Quantifying the Effects of Climate Factors on Carbon Monoxide Poisoning: A Retrospective Study in Taiwan

Wang, Chien-Ho; Shao, Shih‐Chieh; Chang, Kai-Cheng; Hung, Ming‐Jui; Yang, Chen-Chang; Liao, Shih‐Chieh

doi:10.3389/fpubh.2021.718846

Cited by 7 publications

(5 citation statements)

References 36 publications

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“…Our study shows a higher incidence of CO poisoning in winter, which is similar to previous studies. For example, the study by Wang et al in Taiwan noted that more than 70% of CO poisoning incidents occur in spring and winter ( 33 ). A five-year study of Iran by Mitra Rahimi also supports this finding ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Quantifying the effects of cold waves on carbon monoxide poisoning: A time-stratified case-crossover study in Jinan, China

Wei

Ren

Zhang

et al. 2023

Front. Public Health

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BackgroundPrevious studies have shown that carbon monoxide (CO) poisoning occurs mostly in winter and is associated with severe cold weather (e.g., ice storms, temperature drops). However, according to previous studies, the impact of low temperature on health has a delayed effect, and the existing research cannot fully reveal the delayed effect of cold waves on CO poisoning.ObjectivesThe purpose of this study is to analyze the temporal distribution of CO poisoning in Jinan and to explore the acute effect of cold waves on CO poisoning.MethodsWe collected emergency call data for CO poisoning in Jinan from 2013 to 2020 and used a time-stratified case-crossover design combined with a conditional logistic regression model to evaluate the impact of the cold wave day and lag 0–8 days on CO poisoning. In addition, 10 definitions of a cold wave were considered to evaluate the impact of different temperature thresholds and durations.ResultsDuring the study period, a total of 1,387 cases of CO poisoning in Jinan used the emergency call system, and more than 85% occurred in cold months. Our findings suggest that cold waves are associated with an increased risk of CO poisoning in Jinan. When P01, P05, and P10 (P01, P05, and P10 refer to the 1st, 5th, and 10th percentiles of the lowest temperature, respectively) were used as temperature thresholds for cold waves, the most significant effects (the maximum OR value, which refers to the risk of CO poisoning on cold wave days compared to other days) were 2.53 (95% CI:1.54, 4.16), 2.06 (95% CI:1.57, 2.7), and 1.49 (95% CI:1.27, 1.74), respectively.ConclusionCold waves are associated with an increased risk of CO poisoning, and the risk increases with lower temperature thresholds and longer cold wave durations. Cold wave warnings should be issued and corresponding protective policies should be formulated to reduce the potential risk of CO poisoning.

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Section: Discussionmentioning

confidence: 99%

Quantifying the effects of cold waves on carbon monoxide poisoning: A time-stratified case-crossover study in Jinan, China

Wei

Ren

Zhang

et al. 2023

Front. Public Health

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“…In the US, Japan, France, and England, CO exposure is increased by power outages during natural disasters such as hurricanes, sea storms, earthquakes, and floods [5] [26] [27] [28]. According to epidemiological studies, during autumn (October-November) and winter (December-January) temperature changes or on rainy and snowy days, COP occurs when coal, briquettes, kerosene, and gas fuel are burned in damaged and unrepaired stoves, chimneys, and open stoves, increases due to ignition of the gas generator [26] [29]- [36].…”

Section: Discussionmentioning

confidence: 99%

Unintentional Carbon Monoxide Poisoning Outbreak from 2 to 9 October 2019 in Ulaanbaatar, Mongolia

