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DRAFT-Do not distribute
Introduction
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II. Introduction
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Unintentional carbon monoxide (CO) poisoning is a leading cause of poisonings in the US. CO is a colorless,
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odorless, nonirritating gas that is produced through incomplete combustion. Sources of CO include common
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household and workplace devices such as boilers, furnaces, motor-vehicle exhaust, generators, gas space
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heaters, woodstoves, gas stoves, and fireplaces. Sources of CO are ubiquitous and can lead to unintentional CO
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poisoning if not properly checked or maintained.
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CO poisoning can often be misdiagnosed as health effects include a range of nonspecific symptoms from minor
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flu-like symptoms (e.g., headache, dizziness, nausea, vomiting, fatigue, and confusion) to more severe effects
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(e.g., impaired memory, collapse, cardiac irregularities, coma, and death) [5] [6] CO poisoning is treated by
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removing the person from the CO exposure and administration of oxygen.
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Primary, secondary and tertiary forms of prevention are effective in reducing CO-related morbidity and mortality
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(citation?). Examples of primary prevention include substituting electric -powered for fuel powered equipment,
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using fuel-based products only in well ventilated areas, installing CO alarms, and maintaining non-electric home
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heating systems and appliances. CO alarms are an important primary and secondary prevention strategy [5].
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Laws and ordinances requiring installation of CO alarms can reduce the number of CO exposures. (Iqbal et al.
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2012) Treatment or tertiary prevention of CO poisoning include removing the persons from the exposure to CO
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and administering oxygen.
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Unintentional, non-fire related CO poisoning is responsible for approximately 415 deaths [In clearance paper
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Sircar et al] and 21,000 emergency department (ED) visits each year. [1] [2] [3] Between 2000 and 2009, 68,316
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calls about CO exposure or poisoning were reported to poison control centers (PCCs) nationally, of which 36,691
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calls (53.7%) led to treatment at a health care facility [4].
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DRAFT-Do not distribute
Introduction
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To help understand the burden of CO poisoning and guide public health action in their state, many health
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departments formed surveillance systems. Ten jurisdictions (Connecticut, Florida, Louisiana, Maine, Michigan,
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Minnesota, Missouri, New York, New York City, and Wisconsin) conduct case-based CO surveillance that is
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supported by public health reporting requirements and utilize multiple data sources. The states vary in their CO
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poisoning prevention programs and case definitions that are used.
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With the absence of active surveillance data, national surveillance depends on secondary data sources. (Iqbal,
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2012). CDC’s National Center for Environmental Health (NCEH)’s Air Pollution and Respiratory Health Branch
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provides national estimates of unintentional non-fire related CO poisoning by using various sources such as PCC,
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Healthcare Cost and Utilization Project’s (HCUP) National Emergency Department Sample and Nationwide
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Inpatient Sample and National Vital Statistic System.
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This report is the first surveillance summary on CO poisoning surveillance. It will summarize CO poisoning
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surveillance data from 10 state and local jurisdictions and the national level. The data in this summary will focus
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on 2009-2011, [the most recent data available to the majority of the contributing states and juridictionswhy this
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period]. Additionally, it includes a discussion of the importance of jurisdiction’s implementation of standardized
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CO surveillance. Finally, it provides illustrations on how surveillance data has been used to initiate successful
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public health actions.
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