Tracking of Carbon Monoxide Poisoning Using Michigan Emergency Department and Hospital Records

Objectives: Among all deaths due to poisonings, carbon monoxide (CO) is the leading cause. Development of a surveillance system to track CO poisoning is a recommended public health activity. Initial steps to develop such a system are discussed. Methods: Michigan hospitals provided face sheets and discharge summaries of hospitalized and emergency department visits for CO poisonings. Reports were divided into three categories; intentional poisoning, non-work-related poisoning, and work related poisoning. The characteristics of the three groups, including demographics, sources of exposure, carboxyhemoglobin levels, and time of year were described. Results: There were 847 cases of CO poisoning reported. Another 312 cases were estimated to have been diagnosed and to have required treatment in the emergency department but were not reported. Most cases were male, aged 22-44 years. The overall incidence rate for the state was 5.83 CO poisonings per 100,000 individuals. Conclusions: A CO surveillance system using hospital and ED data as proposed in a CDC/CSTE initiative is feasible. Useful information about source of exposure can be generated to prioritize public health intervention. A more comprehensive system using additional data sources such as poison control center data would increase the timeliness of the reports received