Non-Fire Related Carbon Monoxide Poisoning in Sichuan, China: A 9-Year Study (2008-2016)
Background: Carbon monoxide (CO) poisoning is one of the most important intoxications in the modern world. This study aimed to identify the characteristics of CO poisoning deaths in Sichuan province in the west of China.
Methods: Data on fatal non-fire-related carbon monoxide poisoning in Sichuan from 2008 to 2016 were obtained from the Department of Forensic Analytical Toxicology of Sichuan University and were analyzed by the month and year of registration of death, sex, age group, manner of death, source of CO, and location of CO exposure. Comparing with the previous studies carried out in Wuhan and Shanghai to identify the regional differences of CO poisoning in China.
Results: A total of 165 non-fire related CO poisoning cases including 237 victims were recorded. Over 90% of the victims died from accidental poisoning. Non-fire related CO poisoning occurred more frequently in winter months and was most prevalent in individuals aged between 18 and 60 yr old. Showering gas accident and coal or charcoal burning was found to be the major source of CO in accident and in suicide cases, respectively. Furthermore, significant regional differences of CO poisoning have been detected in the manner of death and the source of CO.
Conclusion: These findings will be valuable in the targeted prevention of non-fire related CO poisoning in China.
2. Stefanidou M, Athanaselis S, Koutselinis A (2003). Carbon monoxide: old poison—recent problems. Leg Med (Tokyo), 5(4):253-4.
3. Hampson NB (2016). U.S. Mortality Due to Carbon Monoxide Poisoning, 1999-2014. Accidental and Intentional Deaths. Ann Am Thorac Soc, 13(10):1768-74.
4. Dirlik M, Bostancioglu B (2017). Deaths due to carbon monoxide poisoning in Aydin, western Turkey. Death Stud, 41(4):246-50.
5. Stefanidou ME, Maravelias CP, Dona AA et al (2012). Carbon Monoxide–Related Deaths in Greece. Am J Forensic Med Pathol, 33(2):128-31.
6. Braubach M, Algoet A, Beaton M et al (2013). Mortality associated with exposure to carbon monoxide in WHO European Member States. Indoor Air, 23(2):115-25.
7. Nielsen PR, Gheorghe A, Lynnerup N (2014). Forensic aspects of carbon monoxide poisoning by charcoal burning in Denmark, 2008–2012: an autopsy based study. Forensic Sci Med Pathol, 10(3):390-4.
8. Ruas F, Mendonça MC, Real FC et al (2014). Carbon monoxide poisoning as a cause of death and differential diagnosis in the forensic practice: A retrospective study, 2000–2010. J Forensic Leg Med, 24:1-6.
9. Dimaio D, Dimaio VJM, M.D (2001). Forensic Pathology, Second Edition. Informa Healthcare.
10. Raub JA, Mathieu-Nolf M, Hampson NB, Thom SR (2000). Carbon monoxide poisoning—a public health perspective. Toxicology, 145(1):1-14.
11. Li F, Chan HC, Liu S et al (2015). Carbon monoxide poisoning as a cause of death in Wuhan, China: A retrospective six-year epidemiological study (2009–2014). Forensic Sci Int, 253:112-8.
12. Lu X, Li F, Chan HC et al (2016). Carbon monoxide poisoning deaths in Shanghai, China: A 10-year epidemiological and comparative study with the Wuhan sample. Cogent Med, 3(1):1137131.
13. Teige B, Lundevall J, Fleischer E (1977). Carboxyhemoglobin concentrations in fire victims and in cases of fatal carbon monoxide poisoning. Z Rechtsmed, 80(1):17-21.
14. Gormsen H, Jeppesen N, Lund A (1984). The causes of death in fire victims. Forensic Sci Int, 24(2):107-11.
15. Alarifi AA, Phylaktou HN, Andrews GE (2016). What Kills People in a Fire? Heat or Smoke? The Saudi Students Conference.
16. Fisher DS, Leonardi G, Flanagan RJ (2014). Fatal unintentional non-fire-related carbon monoxide poisoning: England and Wales, 1979–2012. Clin Toxicol (Phila), 52(3):166-70.
17. Sircar K, Clower J, Shin Mk et al (2015). Carbon monoxide poisoning deaths in the United States, 1999 to 2012. Am J Emerg Med, 33(9):1140-5.
18. Wilson RC, Saunders PJ, Smith G (1998). An epidemiological study of acute carbon monoxide poisoning in the West Midlands. Occup Environ Med, 55(11):723-8.
19. Hnatov MV (2013). Incidents, Deaths, and In-Depth Investigations Associated with Non-Fire Carbon Monoxide from Engine-Driven Generators and Other Eng Sircar K ine-Driven Tools, 1999-2012. US Consumer Product Safety Commission.
20. Fisher DS, Bowskill S, Saliba L, Flanagan RJ (2013). Unintentional domestic non-fire related carbon monoxide poisoning: data from media reports, UK/Republic of Ireland 1986–2011. Clin Toxicol (Phila), 51(5):409-16.
21. Karapirli M, Kandemir E, Akyol S et al (2013). Forensic and clinical carbon monoxide (CO) poisonings in Turkey: A detailed analysis. J Forensic Leg Med, 20(2):95-101.
22. Sheikhazadi A, Saberi Anary SH, Ghadyani MH (2010). Nonfire Carbon Monoxide-Related Deaths. Am J Forensic Med Pathol, 31(4):359-63.
23. Wu KC-C, Chen Y-Y, Yip PS (2012). Suicide methods in Asia: implications in suicide prevention. Int J Environ Res Public Health, 9(4):1135-58.
24. Choi Y-R, Cha ES, Chang S-S et al (2014). Suicide from carbon monoxide poisoning in South Korea: 2006–2012. J Affect Disord, 167:322-5.
25. Shie H-G, Li C-Y (2007). Population-Based Case-Control Study of Risk Factors for Unintentional Mortality from Carbon Monoxide Poisoning in Taiwan. Inhal Toxicol, 19(10):905-12.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.