title: Carbon monoxide poisoning after an ice storm in Kentucky, 2009.
abstract: OBJECTIVE
  Carbon monoxide (CO) poisoning is a leading cause of morbidity and mortality during natural disasters. On January 26-27, 2009, a severe ice storm occurred in Kentucky, causing widespread, extended power outages and disrupting transportation and communications. After the storm, CO poisonings were reported throughout the state. The objectives of this investigation were to determine the extent of the problem, identify sources of CO poisoning, characterize cases, make recommendations to reduce morbidity and mortality, and develop prevention strategies.
  
  
  METHODS
  We obtained data from the Kentucky Regional Poison Center (KRPC), hyperbaric oxygen treatment (HBOT) facilities, and coroners. Additionally, the Kentucky Department for Public Health provided statewide emergency department (ED) and hospitalization data.
  
  
  RESULTS
  During the two weeks after the storm, KRPC identified 144 cases of CO poisoning; exposure sources included kerosene heaters, generators, and propane heaters. Hospitals reported 202 ED visits and 26 admissions. Twenty-eight people received HBOT. Ten deaths were attributed to CO poisoning, eight of which were related to inappropriate generator location. Higher rates of CO poisoning were reported in areas with the most ice accumulation.
  
  
  CONCLUSIONS
  Although CO poisonings are preventable, they continue to occur in postdisaster situations. Recommendations include encouraging use of CO alarms, exploring use of engineering controls on generators to decrease CO exposure, providing specific information regarding safe use and placement of CO-producing devices, and using multiple communication methods to reach people without electricity.
authors.affiliation: Centers for Disease Control and Prevention, Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Atlanta, GA 30341, USA.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Lutterloh
authors.forename: Shahed
authors.initials: S
authors.lastname: Iqbal
authors.forename: Jacquelyn H
authors.initials: JH
authors.lastname: Clower
authors.forename: Henry A
authors.initials: HA
authors.lastname: Spiller
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Riggs
authors.forename: Tennis J
authors.initials: TJ
authors.lastname: Sugg
authors.forename: Kraig E
authors.initials: KE
authors.lastname: Humbaugh
authors.forename: Betsy L
authors.initials: BL
authors.lastname: Cadwell
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Thoroughman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002249:Carbon Monoxide Poisoning / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004190:Disasters / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004736:Energy-Generating Resources / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007053:Ice; D007223:Infant; D007231:Infant, Newborn; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
chemical_list: D007053:Ice