Epidemiology

Worldwide, the incidence of carbon monoxide poisoning has not changed significantly since the 1990s, but mortality has declined markedly during this period.[6]​ Incidence of poisoning is higher in middle and middle-to-high than in low-to-middle socio-demographic index (SDI) countries.[6]​ However, primary data about carbon monoxide poisoning in many countries is unreliable, particularly in areas where the infrastructure for accurate diagnosis may not be available (e.g., remote or resource-poor regions).[6]​

In the UK, 2970 non-fire related, accidental incidents of exposure to carbon monoxide were reported to the National Poisons Information Service from 2015 to 2019.[7]​ In England and Wales, 43 people died from accidental carbon monoxide poisoning in 2021.[8]​ In the US, the best available estimates of the yearly incidence of carbon monoxide poisoning are 50,000 (intentional and accidental), based on emergency department visits.[9]

There are two main peaks of incidence of carbon monoxide poisoning; one in people aged 0 to 14 years and another in those aged 20 to 39 years.[6]​ The highest rate of mortality following poisoning is in those aged over 80 years.[6]​ The incidence of poisoning is the same in men and women, but men have a higher mortality compared with women.[6]​

Poisoning may be more common during the winter months when heating devices are more likely to be used.[10][11]

Risk factors

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exposure to incomplete combustion of carbon-containing material

Potential sources of carbon monoxide exposure due to incomplete combustion of carbon-containing material include:[10][18]

  • Stoves[19]

  • Barbeques​[1][19]

  • Heaters

  • Boilers[1]

  • Fires and portable fuel burners[19]

  • Exhaust fumes

  • Shisha/hookah pipes[1][17]

  • Cigarette smoke

  • Gas-powered tools or generators[19]

  • House fires.[1]

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exposure to methylene chloride

Carbon monoxide is formed during metabolism of methylene dichloride (dichloromethane). Exposure to carbon monoxide during paint or furniture stripping and de-greasing may result in poisoning.[20]

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