Objective: Building collapses, debris removal, new construction, and increased stove use for heating have elevated air pollution in regions affected by the February 6, 2023, Kahramanmaraş earthquake. This study examines the relationship between carbon monoxide (CO) poisoning and air pollution in these areas 1 year after the disaster.
Methods: A retrospective analysis of 151 patients from 10 hospitals in 8 cities was conducted, including data on demographics, clinical symptoms, sources of CO exposure, vital signs, laboratory findings, air pollution levels, and outcomes.
Results: Indoor stove use was the primary source of CO exposure. The average Air Quality Index (AQI) was 55 (IQR 44-56), and particulate matter (PM2.5) levels averaged 17.5 μg/m3 (IQR 10-27), exceeding EPA (Environmental Protection Agency) thresholds. AQI levels post-earthquake were significantly higher than pre-earthquake in Kahramanmaraş (AQI1 = 48.5 [IQR 48-55], AQI2 = 55 [IQR 55-80]; P = 0.007), Hatay (AQI1 = 40.5 ± 13.7, AQI2 = 56 [IQR 51-60.5]; P <0.001), and Gaziantep (AQI1 = 44 [IQR 41-56], AQI2 = 55 [IQR 54-55.5]; P = 0.014). Leukocytosis (P = 0.004) and myocardial injury (P <0.001) in CO poisoning cases varied significantly across provinces.
Conclusions: In conclusion, elevated AQI and PM2.5 levels likely worsened myocardial injury in CO poisoning cases due to combined outdoor and indoor pollution effects. These findings emphasize the need for air quality monitoring and mitigation in disaster regions.
Keywords: Air pollution; air quality index; carbon monoxide; earthquake; myocardial injury; particulate matter.