title: National carbon monoxide poisoning surveillance framework and recent estimates.
abstract: OBJECTIVE
  Unintentional, non-fire-related (UNFR) carbon monoxide (CO) poisoning is a leading cause of poisoning in the United States. A comprehensive national CO poisoning surveillance framework is needed to obtain accurate estimates of CO poisoning burden and guide prevention efforts. This article describes the current national CO poisoning surveillance framework and reports the most recent national estimates.
  
  
  METHODS
  We analyzed mortality data from the National Vital Statistics System multiple cause-of-death file, emergency department (ED) and hospitalization data from the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample and Nationwide Inpatient Sample, hyperbaric oxygen treatment (HBOT) data from HBOT facilities, exposure data from the National Poison Data System, and CO alarm prevalence data from the American Housing Survey and the National Health Interview Survey.
  
  
  RESULTS
  In the United States, 2,631 UNFR CO deaths occurred from 1999 to 2004, an average of 439 deaths annually. In 2007, there were 21,304 (71 per one million population) ED visits and 2,302 (eight per one million population) hospitalizations for confirmed cases of CO poisoning. In 2009, 552 patients received HBOT, and from 2000 to 2009, 68,316 UNFR CO exposures were reported to poison centers. Most nonfatal poisonings were among children (<18 years of age) and females; hospitalizations and deaths occurred more frequently among males and elderly people (>65 years of age). More poisonings occurred during winter months and in the Midwest and Northeast.
  
  
  CONCLUSIONS
  UNFR CO poisoning poses a significant public health burden. Systematic evaluation of data sources coupled with modification and expansion of the surveillance framework might assist in developing effective prevention strategies.
authors.affiliation: Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Air Pollution and Respiratory Health Branch, Atlanta, GA 30333, USA. SIqbal@cdc.gov
authors.forename: Shahed
authors.initials: S
authors.lastname: Iqbal
authors.forename: Jacquelyn H
authors.initials: JH
authors.lastname: Clower
authors.forename: Michael
authors.initials: M
authors.lastname: King
authors.forename: Jeneita
authors.initials: J
authors.lastname: Bell
authors.forename: Fuyuen Y
authors.initials: FY
authors.lastname: Yip
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002249:Carbon Monoxide Poisoning / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012621:Seasons; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult