Unintentional domestic non-fire related carbon monoxide poisoning: data from media reports, UK/Republic of Ireland 1986-2011.

CONTEXT: Gathering information on the circumstances that give rise to unintentional domestic non-fire related carbon monoxide poisoning and the associated morbidity and mortality is not straightforward because the diagnosis is so often missed in life.
METHODS: We searched Newsbank and related databases (at least 332 sources, UK and Republic of Ireland) for reports of domestic carbon monoxide poisoning, 1986-end 2011 inclusive. The search terms were 'carbon monoxide AND (house* OR home* OR caravan* OR tent*) NOT (work OR fire OR suicide*)'. Newsbank includes full-text articles from 19 UK national newspapers and over 140 UK & Irish regional and local newspapers and periodicals. RESULTS AND DISCUSSION: There were reports of 348 incidents (880 victims: 334 male, 352 female, 194 sex not stated). Reports of incidents increased from 1986 (1) to 2011 (28). There were 298 deaths (169 male, 124 female, 5 sex not reported). The likelihood of a fatal outcome increased with age for both males and females (28%, 1-9 years; 71%, 80 + years). The source of carbon monoxide was often a central heating or water boiler (48% of 244 incidents). Many incidents (49%) occurred in private dwellings. However, incidents in caravans, tents, sheds and outhouses had a much higher death rate. If a victim was discovered alive chances of survival were relatively good (87%), even if found unconscious. The estimated duration of carbon monoxide exposure ranged from minutes to years in both fatal and non-fatal incidents. Pets were recorded in 31 incidents (17 died). In 5 cases, carbon monoxide poisoning was identified through illness or death of a pet. Prosecutions were recorded in 49 incidents and at least 7 custodial (prison) sentences resulted, with 34 further convictions resulting in a fine. Charges were preferred against either an installer/maintenance engineer (42%), or the landlord (31%).
CONCLUSION: Deaths and permanent injuries from unintentional domestic non-fire related carbon monoxide poisoning continue. Survival rates are relatively high if poisoning is diagnosed in life, but warning signs are often missed and inappropriate behavior such as placing barbecues in tents and failure to perform proper safety checks by gas appliance fitters still kills.