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Carbon monoxide poisoning surveillance: a French Environmental & Health surveillance system integrated in preventive policies
  1. A Verrier*,
  2. J Daoudi,
  3. C Gourier-Frry,
  4. G Salines
  1. Correspondence Institut de veille sanitaire, 12 rue du val d'osne Saint Maurice 94412, France

Abstract

In France, carbon monoxide (CO) poisoning strikes over 5000 people who have to be managed in emergency conditions. In order to improve our knowledge on CO poisoning circumstances, a specific surveillance system has been set up. Its main objective is to provide epidemiological description of poisoning in order to improve preventive messages and rules.

Methods In France, governmental procedures impose that each CO poisoning case has to be reported to poison control centres or public health services. A technical investigation is immediately conducted to identify causes of poisoning. A medical investigation is also set up to describe clinical symptoms, medical management and severity. Since there are no specific clinic symptoms of CO poisoning, an epidemiological case definition was built, combining both environmental and medical criteria (clinical symptoms, impregnation estimation, atmospheric measurements, and technological signs).

Results About 1300 CO poisoning incidents involving 4000 exposed persons were yearly declared. 85% of those were domestic unintentional poisoning, half of which concerned home owners and were caused by gas furnaces with favouring conditions like voluntarily obstructed ventilation. Public health preventive messages focused on good ventilation and annual check of gas furnaces. During winter power outages, outbreaks were due to misuse of generators or portable heating devices. Preventive messages then focused on the right use of these devices.

Conclusions This surveillance system has improved our knowledge about CO poisoning circumstances. A dual strategy of preventive messages and rules has been set up to transform public health knowledge into action.

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