Surveillance of carbon monoxide-related incidents - Implications for prevention of related illnesses and injuries, 2005-2014.

BACKGROUND: Carbon monoxide (CO) is an insidious gas responsible for approximately 21,000 emergency department visits, 2300 hospitalizations, and 500 deaths in the United States annually. We analyzed 10 combined years of data from two Agency for Toxic Substances and Disease Registry acute hazardous substance release surveillance programs to evaluate CO incident-related injuries. METHODS: Seventeen states participated in these programs during 2005-2014. RESULTS: In those 10years, the states identified 1795 CO incidents. Our analysis focused on 897 CO incidents having injured persons. Of the 3414 CO injured people, 61.0% were classified as general public, 27.7% were employees, 7.6% were students, and 2.2% were first responders. More than 78% of CO injured people required hospital or pre-hospital treatment and 4.3% died. The location for most injured people (39.9%) were homes or apartments, followed by educational facilities (10.0%). Educational services had a high number of people injured per incident (16.3%). The three most common sources of CO were heating, ventilation, and air conditioning systems; generators; and motor vehicles. Equipment failure was the primary contributing factor for most CO incidents. CONCLUSIONS: States have used the data to evaluate trends in CO poisoning and develop targeted public health outreach. Surveillance data are useful for setting new policies or supporting existing policy such as making CO poisoning a reportable condition at the state level and requiring CO alarms in all schools and housing. Public health needs to remain vigilant to the sources and causes of CO to help reduce this injury and death.

North Carolina Toxic Substance Incidents Program 2010-2015: Identifying Areas for Injury Prevention Efforts.

The National Toxic Substance Incidents Program (NTSIP) is a surveillance system designed to capture acute toxic substance releases, factors contributing to the release, and any associated injuries. North Carolina has participated since 2010, when NTSIP was established. This article will present a descriptive statistical summary from 2010 to 2015 focused on releases that resulted in injuries in order to identify areas for public health prevention efforts. Of the 1690 toxic releases in North Carolina, 155 incidents resulted in injuries and 500 people were injured. Carbon monoxide injured the greatest number of people. Of the incidents that resulted in injuries, 68 occurred at private vehicles or residences (44%), injuring 124 people (25%). Over half of events where at least one responder was injured occurred at private vehicles or residences. Events occurring at private residences did not have a significant relationship between evacuations and injuries, while for industry-related events, the odds of an evacuation being ordered were 8.18 times greater (OR = 8.18, 95% CI = 5.19, 12.89) when there were injuries associated with an event. Intervention efforts should focus on preventing responder injuries while responding to private residence releases and educating the general public on how to prevent injuries by self-evacuating areas where hazardous chemicals have been released.