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Hampson NB. Carbon monoxide poisoning mortality in the United States from 2015-2021. Clin Toxicol (Phila) 2023; 61:483-491. [PMID: 37535036 DOI: 10.1080/15563650.2023.2237667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Most carbon monoxide poisoning is preventable. Tracking of longitudinal trends in carbon monoxide-related mortality is needed to guide public health efforts. This study sought to describe mortality in the United States from carbon monoxide poisoning, examine the epidemiology of unintentional ("accidental") and intentional exposures, and identify trends in both. METHODS The Centers for Disease Control and Prevention's Wonder databases were utilized to extract online data from National Center for Health Statistics files containing mortality data in the United States from 2015-2021. Extracted were deaths, crude death rates, intent of exposure, and demographics of persons dying from carbon monoxide poisoning, excluding cases related to fires. Also extracted was the number of suicidal deaths of all types. Carbon monoxide deaths related to consumer products were obtained from the Consumer Product Safety Commission. Information on state legislation mandating residential carbon monoxide alarms was obtained from online resources. RESULTS Total carbon monoxide deaths decreased from 1,253 in 2015 to 1,067 in 2021. An increase in accidental poisoning deaths was offset by a larger decrease in intentional deaths, despite an increase in suicides of all types in the country. For the first time in the United States, accidental carbon monoxide deaths (543) outnumbered intentional deaths (524) in 2021. The increase in accidental deaths is consistent with those recently reported from carbon monoxide-emitting consumer products by the Consumer Product Safety Commission. Furthermore, even though over one-half of accidental deaths occurred at home, no evidence of a protective effect of state laws requiring residential carbon monoxide alarms was seen. CONCLUSIONS Accidental carbon monoxide poisoning deaths increased from 2015-2021 for the first time in four decades. Exploration of the possibility they are due to consumer products warrants attention and prevention efforts. We were unable to demonstrate the preventive effect of residential carbon monoxide alarm legislation.
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Affiliation(s)
- Neil B Hampson
- Virginia Mason Medical Center and University of WA, Seattle, WA, USA
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Jarman H, Atkinson RW, Babu A, Moss P. Cross-sectional study of carbon monoxide alarm use in patients attending the emergency department: a multicentre survey protocol. BMJ Open 2022; 12:e061202. [PMID: 36385037 PMCID: PMC9670950 DOI: 10.1136/bmjopen-2022-061202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The most common place for unintentional, non-fire-related carbon monoxide (CO) exposure to occur is in the home, but this is preventable if CO producing sources are properly maintained and CO alarms/detectors are in use. It is estimated that less than half of all homes have a CO alarm, but there is variation across countries, housing types and different demographic and socioeconomic groups. The purpose of this study is to provide up-to-date data on the use of CO alarms by surveying attendees to emergency departments using an online anonymous questionnaire. METHODS AND ANALYSIS A multicentre prospective, cross-sectional survey of 4000 patients or carers in three emergency departments will be used. A questionnaire comprising of a maximum of 14 items will be administered following completion of an informed consent process. Data collected include participant demographics, household information and CO alarm use. Statistical analyses will comprise descriptive techniques to present respondents' use of CO alarms and examine associations between alarm use and participant characteristics. The proportion of homes with CO alarms installed will be calculated for all subjects and for selected subgroups. ETHICS AND DISSEMINATION The study obtained ethical approval from the Westminster Research Ethics Committee (REC number 1/PR/1657). Informed consent will be obtained prior to the participant undergoing any activities that are specifically for the purposes of the study. Findings will be published in scientific journals, presented to national and international conferences and disseminated to CO safety groups. TRIAL REGISTRATION NUMBER ISRCTN registry 12562718.
