Carbon monoxide poisonings in hotels and motels: The problem silently continues

Carbon monoxide poisoning remains common in the United States. One component of effective prevention involves identification of scenarios in which poisoning occurs to guide development of appropriate interventions. This study was conducted to determine the significance of the problem of carbon monoxide poisoning occurring in US hotels, motels and resorts. This is a population-based case series of guests staying at US hotels, motels, and resorts from 2005 to 2018. Details of incidents and individuals poisoned with carbon monoxide were collected from online searches and professional experience of the authors. Data extracted included number of incidents and individuals poisoned, age of those poisoned, outcomes, source of carbon monoxide, and lodging type. From January 1, 2005 to December 31, 2018, 905 guests were poisoned in 115 identified incidents, including 22 fatalities. Children represented 16% of those poisoned and 27% of fatalities. Type of lodgings were hotels, motels, and resorts of all classes and located in a majority of states. Most poisonings were caused by natural gas fueled appliances and could likely have been prevented by an in-room carbon monoxide alarm. To reduce morbidity and mortality from unintentional CO poisoning in lodging facilities, government should mandate installation of in-room CO alarms, similar to the current requirement for smoke alarms.