scholarly journals Spatio-temporal Analysis of Deaths From Carbon Monoxide Poisoning in Iran Between 2011 and 2018- An Ecological Study

2021 ◽  
Author(s):  
Yousef Alimohamadi ◽  
Danial Rahimi ◽  
Delniya Ahmadi ◽  
Ahmad Mehri
Keyword(s):  
Carbon Monoxide ◽  
Mortality Rate ◽  
General Education ◽  
Ecological Study ◽  
Carbon Monoxide Poisoning ◽  
Temporal Analysis ◽  
Mortality Rates ◽  
Co Poisoning ◽  
Female Ratio ◽  
Spatio Temporal

Abstract Background: Carbon monoxide (CO) poisoning, as one of the lethal poisoning, is responsible for a large percentage of poisonings and accidental deaths. Since the investigation of the mortality and the distribution of CO poisoning deaths in Iranian provinces is still unknown and no study has investigated so far, this study was conducted to determine the trend of mortality rate changes due to CO poisoning by Spatio-temporal analysis in Iran from 2011 to 2018. Methods: An ecological study was conducted based on data from the reports of at the National Center for Statistics of Iran for eight years from 21 March 2011 to 21 March 2018. The number of deaths due to CO poisoning and the annual mortality rates of CO poisoning per 100,000 population were calculated. The Spatio-temporal analysis used to determine the spatial and temporal distribution of deaths.Results: A total of 6078 deaths were reported due to CO poisoning that 4497 death were male (74%) and 1596 were female (26%) from 2011 to 2018. In both sexes, the mortality rate due to CO poisoning was 1.26 from 2011 to 0.91 in 2018. According to the results, the overall male-to-female ratio was 2.8. The mortality rate due to CO Poisoning had a decreasing trend. However, this trend did not have a linear trend (p=0.37). Our results showed that most of the deaths due to CO poisoning are higher in the northern and western provinces of Iran.Conclusion: This study is one of the first studies to compare the spatial and temporal mortality rates due to CO poisoning in Iran. Paying attention to general education about the principles of safety in the installation of heaters and the use of the gas networks, continuous and accurate monitoring of the installation and operation of CO-producing, and the use of sensitive alarms can reduce mortality and morbidity due to CO poisoning.

scholarly journals Deaths from Carbon monoxide poisoning in Iran between 2011 and 2018- An ecological study

2020 ◽  
Author(s):  
Yousef Alimohamadi ◽  
Danial Rahimi ◽  
Ahmad Mehri
Keyword(s):  
Carbon Monoxide ◽  
Mortality Rate ◽  
General Education ◽  
Ecological Study ◽  
Carbon Monoxide Poisoning ◽  
Temporal Analysis ◽  
Mortality Rates ◽  
Co Poisoning ◽  
Female Ratio ◽  
Spatio Temporal

Abstract Background: Carbon monoxide (CO) poisoning, as one of the lethal poisoning, is responsible for a large percentage of poisonings and accidental deaths. Since the investigation of the mortality and the distribution of CO poisoning deaths in Iranian provinces is still unknown and no study has investigated so far, this study was conducted to determine the trend of mortality rate changes due to CO poisoning by Spatio-temporal analysis in Iran from 2011 to 2018. Methods: An ecological study was conducted based on data from the reports of at the National Center for Statistics of Iran for eight years from 21 March 2011 to 21 March 2018. The number of deaths due to CO poisoning and the annual mortality rates of CO poisoning per 100,000 population were calculated. The Spatio-temporal analysis used to determine the spatial and temporal distribution of deaths.Results: A total of 6078 deaths were reported due to CO poisoning that 4497 death were male (74%) and 1596 were female (26%) from 2011 to 2018. In both sexes, the mortality rate due to CO poisoning was 1.26 from 2011 to 0.91 in 2018. According to the results, the overall male-to-female ratio was 2.8. The mortality rate due to CO Poisoning had a decreasing trend. However, this trend did not have a linear trend (p=0.37). Our results showed that most of the deaths due to CO poisoning are higher in the northern and western provinces of Iran.Conclusion: This study is one of the first studies to compare the spatial and temporal mortality rates due to CO poisoning in Iran. Paying attention to general education about the principles of safety in the installation of heaters and the use of the gas networks, continuous and accurate monitoring of the installation and operation of CO-producing, and the use of sensitive alarms can reduce mortality and morbidity due to CO poisoning.

