U.S. State CO Risk Assessment Report: Key Insights & Actionable Recommendations

By: Anna Schnerre, Senior Insights Analyst at UL Standards & Engagement 

UL Standards & Engagement’s latest U.S. State CO Risk Assessment Report evaluates each state across three pillars, health outcomes, code & regulatory framework, and public awareness, to produce a weighted score and place states into four performance tiers. 

Carbon monoxide awareness & regulations vary from state to state.

Carbon monoxide is a deadly, invisible gas that poses serious risks in enclosed spaces, and yet, CO safety regulations and public awareness efforts vary widely from state to state. A new report from UL Standards & Engagement reveals just how uneven this protection is and what actions can help close the gap. 

The U.S. State CO Risk Assessment Report evaluates states across three key pillars: health outcomes, code and regulatory frameworks, and public awareness. Based on these metrics, states are placed into one of four performance tiers, offering a nationwide snapshot of strengths, weaknesses, and opportunities for improvement. 

Many people assume hotels and other venues are equipped with CO alarms. This is not always true.

The need for action is urgent. ULSE’s research, based on data collected from August 2023 to August 2024, paints a concerning picture of consumer confusion and under-protection. An estimated 36% of U.S. adults — roughly 86.2 million people — do not have a working CO detector in their home. Many Americans are misinformed about how to protect themselves: nearly three in ten believe a smoke alarm also detects CO, and almost half assume public venues like hotels and restaurants are already equipped with CO alarms. Among the 29 million Americans who own a portable generator, 62% don’t perceive a risk of CO poisoning from their use, putting themselves and their families in danger. 

To better understand and address this fragmented landscape, the report categorizes states into four tiers of performance: 

CO Safety Champions: Gold‑Standard States for Carbon Monoxide Protection 

Leading the nation in CO safety, these six Champion states achieve top scores across all metrics. They consistently mandate CO detectors in new and existing buildings, run year‑round public awareness campaigns, and coordinate across agencies to ensure compliance. Many Champions also deploy targeted emergency CO protocols during storms and power outages, setting the benchmark for comprehensive carbon monoxide risk management. 

CO Safety Leaders: Strong Frameworks with Growth Potential 

CO Safety Leaders excel in most areas, boasting broad alarm requirements and seasonal awareness drives, yet still fall short of the top tier. To advance, Leaders can strengthen uniform inspection protocols, expand detector coverage in older homes, and maintain consistent year‑round outreach. These steps will help close remaining gaps and elevate them to Champion status. 

CO Safety Advocates: Building Foundational CO Regulations 

As the largest group, CO Safety Advocates have established basic code frameworks and are seeing improving health outcomes. However, many only require CO alarms in newer constructions, leaving older housing under‑protected. By extending detector mandates, launching robust public education efforts, and incentivizing installations, Advocates can move up to the Leader tier. 

CO Safety Starters: Early Adoption and Key Opportunities

Starter states are in the initial phase of CO safety implementation, often relying on local ordinances or voluntary measures. Public education is limited, and statewide regulations are minimal. To enhance safety, Starters should adopt comprehensive CO codes, expand inspection requirements, and allocate funding for consistent public awareness campaigns, laying the groundwork for stronger carbon monoxide protection. 

While the tier categories highlight key differences in preparedness, the report also lays out a clear path forward. No matter where a state currently falls on the CO safety spectrum, progress is possible through these four steps:

1. Mandate Comprehensive Alarm Coverage: Require CO detectors in all new and existing residential, commercial, and rental properties, plus regular maintenance checks. 

2. Scale Public Education: Launch annual, multichannel safety campaigns, leveraging utilities, healthcare providers, and social media to boost awareness and recall. 

3. Enhance Incident Surveillance: Implement real-time reporting systems with public dashboards for both fatal and nonfatal CO events. 

4. Empower First Responders: Integrate CO poisoning modules into all fire and EMS certification programs and conduct regular refresher training. 

Together, these actions represent a proactive, scalable strategy to prevent needless injuries and fatalities caused by carbon monoxide exposure. 

The ULSE CO Risk Assessment Report is more than just a scoring system; it serves as both a benchmark and a call to action. Its findings emphasize that effective CO safety blends well-enforced policies, targeted public outreach, and reliable technology standards.

To explore the full methodology, state-specific one-pagers, and in-depth guidance, download the full report.