Advertisement

Carbon monoxide poisoning deaths in the United States, 1999 to 2012

  • Kanta Sircar
    Correspondence
    Corresponding author. Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, NE, MS F-58, Chamblee, GA 30341. Tel.: +1 770 488 3384; fax: +1 770 488 1540.
    Affiliations
    Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Chamblee, GA 30341
    Search for articles by this author
  • Jacquelyn Clower
    Affiliations
    Cazador Contractor, Herndon, Virginia, United States
    Search for articles by this author
  • Mi kyong Shin
    Affiliations
    Environmental Public Health Tracking, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Chamblee, GA 30341
    Search for articles by this author
  • Cathy Bailey
    Affiliations
    Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Chamblee, GA 30341
    Search for articles by this author
  • Michael King
    Affiliations
    Epidemiology Workforce Branch, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology and Laboratory Service, Centers for Disease Control and Prevention, Chamblee, GA 30341
    Search for articles by this author
  • Fuyuen Yip
    Affiliations
    Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Chamblee, GA 30341
    Search for articles by this author

      Abstract

      Background

      Unintentional, non-fire related (UNFR) carbon monoxide (CO) poisoning deaths are preventable. Surveillance of the populations most at-risk for unintentional, non-fire related (UNFR) carbon monoxide (CO) poisoning is crucial for targeting prevention efforts.

      Objective

      This study provides estimates on UNFR CO poisoning mortality in the United States and characterizes the at-risk populations.

      Methods

      We used 1999 to 2012 data to calculate death rates. We used underlying and multiple conditions variables from death records to identify UNFR CO poisoning cases.

      Results

      For this study, we identified 6136 CO poisoning fatalities during 1999 to 2012 resulting in an average of 438 deaths annually. The annual average age-adjusted death rate was 1.48 deaths per million. Fifty four percent of the deaths occurred in a home. Age-adjusted death rates were highest for males (2.21 deaths per million) and non-Hispanic blacks (1.74 deaths per million). The age-specific death rate was highest for those aged ≥85 years (6.00 deaths per million). The annual rate of UNFR CO poisoning deaths did not change substantially during the study period, but we observed a decrease in the rate of suicide and unintentional fire related cases.

      Conclusion

      CO poisoning was the second most common non-medicinal poisonings death. Developing and enhancing current public health interventions could reduce ongoing exposures to CO from common sources, such as those in the residential setting.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. United States Environmental Protection Agency. An Introduction to Indoor Air Quality (IAQ). Carbon Monoxide (CO). http://www.epa.gov/iaq/co.html.