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Affiliation(s)
- Heather Jarman
- Emergency Department Clinical Research Group, St George's University Hospitals NHS Foundation Trust, London, UK
- Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
| | - Richard W Atkinson
- Population Health Research Institute, St George's University of London, London, UK
| | - Ashik Babu
- Emergency Department Clinical Research Group, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Phil Moss
- Emergency Department Clinical Research Group, St George's University Hospitals NHS Foundation Trust, London, UK
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Long J, Sun Y, Zhao J, Liu J, Peng X. Temporal trends of carbon monoxide poisoning mortality at the global, regional and national levels: a cross-sectional study from the Global Burden of Disease study, 1990 and 2017. BMJ Open 2021; 11:e053240. [PMID: 34789496 PMCID: PMC8601087 DOI: 10.1136/bmjopen-2021-053240] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Carbon monoxide (CO) poisoning is one of the most frequent causes of fatal poisoning worldwide. Few studies have explored the mortality trends of CO poisoning grouped by age and gender, at the regional, national and global levels. We therefore aimed to determine the pattern of CO poisoning mortality, as well as temporal trends at all levels. DESIGN A cross-sectional survey design was used in this study. SETTING CO poisoning data collected from the Global Burden of Diseases (GBDs), from 1990 to 2017, was arranged by sex, age, region and country. In addition, we used human development index data at the national level from the World Bank. PARTICIPANTS We collected over 100 000 information on CO poisoning mortality between 1990 and 2017, derived from the GBD study in 2017. MAIN OUTCOMES AND MEASURES We have calculated the estimated annual percentage changes in CO poisoning age-standardised mortality rate (ASR), by sex and age at different regions and countries to quantify the temporal trends in CO poisoning ASR. RESULTS Globally, death cases of CO poisoning decreased 7.2% from 38 210 in 1990 to 35 480 in 2017. The overall ASR decreased by an average of 1.83% (95% CI 2.10% to 1.56%) per year in this period. This decreasing pattern was heterogeneous across ages, regions and countries. The most pronounced decreases were generally observed in countries with a high sociodemographic index, including Estonia, South Korea and Puerto Rico. CONCLUSIONS Current prevention strategies should be reoriented, and much more targeted and specific strategies should be established in some countries to forestall CO poisoning.
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Affiliation(s)
- Jianhai Long
- Pulmonary and Critical Care Medicine, Beijing Tian Tan Hospital, Capital Medical University, Fengtai-qu, Beijing, China
| | - Yawei Sun
- Department of Chemical Poisoning Treatment, Department of Hematology, 5th Medical Center of Chinese PLA General Hospital, Fengtai-qu, Beijing, China
| | - Junxiu Zhao
- Department of Chemical Poisoning Treatment, Department of Hematology, 5th Medical Center of Chinese PLA General Hospital, Fengtai-qu, Beijing, China
| | - Jie Liu
- Department of Intensive Care Medicine, Hainan Hospital of PLA General Hospital, Sanya, Hainan, China
| | - Xiaobo Peng
- Department of Chemical Poisoning Treatment, Department of Hematology, 5th Medical Center of Chinese PLA General Hospital, Fengtai-qu, Beijing, China
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Gleason JA, Taggert E, Goun B. Characteristics and Behaviors Among a Representative Sample of New Jersey Adults Practicing Environmental Risk-Reduction Behaviors. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:588-597. [PMID: 32011589 DOI: 10.1097/phh.0000000000001106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT Environmental exposure to groundwater contamination from agricultural runoff, chemical pollution, or geology and indoor air hazards from misuse of consumer products or naturally occurring radon contributes to adverse health outcomes. Individuals can reduce exposure to environmental hazards by practicing risk-reduction behaviors. OBJECTIVE To characterize the demographic and behavioral characteristics of the population practicing environmental risk-reduction behaviors in order to identify gaps in current prevention outreach efforts. DESIGN The New Jersey Behavioral Risk Factor Survey captures data on self-reported environmental risk-reduction behaviors and health-promoting behaviors (cancer screenings, vaccinations, smoking). To account for complex survey data, weighted analyses were performed in SAS v9.4. SETTING New Jersey, 2014-2015. PARTICIPANTS The New Jersey Behavioral Risk Factor Survey is an ongoing telephone health survey of NJ residents. About 1000 NJ residents are selected randomly each month to derive statewide representative prevalence estimates. MAIN OUTCOME MEASURES Self-reported private well testing, radon screening, and carbon monoxide (CO) detector ownership. RESULTS Statewide prevalence of the practice of environmental risk-reduction practices includes 56.6% for private well testing, 44.3% for radon screening, and 86.1% for CO detector ownership. A larger percentage of individuals who are white or Asian, college-educated, earn more than $50 000, and own their homes reported CO detector ownership and radon screening. Age was the only demographic factor associated with private well testing. Screening for radon and CO detector ownership was positively associated with receiving an influenza shot, colonoscopy, aerobic exercise, and positive self-reported health and not smoking. CONCLUSIONS There is a need to improve rates of environmental risk-reduction behaviors and reduce disparities in the practice of these behaviors through efforts to increase awareness. Public health officials should target outreach to specific populations that do not practice risk-reduction behaviors.
