Adrian McConnell, Chief Executive, The CO Research Trust

For many years, the CO Research Trust has highlighted the conflicting priorities of housing policy. The need to balance the health effects of air quality, with affordability, and environmental sustainability. However, recent rises in the cost of energy, have sharpened the focus very clearly on affordability.

The Housing Trilemma
The Housing Trilemma

The short-term goal for many is finding ways of keeping warm without generating an unmanageable energy bill. The concern now is the impact that this will have on health and well-being.

Many of the solutions to rising energy bills are to decrease your usage of energy or make your home more energy efficient. These solutions all come with a significant cost.

Fitting cavity walls, floor, and loft insulation, or getting double glazing fitted, are simply not accessible or affordable options for many people, who may be making difficult choices between eating and heating.

Wall insulation is not an affordable option for many
Wall insulation is not an affordable option for many

Decreasing energy usage often has an impact on health. According to a 2021 report by the Building Research Establishment, treating patients who live in cold homes costs the NHS around £860m per year, in England alone.

While living in cold homes provides risks to health, the low-cost solutions to increase warmth often pose dangers to health too.

Attempts to reduce energy usage often lead to dangerous behaviour, such as burning unsafe fuels (i.e. wet, cheap wood) or plastics, which give off toxic gases. People may also be tempted to use the wrong types of heaters, such as outdoor cooking or heating equipment inside.

Outdoor heaters must not be used indoors
Outdoor heaters must not be used indoors

In 2014 the CO Research Trust funded a National Energy Action research project which found that the link between poor health and fuel poverty is well established. It was very clear, those living in fuel poverty are at increased risk of carbon monoxide poisoning. What has changed is the increased number of people this is now affecting.

According to the Joseph Rowntree Foundation’s UK Poverty Profile 2022, around 14.5 million people are currently living in fuel poverty in the UK. That means more than one in five people in the UK. That’s 22% of the UK population.

Of these people, 8.1 million are working-age adults, 4.3 million are children and 2.1 million are pensioners.

This is particularly alarming. Research shows that older people are one of the vulnerable groups who are more susceptible to carbon monoxide poisoning.

Older people are more susceptible to carbon monoxide poisoning
Older people are more susceptible to carbon monoxide poisoning

Fire Officers often report high levels of confusion in older residents who may be at risk of chronic carbon monoxide exposure at levels not sufficient to trigger CO alarms, but which could still be harmful to health.

Research carried out at Lancaster University in 2021 found that older adults may be more susceptible to the effects of carbon monoxide due to reduced physiological reserve. Older people may already have pre-existing conditions that could be exacerbated by exposure to carbon monoxide.

Other groups who are more vulnerable to carbon monoxide poisoning include pregnant women and children.

Pregnant women are also at greater risk of carbon monoxide poisoning
Pregnant women are more vulnerable to carbon monoxide poisoning

The Trust recently funded research into the risks of carbon monoxide poisoning during pregnancy. The findings show that for multiple reasons, pregnant women are at increased risk of carbon monoxide exposure.

So now we are facing two major issues. Firstly, the size of the group of vulnerable people living in fuel poverty is increasing, due to rises in the cost of energy. Secondly, we now have a much better understanding of the risks to specific groups of vulnerable people, with reference to carbon monoxide exposure.

Carbon monoxide is a deadly gas that cannot be detected by human senses - it has no colour, taste, or smell. Most household appliances such as cookers, stoves and fireplaces can produce carbon monoxide. This happens when fossil fuels (oil, gas, wood) burn inefficiently.

Every year in the UK, thousands are harmed, and over 200 people are hospitalised with suspected carbon monoxide poisoning. This leads to around 30 deaths. However, we suspect that this number is significantly higher, due to the difficulties in diagnosing poisoning.

CO poisoning is hard to diagnosis in patients presenting with flu-like symptoms
CO poisoning is hard to diagnosis in patients presenting with flu-like symptoms

After exposure, carboxyhaemoblin levels quickly reduce as the patient breathes fresh air or oxygen. This means by the time a patient reaches the hospital, there is often no trace of the poison to be found. This offers very few clues to medical professionals that carbon monoxide poisoning may be the cause of the symptoms and so it is often overlooked.

Given all these increased risks, many people are still finding themselves in an impossible situation. Difficult choices are being made about where and how to spend money. These choices will have consequences for health and well-being.

The good news is that with a little lifesaving knowledge, exposure to carbon monoxide can be easily avoided.

In support of the ‘Cutting corners costs lives’ campaign as part of Carbon Monoxide Awareness Week 2022, we wanted to share some important tips to help people during these challenging times.

Cutting corners costs lives
Cutting corners costs lives

Below is a list of seven low-cost and potentially life-saving things to do. Please share with friends and family.

