Bureau of Environmental and Occupational Health, Wisconsin Division of Public Health, Madison, WI, USA.
The Medical College of Wisconsin, Milwaukee, WI, USA.
Public Health Rep. 2024 Jul-Aug;139(4):443-450. doi: 10.1177/00333549231200850. Epub 2023 Nov 4.
Prevention methods for carbon monoxide (CO) poisoning in Wisconsin address occupational and nonoccupational exposures together, but differences between the settings could inform new approaches to preventing occupational CO poisonings. We described occupational CO poisonings in Wisconsin from July 1, 2018, through July 1, 2021, using surveillance data from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center.
We identified cases of CO poisoning from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. Occupational CO poisonings were records where "workplace" was recorded as the location of exposure. We excluded records classified as suspect/not a case, those missing laboratory results or information on exposure source/location, and intentional poisonings. We compared characteristics between occupational and nonoccupational settings using odds ratios (ORs), and we estimated crude incidence rates of occupational exposures by occupation.
We identified 614 cases of CO poisoning, of which 168 (27.4%) were occupational exposures. When compared with patients with nonoccupational exposures, patients with occupational exposures were more likely to be male (OR = 3.8; 95% CI, 2.4-6.1), Hispanic (OR = 2.4; 95% CI, 1.4-4.2), and younger (mean difference [SD] = 6.6 [20.9]). Several CO sources were significantly associated with occupational poisonings: forklifts (OR = 58.4; 95% CI, 13.9-246.1; < .001), pressure sprayers (OR = 2.4; 95% CI, 1.3-4.4; = .003), and other gasoline-powered tools (OR = 3.8; 95% CI, 2.3-6.3; < .001). The natural resources, construction, and maintenance occupation group had the highest crude incidence rate-45.0 poisonings per 100 000 full-time equivalent employees.
Incorporating data from the Wisconsin Poison Center improved data quality, but surveillance is limited by underreporting. Creating strategies to increase reporting would allow for a more comprehensive understanding of occupational CO poisoning.
威斯康星州针对一氧化碳（CO）中毒的预防方法同时针对职业和非职业暴露，但暴露环境之间的差异可能为预防职业性 CO 中毒提供新方法。我们利用威斯康星州电子疾病监测系统和威斯康星州毒物中心的监测数据，描述了 2018 年 7 月 1 日至 2021 年 7 月 1 日期间威斯康星州的职业性 CO 中毒情况。
我们从威斯康星州电子疾病监测系统和威斯康星州毒物中心确定了 CO 中毒病例。职业性 CO 中毒记录中，“工作场所”被记录为暴露地点。我们排除了分类为疑似/非病例、缺少实验室结果或暴露源/位置信息以及故意中毒的记录。我们使用比值比（OR）比较了职业和非职业环境之间的特征，并按职业估算了职业暴露的粗发病率。
我们共确定了 614 例 CO 中毒病例，其中 168 例（27.4%）为职业性暴露。与非职业性暴露的患者相比，职业性暴露的患者更可能为男性（OR=3.8；95%CI，2.4-6.1）、西班牙裔（OR=2.4；95%CI，1.4-4.2）和年轻（平均差异[SD] = 6.6 [20.9]）。几种 CO 来源与职业性中毒显著相关：叉车（OR=58.4；95%CI，13.9-246.1；<.001）、压力喷雾器（OR=2.4；95%CI，1.3-4.4；=0.003）和其他汽油动力工具（OR=3.8；95%CI，2.3-6.3；<.001）。自然资源、建筑和维护职业组的粗发病率最高，每 100000 名全职等效员工中有 45.0 例中毒。
纳入来自威斯康星州毒物中心的数据提高了数据质量，但监测受到漏报的限制。制定增加报告的策略将有助于更全面地了解职业性 CO 中毒。