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Affiliation(s)
- Jessie A Gleason
- Environmental and Occupational Health Surveillance Program, New Jersey Department of Health, Trenton, New Jersey
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Chen J, Dignam T, Yip F, García BR, Blanton C, Brown MJ, Sircar K. Smoke Alarms and Carbon Monoxide Alarms in Households With Children, Puerto Rico, 2010. J Prim Prev 2020; 41:279-295. [PMID: 32410066 PMCID: PMC7936878 DOI: 10.1007/s10935-020-00590-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In 2017, Puerto Rico sustained extensive damage from Hurricane Maria, increasing the risk of fires and carbon monoxide (CO) poisonings. Using a population-based, in-person survey of households with children less than 6 years old in Puerto Rico, we collected data in 2010 concerning the presence of smoke alarms and CO alarms in these households. We generated national estimates by extrapolating the number of households in each stratum using data from the 2010 Census. We determined which household characteristics predicted the presence of these alarms. Of 355 households analyzed, 31% had functional smoke alarms, or an estimated 109,773 households territory wide. The presence of smoke alarms was associated with living in multifamily housing and no child in the household receiving government medical insurance. Public housing or publicly subsidized housing, as compared to owner-occupied housing and unsubsidized rental housing, was associated with having a functional smoke alarm in households with children aged less than 6 years. Based on only six houses having CO alarms, we estimated only 7685 (2%) households had CO alarms. The low prevalence of functional smoke or CO alarms 7 years before Hurricane Maria is unfortunate and should be remedied by ensuring that such alarms are widely installed in current rebuilding activities.
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Affiliation(s)
- Jessica Chen
- Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Timothy Dignam
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA.
| | - Fuyuen Yip
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA
| | - Brenda Rivera García
- Office of Epidemiology and Research, Puerto Rico Department of Health, San Juan, PR, USA
| | - Curtis Blanton
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary Jean Brown
- Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kanta Sircar
- Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA
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Gonzales D, Bjornson WG, Markin CJ, Coleman TM, Favela F, Clemons N, Koudelka C, Lapidus JA. Improving Smoking Cessation Outcomes Through Tailored-Risk Patient Messages at a University Hospital Tobacco Cessation Service. Jt Comm J Qual Patient Saf 2020; 46:250-260. [PMID: 32362354 DOI: 10.1016/j.jcjq.2020.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/02/2020] [Accepted: 02/11/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Postdischarge follow-up is a critical step for increasing effectiveness of hospital smoking cessation treatment. A quality improvement project was undertaken at an academic medical center tobacco cessation consult service to evaluate whether a tailored message (TM) linking immediate risks of continued smoking-particularly carbon monoxide exposure-to hospital recovery would stimulate more patient interest in the hospital's cessation treatment, including agreement to postdischarge follow-up, compared to patients receiving the usual treatment protocol with a standard message (SM) regarding more general health benefits of abstinence. METHODS Data from 697 smokers ordered/referred for smoking cessation treatment in 2013 who received either the SM (January-April; n = 323) or the TM (April-November; n =374) were analyzed. RESULTS Multivariate regression analysis showed that the TM was associated with significantly greater agreement for follow-up (odds ratio [OR] = 10.83, 95% confidence interval [CI] = 3.66-32.04, p < 0.0001) than the SM. Those patients who received the TM were more willing to try to remain abstinent postdischarge (willingness score = 10, p = 0.0052) and engaged in longer consults (consult time > 10 minutes, p = 0.0075) than SM patients. TM patients also self-reported a higher continuous abstinence rate (OR = 2.07, 95% CI = 1.17-3.66, p = 0.0130] at follow-up than SM. CONCLUSION Linking risks of continued smoking, particularly carbon monoxide exposure, to hospital patients' immediate recovery following discharge in a treatment protocol resulted in longer consult times and increased agreement to follow-up compared to the usual protocol message. The TM was integrated into the hospital tobacco cessation intervention as standard of care.
