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Risk and protective behaviours for residential carbon monoxide poisoning
  1. Douglas J Rupert1,
  2. Jon A Poehlman1,
  3. Scott A Damon2,
  4. Peyton N Williams1
  1. 1Health Communication Program, Public Health and Environment Division, RTI International, Research Triangle Park, North Carolina, USA
  2. 2Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Douglas J Rupert, Health Communication Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, USA; drupert{at}


Background Unintentional, non-fire-related carbon monoxide (CO) poisoning is a leading cause of poisoning death and injury in the USA. Residential poisonings caused by faulty furnaces are the most common type of CO exposure. However, these poisonings are largely preventable with annual furnace inspections and CO alarm installation.

Objective This study aimed to identify the knowledge, attitudes and beliefs that might lead consumers to adopt these protective behaviours.

Methods In August 2009, four focus groups (n=29) were conducted with homeowners in Chicago, Illinois, USA, to identify the knowledge, attitudes and beliefs that lead consumers to adopt risk and protective behaviours. Discussions were transcribed and the findings were analysed using an ordered meta-matrix.

Results Focus group participants were aware of CO poisoning and supported the idea of regular furnace inspections. However, few participants consistently scheduled professional inspections for fear of costly repairs and unscrupulous contractors. Participants often owned CO alarms, but many did not locate them properly, nor maintain them. Some participants confused CO and natural gas and were unsure how to react if a CO alarm sounds. Participants stated that incentives, such as discounts and inspector selection tips, would make them more likely to schedule furnace inspections. Participants also identified trustworthy sources for CO education, including realtors, fire departments, home insurance agents and local media outlets.

Conclusions Participants' residential CO risk behaviours are not random but driven by underlying knowledge, attitudes and beliefs. Correcting misperceptions, providing incentives and partnering with trustworthy sources might encourage greater consumer adoption of protective behaviours.

  • Carbon monoxide
  • poisoning
  • injury
  • alarm
  • behaviour change
  • campaign
  • natural disaster
  • mixed methods

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  • Funding This research was supported by the US Centers for Disease Control and Prevention (CDC). The findings and conclusions are those of the authors and do not necessarily reflect the view of the CDC or the US Department of Health and Human Services.

  • Competing interests None.

  • Ethics approval Approval provided by:(1) RTI International, Institutional Review Board And (2) US Centers for Disease Control and Prevention, Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unpublished study data—such as focus group notes and transcripts—are available only with approval from the paper authors, RTI International and the US Centers for Disease Control and Prevention. Written requests for such data should be submitted to the corresponding author.