Eric Lavigne1, Scott Weichenthal2, Joan Wong3, Marc Smith-Doiron4, Rose Dugandzic3, Tom Kosatsky5. 1. Air Health Science Division, Health Canada, Ottawa, Ont. ; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ont. 2. Air Health Science Division, Health Canada, Ottawa, Ont. ; McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montréal, Que. 3. Air Health Science Division, Health Canada, Ottawa, Ont. 4. Population Studies Division, Health Canada, Ottawa, Ont. 5. British Columbia Centre for Disease Control, Vancouver, BC.
Abstract
BACKGROUND: The epidemiology of mortality and morbidity from carbon monoxide poisoning in Canada has received little attention. Our objective was to evaluate trends in mortality and hospital admission rates for unintentional nonfire-related carbon monoxide poisoning across Canada. METHODS: Age- and sex-standardized mortality (1981-2009) and hospital admission (1995-2010) rates by age group, sex and site of carbon monoxide exposure were calculated for each province and for all of Canada. We quantified the long-term trends by calculating the average annual percent change. Multivariable Poisson regression was used to estimate incidence rate ratios (IRRs) of carbon monoxide poisoning across age groups, sex and month of occurrence. RESULTS: In Canada, there were 1808 unintentional nonfire-related carbon monoxide poisoning deaths between 1981 and 2009 and 1984 admissions to hospital between 1995 and 2010. Average annual decreases of 3.46% (95% confidence interval [CI] -4.59% to -2.31%) and 5.83% (95% CI -7.79% to -3.83%) were observed for mortality and hospital admission rates, respectively. Mortality (IRR 5.31, 95% CI 4.57 to 6.17) and hospital admission (IRR 2.77, 95% CI 2.51 to 3.03) rates were elevated in males compared with females. Decreased trends in the rates were observed for all sites of carbon monoxide exposure, but the magnitude of this decrease was lowest in residential environments. Deaths and admissions to hospital were most frequent from September to April, with peaks in December and January. INTERPRETATION: Mortality and hospital admission rates for unintentional nonfire-related carbon monoxide poisoning in Canada have declined steadily. Continued efforts should focus on reducing carbon monoxide poisoning during the cooler months and in residential environments.
BACKGROUND: The epidemiology of mortality and morbidity from carbon monoxidepoisoning in Canada has received little attention. Our objective was to evaluate trends in mortality and hospital admission rates for unintentional nonfire-related carbon monoxidepoisoning across Canada. METHODS: Age- and sex-standardized mortality (1981-2009) and hospital admission (1995-2010) rates by age group, sex and site of carbon monoxide exposure were calculated for each province and for all of Canada. We quantified the long-term trends by calculating the average annual percent change. Multivariable Poisson regression was used to estimate incidence rate ratios (IRRs) of carbon monoxidepoisoning across age groups, sex and month of occurrence. RESULTS: In Canada, there were 1808 unintentional nonfire-related carbon monoxidepoisoning deaths between 1981 and 2009 and 1984 admissions to hospital between 1995 and 2010. Average annual decreases of 3.46% (95% confidence interval [CI] -4.59% to -2.31%) and 5.83% (95% CI -7.79% to -3.83%) were observed for mortality and hospital admission rates, respectively. Mortality (IRR 5.31, 95% CI 4.57 to 6.17) and hospital admission (IRR 2.77, 95% CI 2.51 to 3.03) rates were elevated in males compared with females. Decreased trends in the rates were observed for all sites of carbon monoxide exposure, but the magnitude of this decrease was lowest in residential environments. Deaths and admissions to hospital were most frequent from September to April, with peaks in December and January. INTERPRETATION: Mortality and hospital admission rates for unintentional nonfire-related carbon monoxidepoisoning in Canada have declined steadily. Continued efforts should focus on reducing carbon monoxidepoisoning during the cooler months and in residential environments.
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