A review of disaster-related carbon monoxide poisoning: surveillance, epidemiology, and opportunities for prevention

Abstract

Objectives: We conducted a systematic literature review to better understand aspects of disaster-related carbon monoxide (CO) poisoning surveillance and determine potentially effective prevention strategies.

Methods: This review included information from 28 journal articles on disaster-related CO poisoning cases occurring between 1991 and 2009 in the United States.

Results: We identified 362 incidents and 1888 disaster-related CO poisoning cases, including 75 fatalities. Fatalities occurred primarily among persons who were aged 18 years or older (88%) and male (79%). Hispanics and Asians accounted for 20% and 14% of fatal cases and 21% and 7% of nonfatal cases, respectively. Generators were the primary exposure source for 83% of fatal and 54% of nonfatal cases; 67% of these fatal cases were caused by indoor generator placement. Charcoal grills were a major source of exposure during winter storms. Most fatalities (94%) occurred at home. Nearly 89% of fatal and 53% of nonfatal cases occurred within 3 days of disaster onset.

Conclusions: Public health prevention efforts could benefit from emphasizing predisaster risk communication and tailoring interventions for racial, ethnic, and linguistic minorities. These findings highlight the need for surveillance and CO-related information as components of disaster preparedness, response, and prevention.

FIGURE 1—

Occurrence of fatal and nonfatal carbon monoxide poisoning cases (n = 1131) by days after disaster onset: United States, 1991–2009.