Surveillance of carbon monoxide poisoning in children, 2001-2011

Carbon monoxide (CO) is a poisonous, odorless, colorless, and tasteless gas associated with faulty, improperly-used, or incorrectly-ventilated fuel-burning appliances. Human exposure to CO can cause serious injuries, including death. Children and teenagers are very susceptible to the harmful effects of CO because of their small size and higher metabolic rates. The Agency for Toxic Substances and Disease Registry's (ATSDR) 2001-2011 surveillance data on chemical incidents were analyzed to identify the frequency, trends, and factors contributing to CO exposure and resulting adverse health consequences experienced by children. Children were defined as less than 20 years old before 2009 and less than 18 years old afterwards. Events were included if the acute release of CO associated with at least one person showing signs or symptoms of illness, regardless of carboxyhemoglobin levels. A total of 959 children were injured in 35.1% (n=523) of 1,490 CO-related events. Of these events, 48.0% occurred in the winter; 47.7% occurred in a commercial area, 37.5% occurred in a residential area; 49.6% resulted from human error, and 44.7% resulted from equipment failure. The most common poisoning symptoms were gastrointestinal (n=415) and central nervous system problems (n=408). Over 71% of the victims were treated at a hospital and 26 victims died. Wide dissemination of safety recommendations and education programs are needed to prevent future CO related injuries among children. Acute hazardous substance release surveillance can help to identify causes and contributing factors of CO-related injuries in children to develop public health prevention outreach activities.