Carbon Monoxide Poisoning in Kuwait: A Five-Year, Retrospective, Epidemiological Study

Abstract

Background: Carbon monoxide (CO) poisoning is a major public health concern and a common cause of death worldwide. However, to our knowledge, no studies have been conducted on CO poisoning exposure and mortality in Kuwait. Objectives: Using epidemiological and forensic data analysis, we investigated the prevalence and characteristics of CO poisoning-associated deaths in Kuwait over five years (2014–2018), using official police data. Methods: The Forensic Toxicology Laboratory analyzed 203 blood specimens of deceased individuals for potential CO poisoning during the study period. We obtained demographic information of the deceased and other information regarding the source of the CO, the type of death and the seasonal and geographical distribution of fatalities. The percentage of carboxyhemoglobin (COHb%) was assessed using a CO-oximeter. Results: CO poisoning was confirmed in ~29% (59 cases) of the analyzed specimens, of which CO poisoning was accidental in the majority of cases (~95%) and homicidal in the remaining of cases (~5%), with no reported suicides. The five-year cumulative mean of COHb% in the blood specimens of the 59 confirmed cases was ~63%. Most of the deceased were males (~68%). The mean age of male and female victims per year were similar (~23–38 years). Fatalities were more common (~44%) during the winter (December–February). Uncontrolled home fires and coal stoves contributed to the primary sources of CO poisoning at 61% and 22%, respectively. Recommendations: Based on our findings, we propose that the local government should mandate the installation of smoke alarms and CO detectors in residential settings and endorse health education, informing the local population about the causes of fire and potential for CO poisoning, with an emphasis on prevention. Practical measures that can be applied include proper installation and regular maintenance of home-heating appliances and appropriate ventilation. The present study could greatly benefit the government in directing efforts toward decreasing CO poisoning incidents in Kuwait in the future.

A patient with toxic encephalopathy associated with acute carbon monoxide poisoning–A clinical case

“…The clinical manifestations of CO intoxication are often nonspecific and depend on several factors, including the concentration of inspired CO, the duration of exposure and the overall health status of the individual (pulmonary ventilation, physical condition, and the rate and efficiency of breathing) [2]. The average blood concentration of COHb varies among individuals.…”

“…When the average blood concentration of COHb reaches 30%-50%, increases in respiratory and heart rates, syncope, motor paralysis and confusion are observed. Beyond 50%, COHb is considered lifethreatening [2].…”

Meta-analysis of the effectiveness and safety of Xingnaojing and naloxone in the treatment of carbon monoxide poisoning

“…Therefore, active and effective treatment measures should be taken in time to enable the patients to regain consciousness in a short time, thereby significantly improving the prognosis of the patients. [1,2] For patients with carbon monoxide poisoning, routine prehospital emergency measures are often used for clinical treatment. However, a large number of clinical studies have shown that the therapeutic effect, rescue success rate and patient prognosis of conventional prehospital emergency measures are still not clinically satisfactory.…”

“…Therefore, active and effective treatment measures should be taken in time to enable the patients to regain consciousness in a short time, thereby significantly improving the prognosis of the patients. [ 1 , 2 ]…”

Carbon Monoxide Poisoning was Associated With Lifetime Suicidal Ideation: Evidence From A Population-Based Cross-Sectional Study in Hebei Province, China

“…Carbon monoxide poisoning (CMP), mainly caused by accidences [ 4 , 5 ], was a frequent cause of acute toxicity with high morbidity and mortality worldwide [ 6 , 7 ]. Previous studies had found that nervous system disorders, including sleep initiation and maintenance disorders, tension-type headache, occur in over half of the patients within the first years after CMP [ 8 ].…”