Disaster Surveillance

Disaster-related carbon monoxide exposure often occurs after a power outage, when homeowners use portable generators or charcoal grills either indoors or too close to living areas. In addition, using fuel-powered tools such as pressure washers or warming up vehicles in attached garages both pose a risk of CO poisoning. Identifying and describing who is at greatest risk for CO poisoning after a disaster is important for targeting public health interventions, such as risk messaging, designed to prevent future poisonings. The figure above illustrates the surveillance components of CDC’s disaster-related carbon monoxide poisoning surveillance framework. Below are the respective data sources identified for each component, the resulting estimates, and the dissemination of the findings.

Mortality

National Vital Statistics System: From 1999 through 2004 there were 439 unintentional, non-fire related carbon monoxide poisoning deaths annually in the U.S.

Carbon Monoxide–Related Deaths — United States, 1999–2004. MMWR December 21, 2007 / 56(50);1309-1312.

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Hospitalization

Nationwide Inpatient Sample: In 2007, there were 2,302 hospitalizations for confirmed cases of unintentional, non-fire related carbon monoxide poisoning in the U.S.

Iqbal S, Law HZ, Clower J, Yip FY, Elixhauser A. (2011) “National hospital burden of unintentional carbon monoxide poisoning.” American Journal of Emergency Medicine.
Iqbal S, Clower JH, Boehmer TK, Yip FY, Garbe P. (2010) “Carbon monoxide-related hospitalizations in the U.S.: evaluation of a web-based query system for public health surveillance.” Public Health Reports 125(3):423-32.

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Hyperbaric Oxygen Treatment

Clower JH, Hampson NB, Iqbal S, Yip FY. (2011) “Recipients of Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning and Exposure Circumstances.” American Journal of Emergency Medicine.

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Emergency Department Visits

Nationwide Emergency Department Sample: In 2007 there were 21,304 emergency department visits for confirmed cases of unintentional, non-fire related carbon monoxide poisoning in the U.S.

Iqbal S, Law HZ, Clower J, Yip FY, Elixhauser A. (2011) “National hospital burden of unintentional carbon monoxide poisoning.” American Journal of Emergency Medicine.
Iqbal S, Clower JH, Boehmer TK, Yip FY, Garbe P. (2010) “Carbon monoxide-related hospitalizations in the U.S.: evaluation of a web-based query system for public health surveillance.” Public Health Reports 125(3):423-32.

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Poison Centers

National Poison Data System [PDF – 4.8 MB]: 6,832 exposure calls annually (2000-2009)

Carbon Monoxide Exposures — United States, 2000—2009. MMWR (2011) 60(30);1014-1017.

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National Fire Protection Association

National Fire Protection Association: During 2006-2010, municipal fire departments in the U.S. responded to an annual average of 72,000 non-fire related carbon monoxide incidents. Top of Page

Health Behaviors

Presence of carbon monoxide alarm at home

American Housing Survey, 2011 [PDF – 420 KB]: 41.6% of occupied U.S. households with working carbon monoxide alarm
National Health Interview Survey, 2009: 40.3% U.S. households with carbon monoxide alarm
Healthstyles Survey, 2006: 46% of households with carbon monoxide alarm.
King ME, Damon SA. “Attitudes about Carbon Monoxide Safety in the United States: Results from the 2005 and 2006 HealthStyles Survey.” Public Health Reports, 2011; 126 (S1): 100-107.

Attitude regarding generator placement

Healthstyles Survey, 2005-2006: 63.3% unsure whether use in garage is safe; 43.1% unsure if use in basement is safe. King ME, Damon SA. “Attitudes about Carbon Monoxide Safety in the United States: Results from the 2005 and 2006 HealthStyles Survey.” Public Health Reports, 2011; 126 (S1): 100-107.

Community Assessment for Public Health Emergency Response