Power Outages: An Underappreciated Risk Factor for Children's Carbon Monoxide Poisoning

Area of Science:

• Environmental Health
• Pediatric Emergency Medicine
• Public Health Policy

Background:

• Children face elevated carbon monoxide (CO) poisoning risks post-disaster, often linked to improper generator use during power outages.
• Understanding the specific impact of power disruptions on pediatric CO exposure is crucial for public health interventions.

Purpose of the Study:

• To evaluate the association between power outages and pediatric emergency department (ED) visits for CO poisoning in New York State (NYS).
• To quantify the increased risk of CO poisoning ED visits following different scales of power outages.

Main Methods:

• Utilized power outage data (2017-2020) and pediatric CO poisoning ED visit data from NYS SPARCS.
• Employed a time-stratified case-crossover design, linking community outage exposure to patient residence.
• Controlled for meteorological factors and stratified analyses by urban and rural settings.

Main Results:

• Identified 917 pediatric CO poisoning ED visits in NYS between 2017-2020, with 83% in urban areas.
• Observed significant associations between power outages (all-size and large-scale) and CO ED visits for up to two days post-outage.
• Four hours of outage increased odds of pediatric CO poisoning ED visits by ≥50% (small-scale) and ≥150% (large-scale), with stronger effects in urban areas.

Conclusions:

• Power outages are a significant risk factor for pediatric carbon monoxide poisoning emergency visits in NYS, particularly in urban environments.
• The findings underscore the need for targeted public health messaging and improved energy infrastructure to protect children.
• Further research on outage health impacts and advocacy for reliable energy access are essential for climate change adaptation.