Spatio-temporal analysis of Deaths from carbon monoxide poisoning in Iran between 2011 and 2018- An ecological study

2020 ◽  
Author(s):  
Yousef Alimohamadi ◽  
Danial Rahimi ◽  
Ahmad Mehri
Keyword(s):  
Carbon Monoxide ◽  
Mortality Rate ◽  
General Education ◽  
Ecological Study ◽  
Carbon Monoxide Poisoning ◽  
Temporal Analysis ◽  
Mortality Rates ◽  
Co Poisoning ◽  
Female Ratio ◽  
Spatio Temporal

Abstract Background Carbon monoxide (CO) poisoning, as one of the lethal poisoning, is responsible for a large percentage of poisonings and accidental deaths. Since the investigation of the mortality and the distribution of CO poisoning deaths in Iranian provinces is still unknown and no study has investigated so far, this study was conducted to determine the trend of mortality rate changes due to CO poisoning by Spatio-temporal analysis in Iran from 2011 to 2018. Methods An ecological study was conducted based on data from the reports of at the National Center for Statistics of Iran for eight years from 21 March 2011 to 21 March 2018. The number of deaths due to CO poisoning and the annual mortality rates of CO poisoning per 100,000 population were calculated. The Spatio-temporal analysis used to determine the spatial and temporal distribution of deaths. Results A total of 6078 deaths were reported due to CO poisoning that 4497 death were male (74%) and 1596 were female (26%) from 2011 to 2018. In both sexes, the mortality rate due to CO poisoning was 1.26 from 2011 to 0.91 in 2018. According to the results, the overall male-to-female ratio was 2.8. The mortality rate due to CO Poisoning had a decreasing trend. However, this trend did not have a linear trend (p=0.37). Our results showed that most of the deaths due to CO poisoning are higher in the northern and western provinces of Iran. Conclusion This study is one of the first studies to compare the spatial and temporal mortality rates due to CO poisoning in Iran. Paying attention to general education about the principles of safety in the installation of heaters and the use of the gas networks, continuous and accurate monitoring of the installation and operation of CO-producing, and the use of sensitive alarms can reduce mortality and morbidity due to CO poisoning.

scholarly journals Trend of Appendicitis Mortality at National and Provincial Levels in Iran from 1990 to 2015

2020 ◽  
Vol 23 (5) ◽  
pp. 302-311
Author(s):  
Seyed Mohammad Piri ◽  
Sahar Saeedi Moghaddam ◽  
Zahra Ghodsi ◽  
Moein Yoosefi ◽  
Nazila Rezaei ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Gaussian Process Regression ◽  
Mortality Rates ◽  
Adult Mortality ◽  
Annual Percent Change ◽  
Registration System ◽  
Female Ratio ◽  
Icd 10 ◽  
Spatio Temporal ◽  
Comparison Of The Results

Background: Appendicitis is one of the most preventable causes of death worldwide. We aimed to determine the trend of mortality due to appendicitis by sex and age at national and provincial levels in Iran during 26 years. Methods: Data were collected from Iran Death Registration System (DRS), cemetery databanks in Tehran and Esfahan, and the national population and housing censuses of Iran. The estimated population was determined for each group from 1990 to 2015 using a growth model. Incompleteness, misalignment, and misclassification in the DRS were addressed and multiple imputation methods were used for dealing with missing data. ICD-10 codes were converted to Global Burden of Disease (GBD) codes to allow comparison of the results with the GBD study. A Spatio-Temporal model and Gaussian Process Regression were used to predict the levels and trends in child and adult mortality rates, as well as cause fractions. Results: From 1990 to 2015, 6,982 deaths due to appendicitis were estimated in Iran. The age-standardized mortality rate per 100000 decreased from 0.72 (95% UI: 0.46–1.12) in 1990 to 0.11 (0.07–0.16) in 2015, a reduction of 84.72% over the course of 26 years. The male: female ratio was 1.13 during the 26 years of the study with an average annual percent change of -2.31% for women and -2.63% for men. Among men and women, appendicitis mortality rate had the highest magnitude of decline in the province of Zanjan and the lowest in the province of Hormozgan. In 1990, the lowest age-standardized appendicitis-related mortality was observed in both women and men in the province of Alborz and the highest mortality rate among men were observed in the province of Lorestan. In 2015, the lowest mortality rates in women and men were in the province of Tehran. The highest mortality rates in women were in Hormozgan, and in men were in Golestan province. Conclusion: The mortality rate due to appendicitis has declined at national and provincial levels in Iran. Understanding the causes of differences across provinces and the trend over years can be useful in priority setting for policy makers to inform preventive actions to further decrease mortality from appendicitis.