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Cushen R, Brunt H, Jones S, Lewis H, Callow P, Kibble A. An unusual incident: carbon monoxide poisoning risk in 540 homes due to faulty wood burner installations. Public Health 2019; 173:17-20. [PMID: 31207424 DOI: 10.1016/j.puhe.2019.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/29/2019] [Accepted: 05/02/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND This report describes the public health management of an unusual incident involving an increased risk of carbon monoxide (CO) exposure due to the installation of at least 541 wood burners in a local authority area in Wales. PUBLIC HEALTH ACTIONS An incident management team (IMT) was convened. The IMT assessed and managed the public health risk associated with the wood burners and promoted CO awareness in the local population. OUTCOMES At least 541 homes were found to have had a wood burner potentially incorrectly installed by a Heating Equipment Testing and Approval Scheme-registered engineer. Local residents were made aware of the dangers and provided with free CO alarms. CONCLUSIONS This incident highlights that even registered engineers may fail to follow guidelines. It is important to inform the public of the need to have a working CO alarm at home, as well as educating the public and professionals about the symptoms and signs of CO poisoning.
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Affiliation(s)
- R Cushen
- Specialty Registrar in Public Health, Public Health Wales, United Kingdom
| | - H Brunt
- Consultant in Environmental Health Protection, Public Health Wales, United Kingdom
| | - S Jones
- Consultant in Environmental Health Protection, Public Health Wales, United Kingdom.
| | - H Lewis
- Consultant in Health Protection, Public Health Wales, United Kingdom
| | - P Callow
- Public Health England Centre for Radiation, Chemicals and the Environment - Wales, United Kingdom
| | - A Kibble
- Public Health England Centre for Radiation, Chemicals and the Environment - Wales, United Kingdom
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Jones VC, Kennedy RD, Welding K, Gielen AC, Frattaroli S. The prevalence of fire and CO safety amenities in Airbnb venues that permit smoking - Findings from 17 countries. Prev Med 2019; 123:8-11. [PMID: 30802470 DOI: 10.1016/j.ypmed.2019.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 02/05/2019] [Accepted: 02/15/2019] [Indexed: 01/07/2023]
Abstract
Airbnb hosts rent their homes to guests as an alternative to traditional hospitality settings. Airbnb venues are not uniformly regulated for allowing smoking or requiring fire-safety amenities. This study quantified the reported prevalence of fire-safety amenities in 413,339 Airbnb venues that allow smoking in 43 cities in 17 countries. Proportions of host-reported smoke detectors and carbon monoxide (CO) alarms, and those that allow smoking were calculated. Across the entire sample 9.3% (n = 38,525) allowed smoking. An overall evaluation of those venues shows that 46% (n = 17,569) had smoke detectors compared to 64% of the 374,814 venues that do not allow smoking, a statistically significant difference (X2 = 5277 p < 0.01). A similar difference is found between venues that allow smoking and had CO alarms (19%, n = 7176) and the 33% of venues that prohibit smoking (X2 = 3442, p < 0.01). Among this sample, most Airbnb venues that allow smoking are less likely to have safety amenities.
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Affiliation(s)
- Vanya C Jones
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Center for Injury Research and Policy, United States.
| | - Ryan D Kennedy
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Institute for Global Tobacco Control, United States
| | - Kevin Welding
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Institute for Global Tobacco Control, United States
| | - Andrea C Gielen
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Center for Injury Research and Policy, United States
| | - Shannon Frattaroli
- Johns Hopkins Center for Injury Research and Policy, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, United States
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Mapping of carbon monoxide related death risk in Turkey: a ten-year analysis based on news agency records. BMC Public Health 2019; 19:9. [PMID: 30606153 PMCID: PMC6318903 DOI: 10.1186/s12889-018-6342-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/19/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Carbon-monoxide (CO) poisoning is a substantial cause of preventable mortality. In Turkey, no nationwide data are being collected nowadays. In our study, we aimed to assess the trend in deaths related to CO exposure in all provinces of Turkey in a 10-year period by using the records of a news agency which collects the news from the majority of the national newspapers, local newspapers and television channels. METHODS In this study, 27,881 news items that were released between January 2008 to December 2017 which included keywords of "poisoning" and "death" or "carbon monoxide" and "death" were evaluated. 2667 non-fire related deaths were used in the final analyses. RESULTS In a 10-year period, the risk of CO-related death in Turkey was 0.35/100000. 1371 (51.4%) of the victims were male and the median age of the patients was 45 years (range, 15 days-108 years). Most of the deaths occurred ≥50 years of age. Stoves were the predominant source [n = 2096 (78.6%)]. There was a stagnating trend of CO-related deaths. Most of the incidents occurred in winter. The Middle Anatolian region was of the highest risk in CO-related mortality. CONCLUSIONS In conclusion, CO poisoning is still a considerable public health concern in Turkey. Results of our study showed that stoves are still frequently being used and are the cause of death especially in rural areas with lower socioeconomic status. A better organized, nationwide surveillance and management approaches are needed to demonstrate the true burden CO related morbidity and mortality as well as its prevention in Turkey.
