Fatal unintentional non-fire-related carbon monoxide poisoning: England and Wales, 1979-2012
ABSTRACT Context. Unintentional carbon monoxide poisoning remains a significant cause of morbidity and mortality in England and Wales. Methods. Study design: observational case series. Data on fatal carbon monoxide poisoning in England and Wales from 1979 to 2012 were obtained from coroner reports. Data on unintentional non-fire-related carbon monoxide poisoning were extracted and were analysed by year of registration of death, sex, age group, and whether death occurred at a private house, flat, associated garage, or residential caravan ('home'), or elsewhere. Results and discussion. There were 28,944 carbon monoxide-related deaths, of which 82% were male. Deaths increased from 965 (1979) to 1700 (1987), and then fell to 182 (2012). Of these 2208 (64% male) were recorded as unintentional non-fire-related deaths. Annual numbers of these latter deaths fell from 166 in 1979 to 25 in 2012 (i.e. from 3.37 to 0.44 per million population). Some 81 and 92% of such deaths in males and in females, respectively, occurred at 'home'. A clear preponderance of male versus female deaths was seen in the 10-19, 20-39 and 40-64 years age groups, with similar numbers of deaths in males and in females in the younger (< 1 and 1-9 year) and higher (65-79 and 80 + years) age groups. A higher proportion of these excess deaths in males occurred outside the deceased's 'home' in those aged 10-19, 20-39 and 40-64 years. Conclusion. Deaths from unintentional non-fire-related carbon monoxide poisoning are now much less common in England and Wales than in earlier years, but remain a cause for concern. Installation and proper maintenance of carbon monoxide alarms in dwellings and outhouses, for example, and education not only of the public, but also of health and other professionals as to the danger posed by carbon monoxide could help prevent such deaths.
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ABSTRACT: Carbon monoxide poisoning is a common cause of accidental death and suicide. This article reports 4 cases of carbon monoxide poisoning following the inhalation of fumes from disposable charcoal barbeques in a confined space. All of the cases occurred within a 2-year period in Northern Ireland.The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 02/2010; 32(3). DOI:10.1097/PAF.0b013e3181d03ce7 · 0.62 Impact Factor
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ABSTRACT: Annually, there are around 30,000 coroner's inquests held in England and Wales that conclude with a verdict. 'Short form' verdicts such as accident or misadventure; natural causes; suicide; and homicide make up the majority of all verdict conclusions. 'Narrative' verdicts can be used by a coroner or jury, instead of a short form verdict, to express their conclusions as to the cause of death following an inquest. Since 2001 narrative verdicts have been more widely used, with over 3,000 narrative verdicts returned in 2009. In some cases, it can be difficult to code the underlying cause of death from the information provided in the narrative. For some time, the Office for National Statistics (ONS) and other organisations have been concerned about the impact of narrative verdicts on the quality of the statistics on cause of death. Our research investigated the impact of narrative verdicts on trends for deaths attributed to injury and poisoning in England and Wales. The research considered narrative verdicts received by ONS between 2001 and 2009. All available information provided by the coroner from the narrative verdict, together with the underlying cause of death, was used in the analysis. All causes of death where a narrative verdict was returned were investigated. More in-depth analysis of accidental deaths was undertaken, as classification of these deaths by intent is more difficult when the information from the coroner is imprecise. A sensitivity analysis of suicide rates (intentional self-harm and event of undetermined intent) was carried out. This involved using two different scenarios of reclassifying selected proportions of accidental hanging and poisoning deaths, where a narrative verdict was returned, as intentional self-harm. An exercise to measure the consistency of coding cause of death from narrative verdicts was also undertaken. The increasing proportion of narrative verdicts involving injury and poisoning has not significantly affected published mortality rates for suicide (intentional self-harm and injury or poisoning of undetermined intent). However, if the rise in narrative verdicts continues at the same rate, the accurate reporting of injury and poisoning deaths, including suicides, is likely to be affected. The exercise to establish the consistency of coding the cause of death by ONS cause coders showed that the current coding rules were being applied uniformly. The increase in the use of narrative verdicts by coroners has not had a statistically significant impact on published suicide rates in England and Wales and so no revision to these rates is needed. A review of current coding practices and the handling of narrative verdicts will be undertaken by ONS with particular reference to deaths from intentional self-harm. A recommendation has been made to coroners to consider ways of recording narrative verdicts to allow more accurate coding of cause of death. This will ensure that mortality statistics are maintained to the highest standards.List of Tables, 83.Health statistics quarterly / Office for National Statistics 01/2011; 49(49):81-100. DOI:10.1057/hsq.2011.4
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ABSTRACT: The study describes the epidemiology and characteristics of unintentional carbon monoxide (CO) poisoning in Northwest Iran between 2007 and 2009 using multiple data sources including records of the main provider of emergency medical transportation, death certificate reports of the Legal Medicine Organization and through household surveys. A total of 1005 people were diagnosed with non-fatal CO poisoning. Ninety deaths were confirmed due to CO exposure. The ratio of unintentional CO-related poisoning cases in relation to all poisonings was 17.6%. Non-fatal CO poisoning was higher in females and adults aged 25-44 year olds, whereas the death rate was highest for those over 64 years. Domestic gas appliances were involved in 98% of non-fatal incidents and in all fatal poisonings, with gas water heaters (59.2%) and free-standing heaters (25.3%) being the most common causes of CO exposure. The main mechanisms of poisoning were faulty installations and defective devices. The main locations of incidents were the bathroom (48%) and living room (32%). Only 19% of the households reported that they were aware of the hazards of CO exposure before the incident, and no household reported having a CO detector at the time of the poisoning. The results suggest that interventions should be targeted at home environments and focus on at-risk groups such as women and elderly people. Setting stricter standards and environmental legislations and promotion of public awareness against the dangers of CO exposure are important considerations for overcoming this public health problem.International Journal of Injury Control and Safety Promotion 06/2011; 18(4):313-20. DOI:10.1080/17457300.2011.589006 · 0.67 Impact Factor