Carbon monoxide poisoning: potentially preventable cases

The objective of the study was to describe epidemiological and clinical data regarding acute carbon monoxide (CO) poisoning in an urban area of North Italy. 95 consecutive adult patients admitted to Milan and Turin Poisons Control Centres (PCC) for CO poisoning between October 1993 and March 1995 were enrolled into the study. Epidemiological and medical parameters were recorded in a standardised collection data sheet, which included age, sex, circumstances of poisoning, severity grading (0-3), blood HbCO level upon admission.

86 cases of CO poisoning (90.5%) were due to accidental exposures, 9 to intentional suicide attempts. A majority of cases occurred in late autumn through winter months, from October to February. The highest proportion of accidental CO poisoning cases (92%) occurred in the household setting. In 57 cases the acute severity grading was higher than 1 (median 2); blood HbCO level upon admission was 40% in 16% of the cases (mean 31.6%--median 32.7%).

Carbon monoxide exposure represents a significant cause of severe but potentially preventable accidental poisoning. The study indicates the need for public education campaigns aimed to warn people against the silent killer at home, and to promote preventive measures. The clinical course of CO poisoning is often severe. A standardised collection data system, to record all the cases of acute CO intoxication in Emergency Departments, can help evaluate the real incidence and clinical significance of this poisoning.