Morbidity, and Mortality of Unintentional Carbon Monoxide Poisoning: United States 2005-2016

Abstract

Background Carbon monoxide (CO) is a colorless, odorless, nonirritating gas that is produced through the incomplete combustion of carbon-containing substances. CO poisoning is a leading cause of unintentional poisoning deaths in the United States. The Centers for Disease Control and Prevention (CDC) routinely collects surveillance data from different sources to better understand unintentional CO exposures and identify potential environmental risk factors. Methods We used four different data sources to track unintentional CO-related exposures and CO poisoning: exposures called to poison control centers (PCCs), emergency department (ED) visits, hospitalizations, and mortality for 2005-2016. We conducted descriptive analyses by cause (fire, non-fire, unknown), month, age, region, and medical outcome (no effect, minor effect, moderate effect, major effect, and death). Results Over the 12-year study period, we observed 141,762 PCCS calls (national), 92,390 ED visits (16 states), 14,816 hospitalizations (25 states), and 12,478 deaths (national) due to unintentional CO poisoning. Non-fire unintentional cases comprised more than 70% of all hospitalizations and ED visits and 48% of all deaths compared to other unintentional cases. Across all data sources, CO exposures and poisonings were most commonly reported in January and December. Adults aged 50-59 years were the highest proportions for hospitalizations (19.7%) and deaths (17.0%). For PCC data, CO exposures were most frequently reported among children aged 0-9 years (21.1%) and in Northeastern states (>70 per 100,000 population). Medical outcomes were most often reported as none or minor effect (n=146,067, 72.2%) in PCC data. Conclusions This surveillance report provides the most comprehensive review of unintentional CO poisonings in the US. Unintentional CO poisoning remains a public health concern. More standardized and continued public health surveillance of unintentional CO poisoning will be necessary to monitor the public health burden, identify novel exposure pathways, and assess the effectiveness of targeted prevention strategies.