasters, as residents turn to portable generators for power and heat, often placing them in unventilated areas. Despite this trend, little is known about the beliefs and attitudes that drive improper generator placement or the use of CO alarms in post-disaster situations.

Methods: We conducted focus groups with portable generator owners (n=32) in two cities frequently hit by summer and winter storms. All participants used generators in post-disaster scenarios. The sessions explored participants' generator locations and rationale, storm preparations, CO awareness, and CO alarm placement.

Results/Outcomes: Most participants had pre-determined locations for generators, and many placed them in semi-enclosed areas, such as garages, carports, and covered patios. Access to key appliances—furnaces, refrigerators, and air conditioning units—was the primary determinant of generator location. Participants were aware of CO but felt their risk of poisoning was minimal, often citing the absence of traditional gas appliances. Only half of participants had CO alarms, and most placed them near appliances rather than in bedrooms or common areas.

Conclusions: Convenience and low perceived risk drive unsafe generator placement after storms and disasters, leading to CO poisoning. Educating residents about proper generator ventilation and CO alarm installation is key to preventing post-disaster injury and death.