Trends in the incidence of carbon monoxide poisoning in the United States.

PURPOSE Recent data demonstrate that the mortality rate from carbon monoxide poisoning has declined over the past 2 decades. It is not known whether this decrease in mortality is reflective of the total burden of carbon monoxide poisoning. This study sought to examine trends in other potential indicators of the incidence of carbon monoxide poisoning in the United States. BASIC PROCEDURES Published data from US poison control centers (PCCs) were used to calculate annual rates of calls regarding carbon monoxide exposures. Data on numbers of carbon monoxide-poisoned patients treated with hyperbaric oxygen (HBO) were used to calculate annual treatment rates. Trends in rates of carbon monoxide-related mortality, calls to PCCs, and HBO treatment were then compared. MAIN FINDINGS Contrary to the decline in carbon monoxide-related mortality from 1968 to 1998, rates of calls to PCCs significantly increased over the same period. Neither rates of PCC calls nor HBO treatment changed significantly from 1992 to 2002. The latter 2 measures were strongly correlated. PRINCIPAL CONCLUSIONS Although deaths from carbon monoxide poisoning have clearly decreased in the United States, other indicators of the incidence of the condition suggest that the total burden (fatal and nonfatal) may not have significantly changed. Efforts to prevent carbon monoxide poisoning should not be relaxed.