By Adrian McConnell, Head of Charitable Operations at CO Research Trust

Back in 2005, when the Gas Safety Trust was established, there were 23 reported incidents relating to CO exposure in Great Britain, leading to seven accidental deaths.

The original purpose of the charity emphasised the prevention of deaths from gas (CO) in the home. In recent years the number of such deaths has declined drastically.

Thanks in part to better regulation and improved technologies, the UK’s gas industry has taken positive steps forward to prevent CO poisoning. Recent incident data suggests that there is a significant downward trend in accidental deaths from exposure to piped natural gas.

Number of fatalities from piped natural gas
DIDR data of fatalities from piped natural gas


I’m delighted that the Gas Safety Trust was able to play a part in this achievement and has made a positive and significant contribution towards saving lives.

However, over the course of the past 15 years it has become apparent that there are many other areas of concern relating to CO. The Trust has identified a number of priorities where research is needed in order to help prevent further incidents.

Firstly, while we know that incidents of CO poisoning from gas appliances have reduced, the picture is less clear from other fuels. There are currently no requirements to report CO incidents involving solid fuel appliances and with fewer regulatory requirements the level of risk from CO exposure is still unclear.

Incident data suggests that in recent years there have been more fatalities relating to solid fuel appliances than natural gas appliances, which given the disproportionate number of solid fuel appliances, is an alarming development.

Wood fire
Wood fire



For this reason, projects that focus on identifying the level of risk and specific issues within the solid fuel sector will be one of a number of key priorities for the CO Research Trust going forward.

What we also now know is that exposure to CO at low levels may be a widespread problem. This is an issue that is not well recognised and has only begun to be considered in recent years. We feel that this may be the tip of the iceberg of a major under-reported public health issue.

Our approach has been to both try and establish the scale of the problem, as well as to establish what can be done to mitigate and prevent it.

The effects of CO poisoning can be devastating. Particularly with low level CO exposure, where people are unaware that they are being poisoned, or worse, unable to do anything about it. As well as the adverse effects on health, exposure to CO can have other life-changing impacts, such as the breakdown of family and personal relationships, loss of job and a significant impact on mental health.

The scale of this problem in the UK is yet to be established and this could potentially be an issue that is impacting on thousands of lives every day. For this reason, quantifying the prevalence of CO exposure in the UK is an important focus for the CO Research Trust.

We also know that exposure to CO in environments outside the home is an area of potential concern. In research carried out by the Trust, shockingly 14% of people admitted to bringing a barbecue inside their tent or caravan due to bad weather. This action leaves people seriously exposed to the risk of CO poisoning.

Kettle on a camping stove
Kettle on a camping stove


According to the Great British Tourism Survey (2019) more than 14 million camping trips took place in the UK in 2019. With COVID restrictions meaning foreign travel continues to be restricted, the number of people holidaying at home and choosing to go camping in the UK is set to increase further in 2021, with many of them inexperienced first time campers.

This conservative estimate suggests that there are potentially two million people unknowingly putting their lives at risk through CO poisoning, by bringing a barbecue inside their tent. This is an area that the CO Research Trust will continue to focus on, particularly in collaboration with leisure industry partners.

As well as camping groups being identified as at risk, work carried out on behalf of the Trust has also identified a number of other groups who are particularly susceptible to CO exposure.

Older people have been identified as a group particularly at risk from CO poisoning, which has led the Trust to fund research into the possible links between CO and dementia.

Elderly lady
Elderly lady



There are significant similarities between the symptoms of CO poisoning and dementia and studies have indicated that patients with CO poisoning have a higher risk of dementia than people without CO poisoning. However, the association between CO poisoning and long-term dementia risk remains unestablished.

Children, pregnant women and people living in fuel poverty are also thought to be more susceptible to CO exposure, as well as people living with underlying health conditions. These are all groups of people for whom COVID lockdowns will have had a significant impact.

A number of people within these groups will have been forced to stay in accommodation during national lockdowns that is putting them at risk of CO poisoning.

As a charity, our vision is a world where CO exposure does not occur, but we are realistic enough to understand that this may not be possible. The current global pandemic is an example of how the risk of CO exposure has increased for many people, in some cases overnight, and with no means on mitigation.

Where CO poisoning does occur, we want it to be easily detected, diagnosed and treated. Improved diagnosis of CO poisoning is a critical area of research for the Trust. It is essential that a new biomarker is found to make diagnosis easier and to ensure that those who need treatment receive it.

However, to improve the treatments and therapeutics for CO exposure, we first need a better understanding of the mechanisms of poisoning.

As you can begin to see, the CO research area is a complex landscape of interconnected issues. There are many challenges to be overcome, many of which involve building a more complete picture of the scale of the problem.

We are determined, however, that the next 15 years will enable us to drive some of these areas forward so that we can help to increase our understanding and, ultimately, work towards reducing the impact of CO.