Otgonbyamba,

Altangerel,

Ganbat

et al. 2023

ODEM

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Carbon monoxide poisoning (COP) from 2 to 9 October 2019 was a major public health concern in Ulaanbaatar, Mongolia, after a transition from consumption of raw coal to upgraded briquette fuel. During the period, a total of 186 residents, which is 16 times more than the previous years, were exposed to COP and 6 persons died at home. We conduct a cross-sectional study by using registration data and medical history of all hospitalized patients with a diagnosis of COP from 2 to 9 October 2019 and had an in-depth interview. 144 (77.4%) people from 85 households registered as potential cases and 124 (86.1%) people were diagnosed with COP. All households used upgraded briquettes, and 41 households (48.2%) used them for the first time. In 50% of cases, the stove was broken, the chimney was short, not heated, and the clay joint connecting the wall stove was broken. The majority of interviewees were unaware of COP and improperly used briquettes, and the safety of chimneys and stoves was insufficient which caused unintentional COP. It is necessary to provide information to the local population about the potential risks of COP, install CO alarms in households, and educate the population. In further, a well-established poisoning surveillance system is an important aspect of public health emergency preparedness in Mongolia.

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“…A possible explanation may lie in cultural differences between Taiwan and other countries. In Taiwan, consumers have become accustomed to using gas powered water heaters, compared to electric water heaters in many Western countries ( Wang et al, 2021 ). In addition, some intentional COP cases in Taiwan result from attempted suicide by indoor charcoal burning, which is rarely used as a suicide method in Western countries ( Ajdacic-Gross et al, 2008 ; Lin et al, 2010 ).…”

Section: Discussionmentioning

confidence: 99%

Validation of Diagnostic Codes to Identify Carbon Monoxide Poisoning in Taiwan’s Claims Data

2022

Self Cite

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Purpose: Previous studies identified the study cohort or outcome of carbon monoxide poisoning (COP) by using the relevant disease diagnosis codes in secondary databases, but the validity of diagnosis codes of COP is unclear in such secondary databases. This study aimed to evaluate the accuracy of case definitions for COP using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes in Taiwan’s health insurance claims data.Methods: We selected a 10% simple random sample from an original cohort of patients newly undergoing carboxyhemoglobin (COHb) testing under any clinical diagnosis at four Chang Gung Memorial Hospitals in Taiwan during 2011–2020. Two clinical doctors independently ascertained the COP diagnosis by reviewing the medical records as the reference standard. We estimated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of various case definitions (e.g., ICD-9-CM code, ICD-10-CM code and the uses of hyperbaric oxygen therapy) in the claims data.Results: We randomly selected 557 cases from the original cohort of 5,571 cases newly receiving COHb test in the study hospitals. We found 90, 35, and 9 cases were true-positive, false-positive, and false-negative episodes of COP, respectively, among 278 cases with an ICD-9-CM code of 986. A further 111, 34, and 6 cases were true-positive, false-positive, and false-negative episodes of COP, respectively, among 279 cases with an ICD-10-CM code of T58. Using ICD-9-CM codes, the sensitivity, specificity, PPV and NPV for COP were 90.9, 80.4, 72, and 94.1%, respectively. Using ICD-10-CM codes they were 94.9, 79, 76.6, and 95.5%, respectively. PPV typically increased when COP was the primary diagnosis and could reach 100% if patients with ICD-CM code 986 or T58 also received hyperbaric oxygen therapy during hospitalization.Conclusion: The COP-related ICD-CM codes alone did not accurately identify COP patients, but accuracy improved after including oxygen therapy data with the ICD-CM codes in Taiwan’s claims data.

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Quantifying the Effects of Climate Factors on Carbon Monoxide Poisoning: A Retrospective Study in Taiwan

Cited by 7 publications

References 36 publications

Quantifying the effects of cold waves on carbon monoxide poisoning: A time-stratified case-crossover study in Jinan, China

Quantifying the effects of cold waves on carbon monoxide poisoning: A time-stratified case-crossover study in Jinan, China

Unintentional Carbon Monoxide Poisoning Outbreak from 2 to 9 October 2019 in Ulaanbaatar, Mongolia

Validation of Diagnostic Codes to Identify Carbon Monoxide Poisoning in Taiwan’s Claims Data

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