Hospital burden of unintentional carbon monoxide poisoning in the United States, 2007

National Carbon Monoxide Poisoning Surveillance Framework and Recent Estimates

“…[1][2][3] As stated previously, exposure to CO can cause death and long-term disability. 2,[7][8][9][10] Prevention messages are fairly simple and can be communicated to the public easily.…”

“…2,3 It has also been used with poison center and HBOT data for CO poisoning surveillance after disasters. 22 A more conservative case definition (i.e., only including principal diagnosis of ICD-9 code 986 without any classification of case types) by the State and Territorial Injury Prevention Directors Association has also been recommended for CO poisoning surveillance but has not been used widely.…”

“…11,13 In comparison, the average cost of hospitalization for CO poisoning is more than $11,000. 3 The public health importance of CO poisoning is highlighted in Healthy People 2020; CO poisoning surveillance is included as one of the environmental health priority areas (Objective EH-22.7).…”

“…The National Vital Statistics System, the National Electronic Injury Surveillance System-All Injury Program, and reports from hyperbaric oxygen treatment (HBOT) facilities have all previously been used for national surveillance of CO-related mortality and morbidity. [1][2][3]16 None of these data sources was primarily designed for CO poisoning surveillance, and data collected for purposes other than surveillance of the health outcome in question may not be sufficient and may suffer limitations in timeliness, availability, completeness, quality, and representation. [17][18][19] In addition to collecting health outcome data, an ideal environmental health surveillance system includes components that enable us to develop a more complete picture of population health status in terms of hazards, exposure, health effects, and intervention; 20 surveillance of environmental public health issues has often been described in this "hazard-exposureoutcome" axis context.…”

“…29,30 In 2007, an estimated 0.3% of patients diagnosed with CO poisoning in EDs and 21.6% of those who were hospitalized received HBOT. 3 Severe CO poisoning cases are defined by presenting signs and symptoms (e.g., transient or prolonged unconsciousness, abnormal neurologic signs or cardiovascular findings, or severe acidosis), severity of exposure (patients $36 years of age with CO exposure history $24 hours including intermittent exposure), or elevated ($25%) COHb levels. 29,31 The CSTE case definition for probable CO poisoning cases was used as the HBOT case definition in conjunction with reports from the facilities to ascertain the cases.…”