Disaster‐related carbon monoxide poisoning after the Great East Japan Earthquake, 2011: a nationwide observational study

Abstract

Aim To investigate disaster‐related carbon monoxide (CO) poisoning after the Great East Japan Earthquake using a nationwide inpatient database in Japan. Methods This was a retrospective cohort study. We identified adult patients with CO poisoning who were registered in the Japanese Diagnosis Procedure Combination inpatient database from 2010 to 2017. We evaluated trends in the numbers of patients with CO poisoning each month from disaster (Tohoku region) and non‐disaster areas. In the disaster area, we compared the numbers of patients with CO poisoning during pre‐ and post‐earthquake periods. We also compared the numbers of CO poisonings after the earthquake (<30 days) and 1 year later. Results Eligible patients (n = 7,814) were categorized into disaster area (n = 988) and non‐disaster area (n = 6,826) groups. The numbers of CO‐poisoned patients in the non‐disaster area showed a seasonal variation, and there was a significant peak registered on March 11 in the disaster area. In the disaster area, the number of patients with CO poisoning in the post‐earthquake period was significantly higher than that in the pre‐earthquake period (135 versus 18; odds ratio, 7.50; 95% confidence interval, 4.59–12.3). The number of patients in the post‐earthquake period was also significantly higher than that on April 9, 2012, which was one month after the annual follow‐up (135 versus 10; odds ratio, 13.5; 95% confidence interval, 7.10–25.7). Conclusion This study showed that CO poisoning significantly increased in the affected area after the Great East Japan Earthquake, underlining the importance of providing information regarding the hazard of earthquake‐related CO poisoning.

Development and Validation of a Novel Method for Converting the Japan Coma Scale to Glasgow Coma Scale

“…The JCS is widely used not only in clinical practice, but also in countless clinical studies in Japan. 5 – 7 Previous studies have demonstrated that the JCS level was beneficial in predicting in-hospital mortality in trauma patients. 3 , 4 Another study revealed that the JCS was associated with activity of daily living at 30 days after stroke and mortality in stroke patients.…”

“…In addition to this, large-scale Japanese medical databases, including nationwide administrative claims and discharge data, often contain the JCS scores as an indicator of consciousness level instead of the GCS. 5 – 7 However, there are no validated methods for converting JCS to GCS scores. Due to the lack of a validated conversion method, the findings reported in clinical research conducted in Japan are often discounted overseas.…”

The diagnostic accuracy of carbon monoxide pulse oximetry in adults with suspected acute carbon monoxide poisoning: a systematic review and meta-analysis

“…In a mass COP event that occurred in Switzerland, SpCO measurement was integrated with symptoms (e.g., transient loss of consciousness) and history (e.g., known pregnancy) in order to develop a rapid triage system that allowed for the identification of patients requiring transport to an HBO center, transport to a general hospital, or who could be treated on-site or directly discharged (21). SpCO measurement could also be of value in mass COP events following an abrupt power outage (e.g., as a result of storms, floods, and earthquakes) and the consequent use of improvised heating or burning devices (22,23).…”

Power outages and pediatric unintentional injury hospitalizations in New York State

“…4 While weather events affect energy infrastructure, access to reliable and affordable energy, or energy security, is also closely intertwined with individuals' vulnerability to climate change. 5 Increasingly, these outage events have been linked to various adverse health effects, including temperature-related illness, 6 increased rates of carbon monoxide poisoning, 7,8 and disruption of electricity-dependent durable medical equipment. 9 However, consistent with the dearth of research on pediatricspecific environmental health outcomes, few populationlevel studies evaluate the association between outages and children's health.…”