We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
From the Centers for Disease Control and Prevention | Morbidity and Mortality Weekly Report|

Notes From the Field: Carbon Monoxide Exposures Reported to Poison Centers and Related to Hurricane Sandy—Northeastern United States, 2012 FREE

JAMA. 2012;308(24):2560. doi:10.1001/jama.2012.114538.
Text Size: A A A
Published online

MMWR. 2012;44:905.

Hurricane Sandy made landfall as a post-tropical cyclone along the coast of southern New Jersey on Monday, October 29, 2012. In the wake of Sandy, state and federal public health agencies have observed an increase in the number of exposures to carbon monoxide (CO) reported to poison centers. CO is imperceptible and can cause adverse health effects ranging from fatigue and headache to cardiorespiratory failure, coma, and death.1 CO poisoning is a leading cause of mortality and morbidity in post-disaster situations, when widespread power outages occur and risky behaviors, such as improper placement of generators and indoor use of charcoal grills, increase.2-3

As of November 6, a total of 263 CO exposures related to Hurricane Sandy had been reported to poison centers in eight states: 80 in New York, 61 in New Jersey, 44 in Connecticut, 39 in Pennsylvania, 27 in West Virginia, eight in Virginia, three in Maryland, and one in Delaware. Four of the reported exposures, all in Pennsylvania, resulted from the use of a generator in a garage and were fatal. This likely is an underestimation of the total number of fatal cases; larger numbers of CO-related deaths have been reported in the media. Where symptom information was available (n = 182), the most frequently reported symptoms were headache (69 cases, 37.9%), nausea (44 cases, 24.2%), and dizziness (36 cases, 19.8%). For comparison, the total number of CO exposures reported to poison centers and related to Hurricane Irene during August 28–September 2, 2011, was 49.

CO exposures can be prevented by 1) placing generators as far from homes as possible, but also at a safe distance from any nearby dwellings; the recommended distance for generator placement outside a home is a minimum of 25 feet (7.6 m)3; 2) never using a generator, grill, camp stove, or other gasoline or charcoal-burning device inside a home, basement, garage, or outside near an open window; 3) never heating homes with a gas oven or by burning charcoal; 4) ensuring that fuel-burning space heaters are properly vented; 5) installing a battery-operated or battery back-up CO alarm in the home; and 6) leaving the building and dialing 911 if a CO alarm sounds, if CO poisoning is supected, or if any person begins to feel dizzy, light-headed, or nauseous. More information about CO poisoning is available at http://www.cdc.gov/co/guidelines.htm. For suspected cases of CO poisoning and other exposures, persons should call their regional poison center at 1-800-222-1222.

Reported by: Jacquelyn Clower, MPH, Cazador, Herndon, Virginia. Fred Henretig, MD, Jeanette Trella, PharmD, Childrens Hospital of Pennsylvania. Robert Hoffman, MD, Katherine Wheeler, New York City Dept of Hygiene and Mental Health; Angela Maxted, DVM, PhD, Charlene Weng, MS, Jian-Hua Chen, MD, Hwa-Gan Chang, PhD, Debra Blog, MD, New York State Dept of Health. Steven Marcus, MD, Bruce Ruck, PharmD, New Jersey Poison Information and Education System. Alvin Bronstein, MD, American Association of Poison Control Centers. Fuyuen Yip, PhD, Royal Law, MPH, Amy Wolkin, MSPH, Lauren Lewis, MD, Joshua G. Schier, MD, Div Environmental Hazards and Health Effects, National Center for Environmental Health, CDC. Corresponding contributor: Jacquelyn Clower, jclower@cdc.gov, 770-488-3700.

REFERENCES: 3 Available.




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic