Centers for Disease Control and Prevention, Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Atlanta, GA 30341, USA.
Public Health Rep. 2011 May-Jun;126 Suppl 1(Suppl 1):108-15. doi: 10.1177/00333549111260S114.
Carbon monoxide (CO) poisoning is a leading cause of morbidity and mortality during natural disasters. On January 26-27, 2009, a severe ice storm occurred in Kentucky, causing widespread, extended power outages and disrupting transportation and communications. After the storm, CO poisonings were reported throughout the state. The objectives of this investigation were to determine the extent of the problem, identify sources of CO poisoning, characterize cases, make recommendations to reduce morbidity and mortality, and develop prevention strategies.
We obtained data from the Kentucky Regional Poison Center (KRPC), hyperbaric oxygen treatment (HBOT) facilities, and coroners. Additionally, the Kentucky Department for Public Health provided statewide emergency department (ED) and hospitalization data.
During the two weeks after the storm, KRPC identified 144 cases of CO poisoning; exposure sources included kerosene heaters, generators, and propane heaters. Hospitals reported 202 ED visits and 26 admissions. Twenty-eight people received HBOT. Ten deaths were attributed to CO poisoning, eight of which were related to inappropriate generator location. Higher rates of CO poisoning were reported in areas with the most ice accumulation.
Although CO poisonings are preventable, they continue to occur in postdisaster situations. Recommendations include encouraging use of CO alarms, exploring use of engineering controls on generators to decrease CO exposure, providing specific information regarding safe use and placement of CO-producing devices, and using multiple communication methods to reach people without electricity.
一氧化碳（CO）中毒是自然灾害期间发病率和死亡率的主要原因。2009 年 1 月 26-27 日，肯塔基州遭遇严重冰暴，导致大范围、长时间停电，并扰乱了交通和通讯。风暴过后，全州各地都报告了 CO 中毒事件。本次调查的目的是确定问题的严重程度，确定 CO 中毒的来源，描述病例特征，提出减少发病率和死亡率的建议，并制定预防策略。
我们从肯塔基州区域中毒中心（KRPC）、高压氧治疗（HBOT）设施和验尸官处获取数据。此外，肯塔基州公共卫生部提供了全州范围内的急诊室（ED）和住院数据。
风暴过后两周内，KRPC 共确定了 144 例 CO 中毒病例；暴露源包括煤油取暖器、发电机和丙烷取暖器。医院报告了 202 例 ED 就诊和 26 例住院病例。28 人接受了 HBOT 治疗。有 10 人死亡归因于 CO 中毒，其中 8 人是由于发电机位置不当导致的。冰积最多的地区报告的 CO 中毒率更高。
尽管 CO 中毒是可以预防的，但在灾后环境中仍会继续发生。建议包括鼓励使用 CO 报警器，探索在发电机上使用工程控制措施以减少 CO 暴露，提供有关 CO 产生设备安全使用和放置的具体信息，并使用多种通讯方式联系无电地区的人员。
