Routine Surveillance

In the absence of an active national surveillance system for carbon monoxide poisoning, estimates and surveillance activities rely on data sources that were not primarily designed for carbon monoxide poisoning surveillance. The figure above illustrates the surveillance components of CDC’s carbon monoxide poisoning surveillance framework. Below are the respective data sources identified for each component, the resulting estimates, and the dissemination of the findings. The surveillance framework outlined here focuses only on unintentional, non-fire related carbon monoxide poisoning because approaches to preventing intentional and fire-related carbon monoxide exposures greatly differ from those for prevention of unintentional exposures.

Mortality

Sircar K, Clower J, Shin Mk, Bailey C, King M, Yip F. “Carbon monoxide poisoning deaths in the United States, 1999 to 2012.” American Journal of Emergency Medicine 2015 33 (9): 1140–1145.

National Vital Statistics System: From 1999 through 2004 there were 439 unintentional, non-fire related carbon monoxide poisoning deaths annually in the U.S.

• Carbon Monoxide–Related Deaths — United States, 1999–2004. MMWR December 21, 2007 / 56(50);1309-1312.
• QuickStats: Average Annual Number of Deaths and Death Rates from Unintentional, Non–Fire-Related Carbon Monoxide Poisoning, by Sex and Age Group — United States, 1999–2010. MMWR January 24, 2014 / 63(03);65.
• QuickStats: Number of Deaths Resulting from Unintentional Carbon Monoxide Poisoning, by Month and Year — National Vital Statistics System, United States, 2010–2015. MMWR March 3, 2017 / 66(8);234.

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Hospitalization

  Nationwide Inpatient Sample: In 2007, there were 2,302 hospitalizations for confirmed cases of unintentional, non-fire related carbon monoxide poisoning in the U.S.

• Iqbal S, Law HZ, Clower J, Yip FY, Elixhauser A. (2011) “National hospital burden of unintentional carbon monoxide poisoning.” American Journal of Emergency Medicine.
• Iqbal S, Clower JH, Boehmer TK, Yip FY, Garbe P. (2010) “Carbon monoxide-related hospitalizations in the U.S.: evaluation of a web-based query system for public health surveillance.” Public Health Reports 125(3):423-32.

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Hyperbaric Oxygen Treatment

• Clower JH, Hampson NB, Iqbal S, Yip FY. (2011) “Recipients of Hyperbaric Oxygen Treatment for Carbon Monoxide Poisoning and Exposure Circumstances.” American Journal of Emergency Medicine.

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Emergency Department Visits

  Nationwide Emergency Department Sample: In 2007 there were 21,304 emergency department visits for confirmed cases of unintentional, non-fire related carbon monoxide poisoning in the U.S.

• Iqbal S, Law HZ, Clower J, Yip FY, Elixhauser A. (2011) “National hospital burden of unintentional carbon monoxide poisoning.” American Journal of Emergency Medicine.
• Iqbal S, Clower JH, Boehmer TK, Yip FY, Garbe P. (2010) “Carbon monoxide-related hospitalizations in the U.S.: evaluation of a web-based query system for public health surveillance.” Public Health Reports 125(3):423-32.

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Poison Centers

National Poison Data System [PDF – 4.8 MB]: From 2000 through 2009 there were approximately 6,832 telephone calls made annually to poison centers in the U.S. concerning unintentional, non-fire related carbon monoxide poisoning.

• Carbon Monoxide Exposures — United States, 2000—2009. MMWR (2011) 60(30);1014-1017.

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National Fire Protection Association

National Fire Protection Association: During 2006-2010, municipal fire departments in the U.S. responded to an annual average of 72,000 non-fire related carbon monoxide incidents.  Top of Page

Health Behaviors

Presence of carbon monoxide alarm at home

• American Housing Survey, 2011 [PDF – 420 KB]: 41.6% of occupied U.S. households with working carbon monoxide alarm
• National Health Interview Survey, 2009: 40.3% U.S. households with carbon monoxide alarm
• Healthstyles Survey, 2006: 46% of households with carbon monoxide alarm.
  King ME, Damon SA. “Attitudes about Carbon Monoxide Safety in the United States: Results from the 2005 and 2006 HealthStyles Survey.” Public Health Reports, 2011; 126 (S1): 100-107.
• Behavioral Risk Factor Surveillance System

Attitude regarding furnace maintenance

• Healthstyles Survey, 2006: 63.5% agree furnace maintenance is important.
  King ME, Damon SA. “Attitudes about Carbon Monoxide Safety in the United States: Results from the 2005 and 2006 HealthStyles Survey.” Public Health Reports, 2011; 126 (S1): 100-107.

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To learn more about CDC’s carbon monoxide surveillance framework please see:
Iqbal S, Clower J, Yip FY, Garbe P. “Carbon monoxide poisoning surveillance.” In: Occupational and environmental health. Levy BS, Wegman DH, Baron SL, Sokas RK, eds. 6th Ed. Oxford University Press, USA (ISBN: 0195397886)