Nine-fold increase in carbon monoxide poisonings after power outages


By Gene Emery

(Reuters Health) - A study of long-term power outages in the U.S. has confirmed the widespread suspicion that carbon monoxide emergencies spike after a power outage, and the increase turns out to be dramatic - a nine-fold hike as people turn to unsafe practices to stay warm or generate their own power.

"The rates of emergency department visits for carbon monoxide poisoning increased significantly during power outages that lasted more than 24 hours," said the research team led by Dr. Christopher Worsham of Harvard Medical School, in Boston, reporting in the New England Journal of Medicine.

The rate was 13.5 times higher among children under 18.

"Similar patterns were not observed after extreme snowfall or cold-weather events that were not specifically accompanied by power outages," the Worsham team said.

"This may seem like a 'water is wet' kind of study, especially when we've had so many severe weather events around the country and we hear these reports of carbon monoxide poisoning," Dr. Worsham told Reuters Health in a telephone interview. "But we wanted to look at it systematically, and we were able to quantify it. If you needed some proof, here it is."

Because the team based their study on a database of people covered by commercial insurance and cases were probably missed due to a variety of factors, the actual rates might be even higher, he and his team cautioned.

In the analysis, researchers correlated poisoning cases with 581 major U.S. power outages reported to the Department of Energy from 2007 through 2018. Just over 83% were weather related. When the team looked at emergency room visits from 10 days before the outage until 10 days after the power failed, the scope of the problem emerged.

It generally took at least 24 hours of no power for the carbon monoxide poisoning risk to become pronounced.

"When you get into the 24- to 48-hour mark there's a spike," said Dr. Worsham, a pulmonologist and critical care physician.

The database did not include Medicare recipients.

The report comes nearly a year after cold weather in Texas sparked a major power grid collapse, leaving millions without heat and causing a surge in carbon monoxide poisoning cases as residents brought grills and campfire stoves indoors in a desperate attempt to stay warm, or ran power generators in a poorly-ventilated area.

"We know from scholars of climate change that severe weather events will be increasing in frequency in the coming years. If we're going to be seeing more nasty storms and if our electrical grids are going to be in rough shape, as they are in many parts of the country, this is a real health effect of these severe events," and it could be mitigated by investing in power grid infrastructure, Dr. Worsham said.

SOURCE: The New England Journal of Medicine, online January 12, 2022.

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