#1 - CO alarms - install and test

Firstly, make sure you install an audible carbon monoxide alarm in every room where you have a heat-producing appliance, for example, a cooker, fire, boiler etc. Here’s a useful guide to making sure you put it in the correct place.

If you live in rented accommodation, the law has recently changed. Landlords are now (from 1st Dec in Wales) legally required to install carbon monoxide alarms in your property. To find out more about these changes, click here.

Install and test your CO alarm regularly
Install and test your CO alarm regularly

Once you have your alarm installed, make sure you test it regularly. Familiarise yourself with the sounds and make sure the batteries are still working #TestitTuesday. For more information on carbon monoxide alarms and what to look for when buying one click here.

#2 - Be aware

Knowing the signs and symptoms of carbon monoxide poisoning is a lifesaver. They are not always obvious and can often be mistaken for flu-like illnesses. The question to ask yourself is ‘Do my symptoms get better when I leave the house?’ If the answer is yes, then it’s possible you have a carbon monoxide leak in your house.

Some examples of symptoms include.

  • Headache
  • Nausea
  • Dizziness
  • Breathlessness
  • Collapse
  • Loss of consciousness
Headaches can be a symptom of carbon monoxide poisoning
Headaches can be a symptom of carbon monoxide poisoning

#3 - Know what to do

If you suspect carbon monoxide poisoning, it’s important that you know what to do.

  • Call the gas emergency number immediately - 0800 111 999. Save this to your phone and tell friends and family to do the same.
  • Stop using appliances you think might be making carbon monoxide (such as a boiler, cooker or heater) if you can.
  • Open any windows and doors to let fresh air in - go outside. Do not go back into the affected building until you have been given advice.
  • Get medical advice as soon as possible - explain your suspicions

    Call the Gas Emergency Number if you suspect a gas or CO leak

#4 - Ventilation

Without fresh air, carbon monoxide can build up very easily. However, it’s often something we don’t think about. You can improve natural ventilation by opening windows, air vents and doors if the weather allows. If windows have been painted shut, they should be reopened.

Make sure you do the following.

  • Ventilate when cooking, use a fan or open windows
  • Never block air vents
  • Optimise the heat - the more effectively you use your heating system, the easier it is to ventilate. Making sure that radiators are not blocked by furniture or covers, and moving seating away from cold windows will help
  • Use the weather - on sunny days in autumn and winter allow the fresh air to come into your home or building, and open more windows on the sunny side

    More information is available on ventilation here.

#5 - Check the flame

Do you know what a safe flame looks like? A healthy, properly burning flame on gas appliances should be blue in colour. This blue colour indicates that there is safe, efficient, and complete fuel combustion.

Red flames or yellow gas flame colour may be a sign of incomplete combustion or wasted gas and is a serious safety hazard. You need to turn the appliance off immediately and get it checked by a registered professional.

To find a registered gas installer click here.

Check that your gas appliances are burning with a blue flame
Check that your gas appliances are burning with a blue flame

#6 - Burn the right fuels

If you have a wood-burning stove, it may be tempting to burn wood you find when you are out and about. However, it’s very important that you don’t burn wet wood. Burning wet wood produces more smoke than dry wood, which releases more pollutants and small particles into the air. Burning wet wood in a fireplace can also cause creosote build-up in your chimney, which may create a fire hazard.

As a rule of thumb, make sure your wood has been left to dry out for at least 6 months before burning it. Alternatively, you can buy a pin meter which will measure the moisture content of your firewood.

The one and only thing you should be burning in your fireplace are dry, seasoned firewood.

Below is a list of things you should never burn on your open fire or wood-burning stove.

  • Cardboard - cardboard is heavily treated with chemicals during its manufacture and burning releases these toxins into the air
  • Plastic - for similar reasons, burning plastic is a bad idea. It is loaded with harmful chemicals that become airborne when the plastic melts in the fire
  • Pressurised cans - the pressure inside the can will increase with the heat, causing potential explosions
  • Rubbish - Lots of household materials contain toxic chemicals, which become airborne when they are burned
  • Treated wood - treated lumber and plywood are usually coated in chemicals to make them more hard-wearing, don’t be tempted to use these as a cheaper alternative

    For more detailed information on what to burn visit the Woodsure website here.

#7 - Use the right appliance

Never be tempted to use outdoor cooking or heating equipment, such as BBQs or patio heaters inside. Carbon monoxide levels can build up to deadly levels very quickly.

When it comes to looking after your appliances, we know that when appliances are not maintained regularly, there is an increased risk to your health.

  • Always use a professional and registered person to install and maintain your gas and solid fuel appliances
  • Get them checked regularly - appliances should be serviced every year

Finally, the four gas distribution networks offer several free services to households in need of support. Click here and enter your postcode to see what additional support is available in your area.

Adrian McConnell, Chief Executive, The CO Research Trust
Adrian McConnell, Chief Executive, The CO Research Trust