Section of Pulmonary, Hyperbaric and Critical Care Medicine, Virginia Mason Medical Center, Seattle, Washington.
Ann Am Thorac Soc. 2016 Oct;13(10):1768-1774. doi: 10.1513/AnnalsATS.201604-318OC.
Carbon monoxide (CO) poisoning accounts for hundreds of deaths and thousands of emergency department visits in the United States annually. Development of initiatives to reduce CO mortality through poisoning prevention requires a comprehensive understanding of the condition.
To describe U.S. mortality from 1999 to 2014 due to CO poisoning from all sources except fires, to examine the epidemiology of accidental and intentional exposures, and to identify trends.
The CDC WONDER database was used to extract and analyze data from the CDC's Multiple Cause of Death 1999-2014 file. The file contains mortality data derived from all death certificates filed in the United States.
Information on deaths, crude death rate, age-adjusted death rate, intent of exposure, and characteristics of exposures from CO poisoning was extracted. Total deaths by CO poisoning decreased from 1,967 in 1999 to 1,319 in 2014 (P < 0.001). Crude and adjusted death rates fell accordingly. Accidental poisoning accounted for 13% fewer deaths per year in 2014 than in 1999 (P < 0.001). The number of intentional deaths by CO poisoning decreased by 47% over the same period (P < 0.001). The rate of decline in combined adjusted death rates from 1999 to 2014 in the 19 states that required residential CO alarms by 2010 was not different from that for the 31 states that did not require residential alarms (P = 0.982).
Numbers of deaths and death rates, both accidental and intentional, due to CO poisoning significantly declined in the United States from 1999 to 2014. Continued public education about CO toxicity should be emphasized. Additional study is needed to demonstrate the efficacy of residential CO alarms.
在美国，每年有数百人死于一氧化碳（CO）中毒，数千人因 CO 中毒到急诊就诊。为了通过预防中毒来降低 CO 死亡率，需要全面了解这种疾病。
描述 1999 年至 2014 年期间美国因 CO 中毒（不包括火灾引起的 CO 中毒）造成的死亡率，研究意外和故意暴露的流行病学情况，并确定相关趋势。
利用疾病预防控制中心的 Wonder 数据库，从疾病预防控制中心的 1999-2014 年多病因死亡率文件中提取和分析数据。该文件包含源自美国所有死亡证明的死亡率数据。
提取了 CO 中毒死亡人数、粗死亡率、年龄调整死亡率、暴露意图和 CO 中毒暴露特征等信息。1999 年至 2014 年期间，CO 中毒总死亡人数从 1967 人减少到 1319 人（P<0.001）。相应地，粗死亡率和调整死亡率也随之下降。与 1999 年相比，2014 年每年因意外中毒导致的死亡人数减少了 13%（P<0.001）。同期，因 CO 中毒故意死亡的人数减少了 47%（P<0.001）。到 2010 年，19 个要求住宅安装 CO 报警器的州的调整后综合死亡率的下降速度与不要求安装报警器的 31 个州没有差异（P=0.982）。
1999 年至 2014 年期间，美国因 CO 中毒导致的死亡人数和死亡率（包括意外和故意中毒）均显著下降。应继续加强公众对 CO 毒性的教育。需要进一步研究以证明住宅 CO 报警器的有效性。
