Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988.

OBJECTIVE To describe the epidemiology of recent unintentional carbon monoxide poisoning deaths in the United States. DESIGN Descriptive analysis of carbon monoxide-related deaths in the United States from 1979 through 1988, based on death certificate reports compiled by the National Center for Health Statistics. POPULATION STUDIED All US deaths, 1979 through 1988. RESULTS We reviewed data from 56,133 death certificates that contained codes implicating carbon monoxide as a contributing cause of death. Of these, 25,889 were suicides, 210 were homicides, 15,523 were associated with severe burns or house fires, and 11,547 were classified as unintentional. The number of unintentional deaths decreased steadily by about 63 deaths per year, from 1513 in 1979 to 878 in 1988. The highest death rates occurred in winter and among males, blacks, the elderly, and residents of northern states. Motor vehicle exhaust gas caused 6552 (57%) of the unintentional deaths; 5432 (83%) of these were associated with stationary automobiles. CONCLUSIONS The rate of unintentional death from carbon monoxide poisoning is decreasing. This may be attributable to improvements in automobile pollution control systems and improved safety of cooking and heating appliances. Prevention programs should target young drivers, males, and the elderly.

[1]  N. Fortuin,et al.  Effect of low-level carbon monoxide exposure on onset and duration of angina pectoris. A study in ten patients with ischemic heart disease. , 1973, Annals of internal medicine.

[2]  K. Kupka,et al.  International classification of diseases: ninth revision. , 1978, WHO chronicle.

[3]  A. Gittelsohn,et al.  Studies on the reliability of vital and health records: I. Comparison of cause of death and hospital record diagnoses. , 1979, American journal of public health.

[4]  D. Davies,et al.  Electrocardiographic changes in healthy men during continuous low-level carbon monoxide exposure. , 1980, Environmental research.

[5]  J. Glasser.  The quality and utility of death certificate data. , 1981, American journal of public health.

[6]  K. Manton,et al.  Mortality data analysis using a multiple-cause approach. , 1982, JAMA.

[7]  E. Cook,et al.  The decline in ischemic heart disease mortality rates. An analysis of the comparative effects of medical interventions and changes in lifestyle. , 1984, Annals of internal medicine.

[8]  R W Hornung,et al.  Heart disease mortality among bridge and tunnel officers exposed to carbon monoxide. , 1988, American journal of epidemiology.

[9]  J. E. Janssen,et al.  Ventilation for acceptable indoor air quality , 1989 .

[10]  J D Hackney,et al.  Short-term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease. , 1989, The New England journal of medicine.

[11]  S. Thom,et al.  Carbon monoxide poisoning: a review epidemiology, pathophysiology, clinical findings, and treatment options including hyperbaric oxygen therapy. , 1989, Journal of toxicology. Clinical toxicology.

[12]  William H. Lewis,et al.  The new Clean Air Act : a guide to the clean air program as amended in 1990 , 1990 .

[13]  S. Gottlieb,et al.  Urban angina, urban arrhythmias: carbon monoxide and the heart. , 1990, Annals of internal medicine.

[14]  S. Davis,et al.  Production of arrhythmias by elevated carboxyhemoglobin in patients with coronary artery disease. , 1990, Annals of internal medicine.