scholarly journals Predictive Role of QTc Prolongation in Carbon Monoxide Poisoning-Related Delayed Neuropsychiatric Sequelae

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Shu-Chen Liao ◽  
Yan-Chiao Mao ◽  
Yao-Min Hung ◽  
Ching-Hsing Lee ◽  
Chen-Chang Yang
Keyword(s):  
Carbon Monoxide ◽  
Roc Curve ◽  
Carbon Monoxide Poisoning ◽  
Chang Gung Memorial Hospital ◽  
Qtc Interval ◽  
Continuous Variables ◽  
Co Poisoning ◽  
Qtc Prolongation ◽  
Roc Curve Analysis ◽  
Delayed Neuropsychiatric Sequelae

Objective. Delayed neuropsychiatric sequelae (DNS) are serious complications of carbon monoxide (CO) poisoning that adversely affect poisoned patients’ quality of life as well as socioeconomic status. This study aimed to determine clinical predictors of DNS in patients with CO poisoning. Methods. This retrospective study included all CO-poisoned patients admitted to the emergency department (ED) of Linkou Chang Gung Memorial Hospital in Taiwan from 1 January 2009 to 31 December 2015. The medical records of all patients with CO poisoning were carefully reviewed, and relevant data were abstracted into a standardised form. Univariate and multivariate logistic regression models were used to identify predictors of DNS after CO poisoning. Receiver operating characteristic (ROC) curve analysis was used to determine the ideal cut-off value for continuous variables that predict the development of DNS. Results. A total of 760 patients with CO poisoning were identified during the study period. Among them, 466 were eligible for the analysis of predictors of DNS. In multivariate analysis, Glasgow Coma Scale <9 (odds ratio [OR], 2.74; 95% confidence interval [CI], 1.21–6.21), transient loss of consciousness (OR, 3.59; 95% CI, 1.31–9.79), longer duration from CO exposure to ED presentation (OR, 1.05; 95% CI, 1.03–1.08), and corrected QT (QTc) prolongation (OR, 2.61; 95% CI, 1.21–5.61) were found to be associated with a higher risk of DNS. The area under the ROC curve (AUC) for QTc interval measured within 6 h after exposure best predicted the development of DNS, with a result of 0.729 (95% CI 0.660–0.791). Moreover, the best cut-off value of the QTc interval was 471 ms, with a sensitivity of 53.3% and a specificity of 85.1%. Conclusions. We identified several potential predictors of DNS following CO poisoning. Among them, QTc prolongation found within 6 h after exposure is a novel predictor of DNS, which may be helpful in the future care of patients with CO poisoning.

Brain stem and spinal cord demyelination due to acute carbon monoxide poisoning

2021 ◽  
pp. 247-253
Author(s):  
Yan Lv ◽  
Yv Zhang ◽  
Shuyi Pam ◽  
Keyword(s):  
Spinal Cord ◽  
Carbon Monoxide ◽  
Brain Stem ◽  
Carbon Monoxide Poisoning ◽  
Recovery Period ◽  
Extended Period ◽  
Severe Case ◽  
Co Poisoning ◽  
Secondary Demyelination ◽  
The Brain

