What causes carbon monoxide poisoning? Identifying scenarios, audience segments, and risk behaviors

Background: Unintentional, non-fire-related carbon monoxide (CO) poisoning causes 500 deaths and more than 15,000 non-fatal injuries in the U.S. annually. A variety of fuel-burning products emit CO, a colorless, odorless gas that poisons individuals if trapped in enclosed areas. Understanding the situations, products, and risk behaviors that lead to CO poisoning—as well as identifying the populations most at risk—is key to prevention. Yet, to date, no study has comprehensively identified the behavioral factors most likely to cause CO poisoning.

Methods: We identified and distilled findings from 90 journal articles on CO poisoning published since 1990. Intentional and fire-related cases were excluded and findings were synthesized to identify exposure patterns. We also interviewed five CO poisoning experts and incorporated their original research findings.

Results/Outcomes: CO poisoning largely occurs in six distinct scenarios—non-emergency residential; non-emergency motor vehicle; summer storm; winter storm; occupational; and recreational. Residential and vehicle poisonings are the leading causes of CO death and injury, occur mostly during winter months, and often involve faulty furnaces or blocked tailpipes. Conversely, summer and winter storm poisonings comprise less than 10% of exposures, occur mostly during power outages, and disproportionately impact Hispanics, Asians, and recent immigrants. Occupational and recreational poisonings, meanwhile, impact niche populations, such as warehouse workers and boaters.

Conclusions: Despite the range of products that cause CO poisoning, there are clear patterns of exposure and risk behavior. By understanding the distinct behaviors and scenarios that lead to CO poisoning, professionals can target prevention efforts to specific audience segments.