CARBON MONOXIDE SURVEILLANCE PROJECT
Neil B. Hampson, MD
years of operation, the joint project between the UHMS and the US Centers for
Disease Control and Prevention (CDC) to conduct online surveillance of cases of
carbon monoxide (CO) poisoning treated with hyperbaric oxygen was completed in
December 2011. Due to cutbacks in Federal funding for the CDC, financial
support was not available for a fourth year. Furthermore, the pilot project had
already achieved all of the goals established when it went online in August 2008,
goal of the project was to determine whether teaming with a specialty medical
society would provide the CDC a tool to acquire complimentary information about
a health condition that their usual surveillance methods would not capture. The
CDC collects epidemiologic data in an attempt to track trends in diseases and
also to look for ways to develop more effective prevention programs. The fact that the project proposed by the
UHMS involved online reporting of case information offered the additional
possibility for near real‐time data acquisition, allowing the potential for
intervention when an epidemic was identified.
64 UHMS affiliated hyperbaric facilities reported unidentifiable demographic,
epidemiologic, and clinical data on 1,907 patients treated with HBO2
for CO poisoning in 42 states. This represents the first comprehensive
collection of nationwide data on this group of patients. A paper has already
been published by CDC and UHMS investigators that summarizes 1 year of data and
discusses the potential that the information offers for improving poisoning prevention
programs (1). Another paper is forthcoming in Undersea
and HyperbaricMedicine summarizing the entire 3‐year
data collection (2).
reporting with an online system did prove to offer the opportunity for intervention
and poisoning prevention. After Hurricane Ike struck the coast of Texas in
2008, we were able to rapidly provide the CDC with information about the outbreak
of CO poisonings that followed, such that they were able to intervene with appropriate
public education resources to prevent further poisoning (3).
Such a large
database containing information that was collected both systematically and
prospectively has allowed us to answer existing some questions about CO
poisoning. A few have included, "What percentage of HBO2‐treated patients are
hospitalized?” (answer: 54%). "Why did people operate generators after
Hurricane Ike?” (answer: Surprisingly, most did it to power video games and DVD
players to entertain their children) (4). "Does the initial blood carboxyhemoglobin
level correlate with the patient’s presenting symptoms?” (answer: No) (5).
project was a success in all regards. The UHMS gained valuable visibility as
the CDC showcased the program as an example of what can be achieved by teaming
with a medical specialty society. Valuable information about CO poisoning in
the US has been collected that will likely continue to yield new findings for
some time to come. Revenue has flowed to the UHMS as the project has donated $20,000
in excess funds to the Society over the past few years.
probable that we will reactivate the system on ad hoc basis from time to time
in the future. This will most likely occur if the CDC calls with a request for timely
information about a specific event, such as a storm. In such a case, emails
will be sent to UHMS members residing in a focused area of the country
requesting case reporting for a short period of time.
things that happen in the UHMS, none of this would have been possible without the enthusiastic volunteer
cooperation of Society members who reported the cases online. I thank all of
you who participated, and hope you enjoyed the coffee.
- Clower JH, Hampson NB, Iqbal S, Yip FY. Recipients of hyperbaric
oxygen therapy for carbon monoxide poisoning and exposure circumstances. Am JEmerg Med 2011; Aug 18, epub
ahead of print.
- Hampson NB, Dunn SL, Yip FY, Clower JH, Weaver LK. The UHMS/CDC carbon
monoxide poisoning surveillance system: Three year data. UnderseaHyperb Med 2012, in press.
- Hampson N, Dunn S, Bronstein A, Fife C, Villanachi J, et al. Carbon monoxide exposures after Hurricane Ike –
September 2008. MMWR 2009;
- Fife CE, Smith L, Maus E, O’Malley E, Hampson NB. Dying to play video games:
Carbon monoxide poisoning from electrical generators following hurricane Ike. Pediatrics; 2009 Jun;(6): e1035‐e1038.
NB, Dunn SL, Members of the UHMS/CDC CO Poisoning Surveillance Group. Symptoms
of acute carbon monoxide poisoning do not correlate with the initial
carboxyhemoglobin level. Undersea Hyperb Med 2012,