Worldwide epidemiology of carbon monoxide poisoning

Hum Exp Toxicol. 2020 Apr;39(4):387-392. doi: 10.1177/0960327119891214. Epub 2019 Dec 1.


This article presents updated information on the worldwide burden of carbon monoxide (CO) poisoning. The worldwide epidemiologic data were obtained from the Global Health Data Exchange registry, a large database of health-related data maintained by the Institute for Health Metrics and Evaluation. The worldwide cumulative incidence and mortality of CO poisoning are currently estimated at 137 cases and 4.6 deaths per million, respectively. The worldwide incidence has remained stable during the last 25 years, while both mortality and percentage of patients who died have declined by 36% and 40%, respectively. The incidence of CO poisoning does not differ between sexes, whilst mortality is double in men. The incidence shows two apparent peaks, between 0-14 years and 20-39 years. The percentage of patients who died constantly increases in parallel with aging, peaking in patients aged 80 years or older. The number of CO poisoning grows in parallel with the socio-demographic index (SDI), though more detailed analyses would be needed to confirm our findings. Mortality displays a similar trend, being approximately 2.1- and 3.6-fold higher in middle and middle-to-high than in low-to-middle SDI countries. In conclusion, while these data suggest that the worldwide burden of CO poisoning remains stable, and the number of fatal outcomes and percentage of patients who die have both consistently declined during the last 25 years, the unreliability of the primary data sources in many countries with respect to accurate diagnosis of CO poisoning means that caution is required, and that field studies, particularly in poorer countries, are required.

Keywords: CO; Carbon monoxide; epidemiology; mortality; poisoning.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Carbon Monoxide Poisoning / epidemiology*
  • Child
  • Child, Preschool
  • Databases, Factual
  • Female
  • Global Health
  • Humans
  • Incidence
  • Infant
  • Male
  • Mortality / trends
  • Sex Distribution
  • Socioeconomic Factors
  • Young Adult