        • Hampson N.B.
        • Weaver L.K.
        Carbon monoxide poisoning: a new incidence for an old disease.
        Undersea Hyperb Med. 2007; 34: 163-168
        • Raub J.A.
        • Mathieu-Nolf M.
        • Hampson N.B.
        • Thom S.R.
        Carbon monoxide poisoning—a public health perspective.
        Toxicology. 2000; 145: 1-14
        • Iqbal S.
        • Clower J.H.
        • Hernandez S.A.
        • Damon S.A.
        • Yip F.Y.
        A review of disaster-related carbon monoxide poisoning: surveillance, epidemiology, and opportunities for prevention.
        Am J Public Health. 2012;
        • Iqbal S.
        • Law H.Z.
        • Clower J.H.
        • Yip F.Y.
        • Elixhauser A.
        Hospital burden of unintentional carbon monoxide poisoning in the United States, 2007.
        Am J Emerg Med. 2012; 30: 657-664
        • Mott J.A.
        • Wolfe M.I.
        • Alverson C.J.
        • Macdonald S.C.
        • Bailey C.R.
        • Ball L.B.
        National vehicle emissions policies and practices and declining US carbon monoxide-related mortality.
        JAMA. 2002; 288: 988-995
        • Cobb N.
        • Etzel R.A.
        Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988.
        JAMA. 1991; 266: 659-663
        • Centers for Disease Control and Prevention
        Carbon monoxide—related deaths—United States, 1999-2004.
        MMWR Morb Mortal Wkly Rep. 2007; 56: 1309-1312
        • Hampson N.B.
        • Stock A.L.
        Storm-related carbon monoxide poisoning: lessons learned from recent epidemics.
        Undersea Hyperb Med. 2006; 33: 257-263
        • Centers for Disease Control and Prevention
        Carbon monoxide exposures after Hurricane Ike - Texas, September 2008.
        MMWR Morb Mortal Wkly Rep. 2009; 58: 845-849
        • Broder J.
        • Mehrotra A.
        • Tintinalli J.
        Injuries from the 2002 North Carolina ice storm, and strategies for prevention.
        Injury. 2005; 36: 21-26
        • Houck P.M.
        • Hampson N.B.
        Epidemic carbon monoxide poisoning following a winter storm.
        J Emerg Med. 1997; 15: 469-473
        • Yoon S.S.
        • Macdonald S.C.
        • Parrish R.G.
        Deaths from unintentional carbon monoxide poisoning and potential for prevention with carbon monoxide detectors.
        JAMA. 1998; 279: 685-687
        • Iqbal S.
        • Clower J.H.
        • Saha S.
        • Boehmer T.K.
        • Mattson C.
        • Yip F.Y.
        Residential carbon monoxide alarm prevalence and ordinance awareness.
        J Public Health Manag Pract. 2012; 18: 272-278
        • National Center for Health Statistics
        Mortality all-county microdata.
        in: Vital statistics. 1999-2008 ([editor])
        • Klein R.J.
        • Schoenborn C.A.
        Age adjustment using the 2000 projected U.S. population.
        Healthy People 2012 Stat Notes. 2001; : 1-10
        • National Center for Health Statistics
        Estimates of the resident population of the United States, by county, single-year of age (0, 1, 2, …, 85 years and over), bridged race, Hispanic origin, and sex. Prepared under a collaborative arrangement with the U.S. Census Bureau.
        ([Last accessed February 15, 2013])
        • Fay M.P.
        • Feuer E.J.
        Confidence intervals for directly standardized rates: a method based on the gamma distribution.
        Stat Med. 1997; 16: 791-801
        • US Census Bureau
        • American Housing Survey
        • Table 988
        Housing Units—Characteristics by Tenure and Region: 2009.
        ([Last accessed May 21, 2013])
        • Runyan C.W.
        • Johnson R.M.
        • Yang J.
        • Waller A.E.
        • Perkis D.
        • Marshall S.W.
        Risk and protective factors for fires, burns, and carbon monoxide poisoning in U.S. households.
        Am J Prev Med. 2005; 28: 102-108
        • Kao L.W.
        • Nanagas K.A.
        Carbon monoxide poisoning.
        Emerg Med Clin North Am. 2004; 22: 985-1018
        • Tomaszewski C.
        Carbon monoxide poisoning. Early awareness and intervention can save lives.
        Postgrad Med. 1999; 105 ([3-8, 50]): 39-40
        • Centers for Disease Control and Prevention
        Carbon monoxide exposures—United States, 2000-2009.
        MMWR Morb Mortal Wkly Rep. 2011; 60: 1014-1017
        • Clower J.H.
        • Hampson N.B.
        • Iqbal S.
        • Yip F.Y.
        Recipients of hyperbaric oxygen treatment for carbon monoxide poisoning and exposure circumstances.
        Am J Emerg Med. 2012; 30: 846-851
        • Centers for Disease Control and Prevention
        Nonfatal, unintentional, non–fire-related carbon monoxide exposures--United States, 2004-2006.
        MMWR Morb Mortal Wkly Rep. 2008; 57: 896-899
        • National Oceaniac and Atmospheric Administration
        NOAA Reviews Record-Setting 2005 Atlantic Hurricane Season.
        ([Last accessed May 20, 2013])
        • Lutterloh E.C.
        • Iqbal S.
        • Clower J.H.
        • Spiller H.A.
        • Riggs M.A.
        • Sugg T.J.
        Carbon monoxide poisoning after an ice storm in Kentucky, 2009.
        Public Health Rep. 2011; 126: 108-115
        • Centers for Disease Control and Prevention
        Use of carbon monoxide alarms to prevent poisonings during a power outage--North Carolina, December 2002.
        MMWR Morb Mortal Wkly Rep. 2004; 53: 189-192
        • Centers for Disease Control and Prevention
        Deaths resulting from residential fires and the prevalence of smoke alarms—United States, 1991-1995.
        MMWR Morb Mortal Wkly Rep. 1998; 47: 803-806
        • Gunell D.
        • Coope C.
        • Fearn V.
        • Wells C.
        • Chang S.S.
        • Hawton K.
        • et al.
        Suicide by gases in England and Wales 2001-2011: Evidence of the emergence of new methods of suicide.
        J Affect Disord. 2014; 170C: 190-195
        • Omaye S.T.
        Metabolic modulation of carbon monoxide toxicity.
        Toxicology. 2002; 180: 139-150
        • Krenzelok E.
        • Roth R.
        • Full R.
        Carbon monoxide…the silent killer with an audible solution.
        Am J Emerg Med. 1996; 14: 484-486
        • Mack K.A.
        • Rudd R.A.
        • Mickalide A.D.
        • Ballesteros Michael F.
        Fatal unintentional injuries in the home in the U.S., 2000–2008.
        Am J Prev Med. 2013; 44: 239-246