Does public education reduce ice storm-related carbon monoxide exposure?

Public education to prevent carbon monoxide exposure during ice storms has been recommended; its effects remain unexamined. We compared patients seen for carbon monoxide inhalation at the area's only academic Emergency Department during 1991 and 2003 ice storms; educational efforts were more intense in 2003. There were fewer patients during the second storm (45 vs. 55); all recovered fully. The percentage of Caucasian patients rose (from 57% to 89%) whereas that of African-American patients fell (from 39% to 7%). Indoor grill use, associated with 11% of 1991 cases, was eliminated in 2003. Indoor gas generators remain the most common source. Carboxyhemoglobin levels correlate poorly with ambient carbon monoxide levels. Enhanced public education had a modest effect, especially in reducing the proportion of African-American patients and those from indoor grill use. Research on more effective public health education targeted at gas generator users and combined with physical interventions should be considered.