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Economic Valuation of Selected Illnesses in Environmental Public Health Tracking. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2017; 23 Suppl 5 Supplement, Environmental Public Health Tracking:S18-S27. [PMID: 28763382 DOI: 10.1097/phh.0000000000000641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In benefit-cost analysis of public health programs, health outcomes need to be assigned monetary values so that different health endpoints can be compared and improvement in health can be compared with cost of the program. There are 2 major approaches for estimating economic value of illnesses: willingness to pay (WTP) and cost of illness (COI). In this study, we compared these 2 approaches and summarized valuation estimates for 3 health endpoints included in the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Network-asthma, carbon monoxide (CO) poisoning, and lead poisoning. METHOD First, we compared results of WTP and COI estimates reported in the peer-reviewed literature when these 2 methods were applied to the same study participants. Second, we reviewed the availability and summarized valuations using these 2 approaches for 3 health endpoints. RESULT For the same study participants, WTP estimates in the literature were higher than COI estimates for minor and moderate cases. For more severe cases, with substantial portion of the costs paid by the third party, COI could exceed WTP. Annual medical cost of asthma based on COI approach ranged from $800 to $3300 and indirect costs ranged from $90 to $1700. WTP to have no asthma symptoms ranged from $580 to $4200 annually. We found no studies estimating WTP to avoid CO or lead poisoning. Cost of a CO poisoning hospitalization ranged from $14 000 to $17 000. For patients who sustained long-term cognitive sequela, lifetime earnings and quality-of-life losses can significantly exceed hospitalization costs. For lead poisoning, most studies focused on lead exposure and cognitive ability, and its impact on lifetime earnings. CONCLUSION For asthma, more WTP studies are needed, particularly studies designed for conditions that involve third-party payers. For CO poisoning and lead poisoning, WTP studies need to be conducted so that more comprehensive economic valuation estimates can be provided. When COI estimates are used alone, it should be clearly stated that COI does not fully capture the nonmarket cost of illness, such as pain and suffering, which highlights the need for WTP estimates.
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Ran T, Nurmagambetov T, Sircar K. Economic implications of unintentional carbon monoxide poisoning in the United States and the cost and benefit of CO detectors. Am J Emerg Med 2017; 36:414-419. [PMID: 28888530 DOI: 10.1016/j.ajem.2017.08.048] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 08/16/2017] [Accepted: 08/22/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Unintentional non-fire-related (UNFR) carbon monoxide (CO) poisoning has been among the leading causes of poisoning in the United States. Current estimation of its economic burden is important for an optimal allocation of resources for UNFR CO poisoning prevention. OBJECTIVE This study was to estimate the morbidity costs of UNFR CO poisoning. We also compared the costs and benefits of installing CO detectors in residences. METHODS We used 2010-2014 charges and cost data from Healthcare Cost and Utilization Project (HCUP), and Truven© Health MarketScan Commercial Claims and Encounters and Medicare Supplemental data. We directly measured the morbidity cost as the summation of costs for different healthcare services. Benefit of installing CO detector was estimated by summing up the avoidable morbidity cost and mortality cost (value of life). Cost of CO detectors was calculated using the average market price of CO detectors. We also calculated the benefit-to-cost ratio by dividing the benefit by its cost. All expenditures were converted into 2013 U.S. dollars. RESULTS For UNFR CO poisoning, total annual medical cost ranged from $33.6 to $37.7 million. Annual non-health-sector costs varied from $3.7 to almost $4.4 million. The benefit-to-cost ratio can be as high as 7.2 to 1. CONCLUSION UNFR CO poisoning causes substantial economic burden in the U.S. The benefit of using CO detectors in homes to prevent UNFR CO poisoning can considerably exceed the cost of installation. Public health programs could use these findings to promote broad installation of CO detectors in homes.
