Predictable, Preventable, and Deadly: Epidemic Carbon Monoxide Poisoning After Storms

Communities Disproportionately Affected by Carbon Monoxide Exposure After Winter Storm Uri

Extreme cold in February 2021 precipitated prolonged power failure in Texas. In Houston, many patients presented for carbon monoxide exposure from neighborhoods with lower per capita income, higher rates of limited English proficiency, and greater median Social Vulnerability Indices than Greater Houston. Weather-related disasters disproportionately affect socially vulnerable communities.

An evaluation of childhood carbon monoxide intoxications in a rural area using the Beaufort wind scale

Climatic changes are known to affect CO intoxications. The purpose of this study was to examine childhood CO intoxications with the Beaufort wind scale (BWS) classification of wind speeds. The demographic data (age and sex) and information concerning the hour, day, and month of presentation to the emergency department for cases diagnosed with CO intoxication over a 7-year period between 2015 and 2021 in the pediatric emergency department of a tertiary training and research hospital in a rural area were examined. Wind speeds (m/s) measured on the days of presentation to the emergency department were recorded. The wind category on the BWS on the day of intoxication was then determined. Four hundred twenty-two patients, with a mean age of 95.12 ± 59.4 (1-215) months, 218 (51.7%) girls and 204 (48.3%) boys were diagnosed with CO intoxication over the 7-year study period. A comparison of wind speeds on the days of presentation to hospital revealed a significantly higher wind speed in 2020 than in the other years (p<0.001). A comparison of the groups in terms of the BWS revealed a significant difference between the years of presentation to hospital (p:0.001). This is the first study to investigate CO intoxications in the pediatric emergency department with the BWS. A significant association was observed between wind speed based on the BWS and childhood CO intoxications. Further studies evaluating wind in the rural setting and CO intoxications are now needed for protection against such intoxications.

Power Outages and Community Health: a Narrative Review

PURPOSE OF REVIEW

Power outages, a common and underappreciated consequence of natural disasters, are increasing in number and severity due to climate change and aging electricity grids. This narrative review synthesizes the literature on power outages and health in communities.

RECENT FINDINGS

We searched Google Scholar and PubMed for English language studies with titles or abstracts containing "power outage" or "blackout." We limited papers to those that explicitly mentioned power outages or blackouts as the exposure of interest for health outcomes among individuals living in the community. We also used the reference list of these studies to identify additional studies. The final sample included 50 articles published between 2004 and 2020, with 17 (34%) appearing between 2016 and 2020. Exposure assessment remains basic and inconsistent, with 43 (86%) of studies evaluating single, large-scale power outages. Few studies used spatial and temporal control groups to assess changes in health outcomes attributable to power outages. Recent research linked data from electricity providers on power outages in space and time and included factors such as number of customers affected and duration to estimate exposure. The existing literature suggests that power outages have important health consequences ranging from carbon monoxide poisoning, temperature-related illness, gastrointestinal illness, and mortality to all-cause, cardiovascular, respiratory, and renal disease hospitalizations, especially for individuals relying on electricity-dependent medical equipment. Nonetheless the studies are limited, and more work is needed to better define and capture the relevant exposures and outcomes. Studies should consider modifying factors such as socioeconomic and other vulnerabilities as well as how community resiliency can minimize the adverse impacts of widespread major power outages.

Poisonings After a Hurricane: Lessons From the New Jersey Poison Information and Education System (NJPIES) During and Following Hurricane Sandy

OBJECTIVE

Hurricane Sandy made landfall in New Jersey on October 29, 2012, resulting in widespread power outages and gasoline shortages. These events led to potentially toxic exposures and the need for information related to poisons/toxins in the environment. This report characterizes the New Jersey Poison Information and Education System (NJPIES) call patterns in the days immediately preceding, during, and after Hurricane Sandy to identify areas in need of public health education and prevention.

METHODS

We examined NJPIES case data from October through December 2012. Most Sandy-related calls had been coded as such by NJPIES staff. Additional Sandy-related cases were identified by performing a case narrative review. Descriptive analyses were performed for timing, case frequencies, exposure substances, gender, caller site, type of information requests, and other data.

RESULTS

The most frequent Sandy-related exposures were gasoline and carbon monoxide (CO). Gasoline exposure cases were predominantly males and CO exposure cases, females (P < 0.0001). Other leading reasons for Sandy-related calls were poison information, food poisoning/spoilage information, and water contamination.

CONCLUSIONS

This analysis identified the need for enhanced public health education and intervention to improve the handling of gasoline and encourage the proper use of gasoline-powered generators and cleaning and cooking equipment, thus reducing toxic exposures.

The Paradoxical Effects of Hurricane Katrina on Births and Adverse Birth Outcomes

Objectives. To review the trends in pregnancy outcomes after Hurricane Katrina and assess effects of the disaster on research and public health related to pregnant women.Methods. We reexamined the 2004-2006 vital statistics data from Alabama, Louisiana, and Mississippi, assessing what the risk of adverse pregnancy outcomes in the population would have been under varying risk scenarios.Results. We saw a reduction in number of births as well as in low birth weight and preterm birth. If the number of births had stayed constant and the relative higher risk in the "missing" births had been between 17% and 100%, the storm would have been associated with an increased risk instead of a decrease. Because the relative decline in births was larger in Black women, the higher risk in the "missing" births required to create a significant increase associated with the storm was generally not as great as for White women.Conclusions. Higher exposure to Katrina may have produced a reduction in births among high-risk women in the region rather than increasing adverse outcomes among those who did give birth.