Carbon monoxide poisoning in Utah: 1996-2013

Abstract

Introduction: The true incidence of carbon monoxide (CO) poisoning is not clearly known, but a description of possible trends could aid in prevention.

Methods: Investigators searched Utah state databases for emergency department (ED) visits and admissions for CO poisoning and medical examiner records for CO-related fatalities.

Results: From 1996-2013, 7,590 individuals were diagnosed with CO poisoning: 6,469 were treated/ released from EDs; 596 were admitted; 525 died. Of 7,065 non-fatal poisonings, 5,950 (84%) were accidental and 498 (7%) were suicide attempts. Few patients (9.7%) were treated with hyperbaric oxygen. For accidental poisonings, internal combustion engines accounted for 43%, smoke inhalation, 34%, and heating sources, 22%. Internal combustion engines were implicated in 97% of suicide attempts. Non-fatal poisonings declined following a 2008 legislative change requiring CO alarms in residences, but we do not know if legislation caused the decline. One hundred forty-one (27%) fatal poisonings were accidental, 361 (70%) suicides and two (0.4%) homicides. Victims with cardiovascular autopsy findings/past cardiovascular history had lower carboxyhemoglobin levels (mean 51.2%, n=53) compared to those without (70.8%, n=472). Mean postmortem carboxyhemoglobin was highest in ages 20-29 years (72.5%).

Conclusions: The incidence of CO poisoning in Utah is declining, but CO poisoning is still common. Alarm legislation may aid prevention efforts. An educational campaign addressing the many causes and circumstances of CO poisoning is required for prevention.

Keywords: carbon monoxide; epidemiology; mortality; poisonings.