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Affiliation(s)
- Tao Ran
- The Environmental Medicine Branch, Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, and Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Tursynbek Nurmagambetov
- The Environmental Medicine Branch, Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, and Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kanta Sircar
- The Environmental Medicine Branch, Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, and Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Jones SJ, Lewis H, McCarthy J, James K, McFarlane K, Brunt H. Carbon monoxide alarms: a community distribution project. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0737-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Carbon monoxide poisoning deaths in the United States, 1999 to 2012. Am J Emerg Med 2015; 33:1140-5. [PMID: 26032660 DOI: 10.1016/j.ajem.2015.05.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/30/2015] [Accepted: 05/07/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Unintentional, non-fire related (UNFR) carbon monoxide (CO) poisoning deaths are preventable. Surveillance of the populations most at-risk for unintentional, non-fire related (UNFR) carbon monoxide (CO) poisoning is crucial for targeting prevention efforts. OBJECTIVE This study provides estimates on UNFR CO poisoning mortality in the United States and characterizes the at-risk populations. METHODS We used 1999 to 2012 data to calculate death rates. We used underlying and multiple conditions variables from death records to identify UNFR CO poisoning cases. RESULTS For this study, we identified 6136 CO poisoning fatalities during 1999 to 2012 resulting in an average of 438 deaths annually. The annual average age-adjusted death rate was 1.48 deaths per million. Fifty four percent of the deaths occurred in a home. Age-adjusted death rates were highest for males (2.21 deaths per million) and non-Hispanic blacks (1.74 deaths per million). The age-specific death rate was highest for those aged ≥85 years (6.00 deaths per million). The annual rate of UNFR CO poisoning deaths did not change substantially during the study period, but we observed a decrease in the rate of suicide and unintentional fire related cases. CONCLUSION CO poisoning was the second most common non-medicinal poisonings death. Developing and enhancing current public health interventions could reduce ongoing exposures to CO from common sources, such as those in the residential setting.
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Chen HT, Yip F, Lavonas EJ, Iqbal S, Turner N, Cobb B, Garbe P. Using the exhibited generalization approach to evaluate a carbon monoxide alarm ordinance. EVALUATION AND PROGRAM PLANNING 2014; 47:35-44. [PMID: 25105583 DOI: 10.1016/j.evalprogplan.2014.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 06/19/2014] [Accepted: 06/25/2014] [Indexed: 06/03/2023]
Abstract
Current interests in enhancing the focus of external validity or transferability call for developing practical evaluation approaches and illustrating their applications in this area for meeting the need. This study takes the challenge by introducing an innovative evaluation approach, named the exhibited generalization approach, and applying it in evaluating the carbon monoxide (CO) alarm ordinance passed by Mecklenburg County, North Carolina. The stakeholders specifically asked evaluators to determine the answers to the following two questions: (1) Does the alarm ordinance work? (2) What generalizable information can the Mecklenburg experience provide to other jurisdictions trying to decide if the alarm ordinance's planning, implementation, adoption, and outcomes are transferable to their communities? This study illustrates how to apply the exhibited generalization approach to provide the stakeholders with answers to these questions. Our results indicate that the alarm ordinance was effective in increasing CO alarm ownerships and reducing CO poisoning cases. The evaluation provides potential users and other interested parties with the necessary information on contextual factors and the causal mechanism underlying the CO alarm ordinance, so that these parties and users could decide whether the Mecklenburg alarm ordinance would be transferable to their own communities. Discussions include implications of this study for contributing in further advancing evaluation theory in addressing transferability or external validity issues.
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Affiliation(s)
| | - Fuyuen Yip
- Centers for Disease Control and Prevention, United States
| | | | - Shahed Iqbal
- Centers for Disease Control and Prevention, United States
| | | | - Bobby Cobb
- Mecklenburg County Health Department, United States
| | - Paul Garbe
- Centers for Disease Control and Prevention, United States
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