Skip to main content

Carbon Monoxide

On September 10, 2017, Hurricane Irma made landfall in Florida. Over 90% of Florida counties reported power outages as of September 11. During power outages, CO poisonings often occur due to indoor use of fuel combustion sources (e.g., cooking, heating) or generators for electricity. CO poisoning is a reportable condition in Florida; health care providers and laboratories are required to report suspected cases to the Florida Department of Health (FDOH). In Florida, approximately 202 cases of CO poisoning are reported each year (three-year average from 2014 to 2016). In addition to passive surveillance, FDOH uses the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL) to find cases of CO poisoning. ESSENCE-FL provides access to ED data from 98% (255 out of 260) of EDs in Florida and all statewide FPICN call data (includes three poison control centers). ESSENCE-FL provides near real-time access to these data sets, as ED data are uploaded every 2 hours or once a day (depending on the hospital system) and FPICN data are uploaded every 10 minutes. The statewide FPICN database includes information about substance, signs and symptoms, exposure scenario, and patient identification information provided by the individual caller or clinician from a health care facility.

Objective: This study describes how Florida Poison Information Center Network (FPICN) and emergency department (ED) data accessed through Florida's syndromic surveillance system were used to conduct near real-time carbon monoxide (CO) poisoning surveillance and active case finding in response to Hurricane Irma in Florida..

Submitted by elamb on

Following an Oct 12-13, 2006 snowstorm, almost 400,000 homes in western New York lost power, some for up to 12 days. News reports said that emergency rooms saw many patients with CO exposure; 3 deaths were attributed to CO poisoning. As part of NYS DOH’s syndromic surveillance system, electronic ED records with a free-text CC field listing the symptoms reported by the patient are sent to NYS DOH daily. Each CC is searched for text strings indicating complaints in one or more of 6 syndromes (asthma, fever, gastrointestinal (GI), neurological, respiratory, rash). The system also allows nonroutine searches of CCs for complaints of interest. NYS hospitals also submit ED records to the Statewide Planning and Research Cooperative System (SPARCS) that include diagnostic codes assigned after evaluation of the patient (due within 30 days of each calendar quarter).

Objective

To assess the ability to identify cases of carbon monoxide (CO) poisoning from chief complaints (CC) in hospital emergency department (ED) records submitted daily to the New York State (NYS) Department of Health (DOH) Electronic Syndromic Surveillance System.

Referenced File
Submitted by elamb on

KDHE has updated the exhisting CO Poisoning Surveillance queries. Version 1 can be found here https://www.surveillancerepository.org/carbon-monoxide-exposure-kansas-…

Previously, we were querying for carbon monoxide-related cases by using the NSSP ESSENCE SubSyndrome for COPoisoning coupled with an ICD10 CM diagnosis code query. SubSyndrome and ICD10 queries had to be run separately and then combined and de-duplicated.

Submitted by ZSteinKS on

On 12/14/06, a windstorm in western Washington caused 4 million residents to lose power; within 24 hours, a surge in patients presented to emergency departments (EDs) with carbon monoxide (CO) poisoning. As previously described, records of all patients presenting to King County EDs with CO poisoning between 12/15/06 to 12/24/06 (n=279) were abstracted, of which 249 met the case definition and eligibility requirements. We attempted to identify each of the 249 confirmed cases of CO poisoning in our syndromic ED data set by comparing the hospital name, date, time, age, sex, zip code, chief complaint, and diagnoses across the two data sets. We designated each record as an exact match, likely match, possible match, or unmatched on the basis of the available fields.

 

Objective

We evaluated ED and emergency medical services data for describing an outbreak of CO poisoning following a windstorm, and determined whether loss of power was followed by an increase in other health conditions.

Referenced File
Submitted by elamb on

On December 14th, 2006, a severe windstorm in western Washington caused hundreds of thousands of residents to lose power. On December 15, 2006, there was a surge in emergency department (ED) visits for patients presenting with signs of acute carbon monoxide (CO) poisoning. A Public Health investigation was initiated following the storm to determine the extent of CO poisoning due to the windstorm. A retrospective analysis was later undertaken to evaluate how well our syndromic surveillance system was able to identify patients who presented to area EDs with carbon monoxide poisoning.

 

Objective

We evaluated the performance of our ED syndromic data for detecting visits associated with CO poisoning.

Referenced File
Submitted by elamb on

Since October 2004, the Indiana State Health Department and the Marion County Health Department have been developing and using a syndromic surveillance system based on emergency department admission data. The system currently receives standards-based HL7 emergency department visit data, including free-text chief complaints from 72 hospitals throughout the state. Fourteen of these hospitals are in Marion County, which serves the Indianapolis metropolitan region (population 865,000).

 

Objective

This paper describes how a syndromic surveillance system based on emergency department data may be leveraged for other public health uses.

Referenced File
Submitted by elamb on

This syndrome was created to query NSSP ESSENCE on CO Poisoning and Exposure

Kansas just made CO Poisoning a mandatory reportable disease, but this was done so rapidly that hospital didn't have the chance to get reporting measures/alerts in place so many of our CO Poisonings went unreported. This set of queries was created to find these cases through EDs and then educate/remind hospitals of the legislation changes.

Submitted by ZSteinKS on

This syndrome was created to capture Kansas ED Visits with chief complaints related to carbon monoxide poisoning/exposure or similar diagnosis codes. The terms "heater" and "generator" are included to potentially capture cases of improper heater and generator use that did not receive relevant CO poisoning terms or codes.

Syndromic Surveillance System - ESSENCE

Data Source - Emergency Room Visits

Fields Used - CCDD (an ESSENCE-concatenated field of Chief Complaint and Discharge Diagnosis)

Submitted by ZSteinKS on

CO poisoning is a leading cause of mortality and morbidity in disaster and post-disaster situations, when widespread power outages most likely occur (1, 2). The NYSDOH Syndromic Surveillance System receives daily ED visit chief complaint data from 140 NYS (excluding New York City) hospitals. Daily power outage data are available from the NYS Department of Public Service (NYSDPS). These data can be used to estimate the risk of CO-EDs and provide useful information for public health situational awareness and emergency response management during disaster events.

Objective

1) To identify carbon monoxide (CO) poisoning in three most affected New York State (NYS) counties (Nassau, Suffolk, and Westchester) during and immediately after Hurricane Sandy with hospital emergency department (ED) chief complaint data reported daily to the New York State Department of Health (NYSDOH). 2) To explore the relationship between power outage and the numbers of CO-related ED visits (CO-EDs).

Submitted by Magou on
Subscribe to Carbon Monoxide