An outbreak of carbon monoxide poisoning after a major ice storm in Maine

Unintentional carbon monoxide (CO) exposure kills over 500 people in the U. S. annually. Outbreaks of CO poisoning have occurred after winter storms,th e objective of this study was to describe clinical features and identify im portant risk factors of a CO poisoning outbreak occurring after a major ice storm. The study design included a case series of CO poisoning patients, a telephone survey of the general community, and a case-controlled study of households using specific CO sources. The setting was the primary service a rea of four hospital emergency departments located in the heavily storm-imp acted interior region of Maine. Participants included all patients with a l aboratory-confirmed diagnosis of CO poisoning during the 2 weeks after the storm onset, and a population-based comparison group of 522 households sele cted by random digit dialing. There were 100 cases identified, involving 42 common-source exposure incidents, most of them during the first week. Thou gh classic CO symptoms of headache, dizziness, and nausea predominated, 9 p atients presented with chest pain and 10 were asymptomatic. One patient die d and 5 were transferred for hyperbaric oxygen therapy, Gasoline-powered el ectric generators were a CO source in 30 incidents, kerosene heaters in 8, and propane heaters in 4, In the community, 31.4% of households used a gene rator after the ice storm. The strongest risk factor for poisoning was loca ting a generator in a basement or an attached structure such as a garage. C ases of CO poisoning with various presentations can be expected in the earl y aftermath of a severe ice storm. Generators are a major CO source and gen erator location an important risk factor for such disasters. (C) 2000 Elsev ier Science Inc.