Epidemiology of acute carbon monoxide poisoning in a Spanish region

Background: In Spain, as in most of the world, the incidence of acute carbo n monoxide poisoning is probably underestimated. Methods: During an eightee n-month period we studied, by means of a standardized data collection form, all the cases of acute carbon monoxide poisoning that were diagnosed in 2 university hospitals. Results: During the study, 154 patients were diagnose d with carbon monoxide poisoning. The mean age was 32.2 +/- 15.5 years. The two principal exposure sites Mere the kitchen (43%) and bathroom (23%). Th e majority of the cases related to malfunction of the water heater (30%) an d of the central heating (23%) and 68% occurred in the home. Improper combu stion of butane (31%), propane (13%), and natural gas (12%) were most frequ ent. The most prevalent clinical manifestations were headache (94%), dizzin ess (56%), nausea (45%), loss of consciousness (38%), and weakness (34%). F ive patients died In 14.4%, symptoms suggested delayed neurological syndrom e. The largest number of cases of poisoning occurred during the months of D ecember and January. Conclusions: Compared with previous Spanish series ol with the antecedent year, acute carbon monoxide poisoning has a high preval ence in our region. Two factors appear to be essential to the accurate diag nosis of acute carbon monoxide poisoning: 1) the ability of emergency room physicians to recognize the clinical symptoms of carbon monoxide poisoning and 2) access to a carbon monoxide-oximeter.