A review of disaster-related carbon monoxide poisoning: surveillance, epidemiology, and opportunities for prevention.
OBJECTIVE
We conducted a systematic literature review to better understand aspects of disaster-related carbon monoxide (CO) poisoning surveillance and determine potentially effective prevention strategies.


METHODS
This review included information from 28 journal articles on disaster-related CO poisoning cases occurring between 1991 and 2009 in the United States.


RESULTS
We identified 362 incidents and 1888 disaster-related CO poisoning cases, including 75 fatalities. Fatalities occurred primarily among persons who were aged 18 years or older (88%) and male (79%). Hispanics and Asians accounted for 20% and 14% of fatal cases and 21% and 7% of nonfatal cases, respectively. Generators were the primary exposure source for 83% of fatal and 54% of nonfatal cases; 67% of these fatal cases were caused by indoor generator placement. Charcoal grills were a major source of exposure during winter storms. Most fatalities (94%) occurred at home. Nearly 89% of fatal and 53% of nonfatal cases occurred within 3 days of disaster onset.


CONCLUSIONS
Public health prevention efforts could benefit from emphasizing predisaster risk communication and tailoring interventions for racial, ethnic, and linguistic minorities. These findings highlight the need for surveillance and CO-related information as components of disaster preparedness, response, and prevention.
Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, Centers for Disease Control and Prevention, Atlanta, GA, USA. siqbal@cdc.gov
Shahed
S
Iqbal
Jacquelyn H
JH
Clower
Sandra A
SA
Hernandez
Scott A
SA
Damon
Fuyuen Y
FY
Yip
D000293:Adolescent; D000328:Adult; D002249:Carbon Monoxide Poisoning / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult