Review of unintentional non-fire-related carbon monoxide poisoning morbidity and mortality in Florida, 1999-2007

Abstract

Objective: Previous Florida evaluations of carbon monoxide (CO) poisoning have been disaster focused. The majority of prevention messages and risk-factor identification efforts have revolved around hurricane season (June-November). We evaluated the prevalence, risk factors, and causes of CO poisoning within Florida throughout the year to produce a more complete presentation of the burden of CO poisoning.

Methods: We obtained data from death certificates, hospital discharge records, and emergency department records. We limited our analysis to unintentional poisonings, calculating rates for age, gender, race, and ethnicity, and reviewing poisoning chronology, location, and exposure situation.

Results: From 1999 to 2007, 493 people were hospitalized, and 230 individuals died as a result of non-fire-related CO poisoning. From 2005 to 2007, 781 people visited emergency departments for non-fire-related CO poisoning. Rates of severe poisoning resulting in hospitalization or death were highest among the elderly (0.56 visits and 0.63 deaths per 100,000 Floridians). Acute poisoning rates were highest among people 25-34 years of age (2.48 visits per 100,000 Floridians). Poisonings were primarily due to motor vehicle exhaust (21%-69%) and generator exposure (12%-33%), and the majority (50%-70%) occurred within the home. A large number of poisonings (25%-29%) occurred during the winter months, outside of hurricane season.

Conclusion: The findings of this study indicate a need for additional prevention strategies in conjunction with current activities to more effectively reduce the number of CO poisonings in Florida. Prevention activities should be conducted year-round, and additional strategies should include public awareness of the hazards of motor vehicle exhaust.

Figure 1.

CSTE definitions for confirmed and probable cases of CO poisoning, based on administrative data

Figure 2.

Codes and definitions used by the Florida Department of Public Health to categorize intent of CO poisoning as intentional (homicide or suicide) or unintentional (fire related, non-fire related, or undetermined)

Figure 3.

Crude UNFR CO poisoning mortality and morbidity rates among Florida residents, by year: 1999–2007