Morbidity and Mortality of Unintentional Carbon Monoxide Poisoning: United States 2005 to 2018 - 20/02/23
, Alvin C. Bronstein, MD b, Emily Glidden, MPH a, Mackenzie Malone, MPH a, Arthur Chang, MD a, Royal Law, PhD a, Tegan K. Boehmer, PhD a, Heather Strosnider, PhD a, Fuyuen Yip, PhD aAbstract |
Study objective |
Centers for Disease Control and Prevention conducts case surveillance through the National Notifiable Diseases Surveillance System (NNDSS). This study aimed to provide surveillance report of unintentional carbon monoxide poisoning across multiple data sources to provide baseline data for the new NNDSS carbon monoxide poisoning surveillance.
Methods |
For the period 2005 to 2018, we used 4 data sources to describe unintentional carbon monoxide poisoning: exposures reported by poison centers, emergency department (ED) visits, hospitalizations, and deaths. We conducted descriptive analyses by the cause of exposure (fire, nonfire, or unknown), age, sex, season, and US census region. Additional analyses were conducted using poison center exposure case data focusing on the reported signs and symptoms, management site, and medical outcome.
Results |
Annually, we observed 39.5 poison center exposure calls (per 1 million, nationally), 56.5 ED visits (per 1 million, across 17 states), 7.3 hospitalizations (per 1 million, in 26 states), and 3.3 deaths (per 1 million, nationally) due to unintentional carbon monoxide poisoning. For 2005 to 2018, there was a decrease in the crude rate for non–fire-related carbon monoxide poisonings from hospital, and death data. Non–fire-related cases comprised 74.0% of ED visits data, 60.1% of hospitalizations, and 40.9% of deaths compared with other unintentional causes. Across all data sources, unintentional carbon monoxide poisonings were most often reported during the winter season, notably in January and December. Children aged 0 to 9 years had the highest reported rates in poison center exposure case data and ED visits (54.1 and 70.5 per 1 million, respectively); adults older than 80 years had the highest rates of hospitalization and deaths (20.2 and 9.9 per 1 million, respectively); and deaths occurred more often among men and in the Midwest region. Poison center exposure call data revealed that 45.9% of persons were treated at a health care facility. Headaches, nausea, and dizziness/vertigo were the most reported symptoms.
Conclusion |
The crude rates in non–fire-related carbon monoxide poisonings from hospitalizations, and mortality significantly decreased over the study period (ie, 2005 to 2018). This surveillance report provides trends and characteristics of unintentional carbon monoxide poisoning and the baseline morbidities and mortality data for the Centers for Disease Control and Prevention national surveillance system of carbon monoxide poisoning.
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| Please see page 310 for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Lewis S. Nelson, MD. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Author contributions: MS, FY, HS, and TB conceived the study. AC and RL provided expertise on poison center call data. MS and MM provided expertise on administration data and death records. MS, LR, EG, MM, and AC designed the analysis plans, and MS, EG, and MM analyzed data. MS, AC, and EG provided statistical advice on study design and analyzed the data, including quality control. FY, HS, and TB supervised the data analysis and data sharing agreements. MS and EG drafted the manuscript, and all authors contributed substantially to its revision. MK takes responsibility for the paper as a whole. |
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| Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. The authors report that this article did not receive any outside funding or support. |
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| Presentation information: The abstract was presented at the 32nd Annual Conference of the International Society for Environmental Epidemiology, August 24 to 27, 2020 (virtual conference). |
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Vol 81 - N° 3
P. 309-317 - mars 2023 Retour au numéro
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