Demyelination throughout the brain stem and spinal cord caused by acute carbon monoxide (CO) poisoning has not been previously reported. Magnetic resonance imaging (MRI) has revealed that acute CO poisoning primarily affects the subcortical white matter of the bilateral cerebral hemispheres and basal ganglia. Here we report the case of a patient with delayed neuropsychological sequelae (DNS) due to acute CO poisoning. A 28-year-old man was admitted to our department following a suicide attempt by acute CO poisoning. After a six-month pseudo-recovery period, he was diagnosed with DNS, with MRI evidence of demyelinating change of the bilateral cerebral peduncles. Demyelination was identified throughout the brain stem, expanding from the bilateral cerebral peduncles to the medulla oblongata, occurring approximately six months after poisoning. One and a half years after acute CO poisoning, demyelination of the cervical and thoracic spine was observed, most notable in the lateral and posterior cords. It is evident that previously published research on this topic is extremely limited. Perhaps in severe cases of acute CO poisoning the fatality rate is higher, leading to fewer surviving cases for possible study. This may be because a more severe case of acute CO poisoning would result in the higher likelihood of secondary demyelination. This research indicates that clinicians should be aware of the risk of secondary demyelination and take increased precautions such as vitamin B supplementation and administration of low-dose corticosteroids for an extended period of time in order to reduce the extent and severity of demyelination.

Epidemiological aspects and a current approach to the problem of carbon monoxide poisoning

2020 ◽  
Vol 6 (4) ◽  
pp. 4-9
Author(s):  
Sayit I. Indiaminov ◽  
Antonina A. Kim
Keyword(s):  
Carbon Monoxide ◽  
World Literature ◽  
Carbon Monoxide Poisoning ◽  
Epidemiological Data ◽  
Current Approach ◽  
Co Poisoning ◽  
Fatal Poisoning ◽  
Young Males ◽  
Causes Of Mortality ◽  
Mechanical Asphyxia

Background: Carbon monoxide (CO) poisoning is the leading cause of death from poisoning (accidental and intentional). The number of cases of CO poisoning is increasing day by day. Aims: The aim of the study was to analyze the epidemiological situation of CO poisoning and identify the urgent aspects of this problem. In the article, the author provided a retrospective analysis of 117 cases of CO poisoning, registered in a number of regional branches of the Republican Scientific and Practical Center of the Forensic Medical Examination of Uzbekistan, after he studied and analyzed the world literature on the epidemiology of CO poisoning. It has been revealed that fatal poisoning ranks third after mechanical injuries and mechanical asphyxia and constitutes 6.3% (513 cases) in the range of deaths by violence (8078 cases). Therefore, CO poisoning is considered as one of the most prevailing (51%) causes of mortality. Conclusion: This is a global problem, with young males at risk. Further studies on the current clinical and forensic aspects of CO poisoning are required, and the necessity for regular analysis of epidemiological data for taking comprehensive measures to prevent CO poisoning is emphasized.

scholarly journals Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022737 ◽  
Author(s):  
Ai Tashiro ◽  
Kayako Sakisaka ◽  
Etsuji Okamoto ◽  
Honami Yoshida
Keyword(s):  
Regression Analysis ◽  
Mortality Rate ◽  
Child Mortality ◽  
Coastal Zone ◽  
Ecological Study ◽  
Mortality Rates ◽  
Population Based ◽  
North Eastern ◽  
Infant And Child Mortality ◽  
Before And After

ObjectivesTo examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011.DesignA population-based ecological study using publicly available data.SettingTwenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi). Participants: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008–2010) and after GEJET (2012–2014).ResultsBetween 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (β=−189.9, p=0.02) and public health nurses (β=−1.7, p=0.01) was negatively associated with mortality rate per person in 2011.ConclusionsIn 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.

scholarly journals Carbon Monoxide Poisoning Effectively Treated with High-flow Nasal Cannula

2019 ◽  
Vol 4 (1) ◽  
pp. 42-45
Author(s):  
Patrick Lee ◽  
Steven Salhanick
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
High Flow ◽  
Nasal Cannula ◽  
The Novel ◽  
Co Poisoning ◽  
High Flow Nasal Cannula ◽  
Disease States ◽  
Cohb Level ◽  
Potential Option

Carbon monoxide (CO) poisoning is typically treated by administration of oxygen via non-rebreather mask (NRB). High-flow nasal cannula (HFNC) is an alternative to NRB in a variety of disease states. We report a case of the novel use of HFNC in the treatment of acute CO poisoning. A 29-year-old man presented with a carboxyhemoglobin (COHb) level of 29.8%. He was treated with HFNC, and COHb levels declined to 5.4% in 230 minutes. Given several theoretical advantages of HFNC relative to NRB, HFNC is a potential option for use in the treatment of CO poisoning.

