Power Outages and Carbon Monoxide Poisoning in Children

INTRODUCTION: Carbon monoxide (CO) is a colorless, odorless, and nonirritating gas that can result in health impacts ranging from mild headaches to death. Children are uniquely vulnerable to CO poisoning. Power outages may increase the risk of CO exposure through improper generator use. METHODS: We used community-level power outage data from 2017 to 2020 and CO emergency department visits among children <18 from the Statewide Planning and Research Cooperative System (SPARCS) in New York State (NYS). We evaluated all-scale (≥1% of a community without power) and large-scale (≥20% of a community without power) outages and their impact on CO poisoning on the day of initial outage exposure and the 3 following days (lag day 0 through lag day 3) in a case-crossover study design. RESULTS: We identified 917 cases of CO poisoning and an incidence rate of 5.6 per 100 000 person-years in NYS from 2017 to 2020. The incidence rate of CO poisoning was highest among children aged 5 years or younger (7.8 per 100 0000 person-years) and among Black children (9.1 per 100 000 person-years). Four hours without power increased the odds of a pediatric CO poisoning ED visit on the day of exposure by ≥50% for all-scale and ≥150% for large-scale outages. Associations were stronger in urban vs rural areas. CONCLUSION: Although CO poisoning is a rare cause of pediatric ED visits in NYS, it is preventable. Outages substantially increased the odds of CO poisoning-related ED visits among children and should be regarded as an important CO poisoning risk factor.