Fatal Weather-Related Carbon Monoxide Poisonings in the United States

Carbon monoxide (CO) is a colorless, odorless gas that can cause injury or death if inhaled. CO is a frequent secondary hazard induced by the aftereffects of natural hazards as individuals, families, and communities often seek alternative power sources for heating, cooking, lighting, and cleanup during the emergency and recovery phases of a disaster. These alternative power sources-such as portable generators, petroleum-based heaters, and vehicles-exhaust CO that can ultimately build to toxic levels in enclosed areas. Ever-increasing environmental and societal changes combined with an aging infrastructure are growing the odds of power failures during hazardous weather events, which, in turn, are increasing the likelihood of CO exposure, illness, and death. This study analyzed weather-related CO fatalities from 2000 to 2019 in the United States using death-certificate data, providing one of the longest assessments of this mortality. Results reveal that over 8300 CO fatalities occurred in the United States during the 20-yr study period, with 17% of those deaths affiliated with weather perils. Cool-season perils such as ice storms, snowstorms, and extreme cold were the leading hazards that led to situations causing CO fatalities. States in the Southeast and Northeast had the highest CO fatality rates, with winter having the greatest seasonal mortality. In general, these preventable CO poisoning influxes are related to a deficiency of knowledge on generator safety and the absence of working detectors and alarms in the enclosed locations where poisonings occur. Education and prevention programs that target the most vulnerable populations will help prevent future weather-related CO fatalities. Significance StatementCarbon monoxide exposure is common after weather disasters when individuals, families, and communities seek alternative power sources-such as portable generators, petroleum-based heaters, and vehicles-that exhaust this deadly, colorless, and odorless gas. Initially, we catalog carbon monoxide fatalities associated with weather events in the United States over two decades; thereafter, we illustrate the characteristics and patterns affiliated with these deaths. Results will assist public officials, first responders, and individuals in their decision-making and response before, during, and after weather events so that these deaths may be prevented in the future.