Epidemiology of acute carbon monoxide poisoning in a Spanish region

A Dueñas-Laita, M Ruiz-Mambrilla, F Gandía, R Cerdá, J C Martín-Escudero, J L Pérez-Castrillón, G Díaz
Journal of Toxicology. Clinical Toxicology 2001, 39 (1): 53-7

BACKGROUND: In Spain, as in most of the world, the incidence of acute carbon monoxide poisoning is probably underestimated.

METHODS: During an eighteen-month period we studied, by means of a standardized data collection form, all the cases of acute carbon monoxide poisoning that were diagnosed in 2 university hospitals.

RESULTS: During the study, 154 patients were diagnosed with carbon monoxide poisoning. The mean age was 32.2+/-15.5 years. The two principal exposure sites were the kitchen (43%) and bathroom (23%). The majority of the cases related to malfunction of the water heater (30%) and of the central heating (23%) and 68% occurred in the home. Improper combustion of butane (31%), propane (13%), and natural gas (12%) were most frequent. The most prevalent clinical manifestations were headache (94%), dizziness (56%), nausea (45%), loss of consciousness (38%), and weakness (34%). Five patients died. In 14.4%, symptoms suggested delayed neurological syndrome. The largest number of cases of poisoning occurred during the months of December and January.

CONCLUSIONS: Compared with previous Spanish series or with the antecedent year, acute carbon monoxide poisoning has a high prevalence in our region. Two factors appear to be essential to the accurate diagnosis of acute carbon monoxide poisoning: 1) the ability of emergency room physicians to recognize the clinical symptoms of carbon monoxide poisoning and 2) access to a carbon monoxide-oximeter.

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