Evaluation of oxidative stress and antioxidant parameters in children with carbon monoxide poisoning

2019 ◽  
Vol 38 (11) ◽  
pp. 1235-1243
Author(s):  
O Teksam ◽  
S Sabuncuoğlu ◽  
G Girgin ◽  
H Özgüneş
Keyword(s):  
Oxidative Stress ◽  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
Venous Blood ◽  
Treatment Modalities ◽  
Control Group ◽  
Co Poisoning ◽  
Erythrocyte Catalase ◽  
Significant Difference ◽  
Before And After

Objective: In this study, we aimed to investigate oxidative stress and antioxidant parameter levels in patients with carbon monoxide (CO) poisoning. Methods: The study was conducted prospectively between March 1, 2015 and April 30, 2016 in the pediatric emergency department. Eligible patients included children aged 0–18 years old with a diagnosis of CO poisoning. To determination of oxidative stress and antioxidant parameter levels, venous blood with heparinized and urine samples were drawn during the admission and after normobaric oxygen (NBO) and hyperbaric oxygen (HBO) treatment. Results: Forty-seven children with CO poisoning for study group and 29 patients as control group were included to the study. Sixteen patients treated with HBO. Basal plasma malondialdehyde levels were found to be significantly higher in the CO poisoning group when compared with the control group ( p = 0.019). There is no significant difference in oxidative stress and antioxidant parameter levels except erythrocyte catalase enzyme levels in patients treated with NBO when comparing before and after NBO treatment ( p > 0.05). Decreasing of basal erythrocyte catalase enzyme levels were found statistically significant after NBO treatment ( p = 0.04). There was no significant difference in oxidative stress and antioxidant parameter levels in patients treated with HBO before and after therapy ( p > 0.05). Conclusions: CO poisoning is associated with increased lipid peroxidation in children immediately after the poisoning. However, both treatment modalities including NBO or HBO do not have a significant effect on oxidative stress or antioxidant parameter levels.

scholarly journals Storm-Related Carbon Monoxide Poisoning

2013 ◽  
Vol 19 (3) ◽  
pp. 188-199 ◽  
Author(s):  
Scott A. Damon ◽  
Jon A. Poehlman ◽  
Douglas J. Rupert ◽  
Peyton N. Williams
Keyword(s):  
Carbon Monoxide ◽  
Carbon Monoxide Poisoning ◽  
The United States ◽  
Attitudes And Beliefs ◽  
Matrix Approach ◽  
Co Poisoning ◽  
Protective Behaviors ◽  
Home Safety ◽  
Severe Storms ◽  
Summer Storm

Carbon monoxide (CO) poisonings in the United States consistently occur when residents improperly use portable gasoline-powered generators and other tools following severe storms and power outages. However, protective behaviors—such as installing CO alarms and placing generators more than 20 feet away from indoor structures—can prevent these poisonings. This study identified knowledge, attitudes, and beliefs that lead consumers to adopt risk and protective behaviors for storm-related CO poisoning and post-storm generator use. Four focus groups (32 participants in total) were conducted with generator owners in winter and summer storm-prone areas to explore home safety, portable generator use, CO poisoning knowledge, and generator safety messages. Discussions were transcribed, and findings analyzed using an ordered meta-matrix approach. Although most generator owners were aware of CO poisoning, many were unsure what constitutes a safe location for generator operation and incorrectly stated that enclosed areas outside the home—such as attached garages, sheds, and covered porches—were safe. Convenience and access to appliances often dictated generator placement. Participants were receptive to installing CO alarms in their homes but were unsure where to place them. These findings suggest a deficit in understanding how to operate portable generators safely and a need to correct misconceptions around safe placement. In terms of behavioral price, the simple installation and maintenance of inexpensive CO alarms may be the most important strategy for ultimately protecting homes from both storm-related and other CO exposures.

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