Injuries from Carbon Monoxide Ontario Injury
Poisoning in Ontario
This Ontario Injury Compass presents
emergency visit data for injuries related
to Carbon Monoxide (CO) Poisonings in
Ontario between 2011-2015, with an
emphasis on the latest year of available
data (2015) .
Rate per 100,000
Age
Children (0-9 years) and adults (20-44
years) were most vulnerable to injury
related to carbon monoxide poisoning
(Table 1) in 2015. Ontarians aged 25-44
years had the highest rate of ED visits
for these injuries (7.80 per 100,ooo),
followed by 20-24 year olds (7.75 per
100,ooo) and 0-9 year olds (6.94 per
100,ooo).
Sex
In 2015, males accounted for 56% of ED
visits related to carbon monoxide
poisoning. (Figure 2) Males had higher
numbers of ED visits compared to
females in every age group except for
Number of Visits
1000
10
6.79
800
600
5.32
6.78
8
6.03
4.71
6
400
200
0
4
705
632
920
927
831
2011
2012
2013
2014
2015
2
0
Year
TABLE 1. ED visits for CO Poisoning, age-specific rates, NACRS, Ontario, 2015
Age Group
0-9
ED Visit Rate
per 100,000
6.94
10-14
15-19 20-24
5.83
5.44
7.75
25-44
45-64
65-74
7.80
5.31
2.75
FIGURE 2. ED visits (counts) for CO Poisoning, by age group and sex, NACRS, Ontario, 2015
75+
18
20
65-74
14
20
Females (n = 362)
Males (n = 496)
89
45-64
Age group (years)
Risk Factors
Analysis and
discussion of injury
issues in the province
FIGURE 1. ED visits for CO Poisoning, counts and rates, NACRS, Ontario, 2011 - 2015
5-year Trend: 2011-2015
Considering the counts and rates for ED
visits over the 5 years from 2011 to
2015, the trend for injuries related to
carbon monoxide poisoning has
generally increased (Figure 1). ED visits
for these injuries increased by 13%,
from 705 in 2011 to 831 in 2015.
Ontario’s population increased by 4% in
the same time period. The crude rate
for ED visits based on annual
population estimates ranged from 5.32
per 100,000 in 2011 to 6.03 per 100,000
in 2015.
Issue 15
March 2017
ED Visit Rate
Between 2011-2015, there were more
than 4,000 emergency visits related to
Carbon Monoxide Poisoning in Ontario.
COMP SS
children between 10-14 years. Of
particular concern were males aged
25-44 years, with 1.47 times more CO
poisoning related ED visits than
females. (Figure 2)
ED Visit Count
Understanding the Issue
117
116
25-44
171
33
20-24
43
15-19
21
25
10-14
23
20
48
53
0-9
0
40
80
120
Number of ED Visits
160
200
75+
3.90
Prevention Strategies
Education
Carbon Monoxide (CO) is a colourless,
odourless, and tasteless gas that can
be deadly. Common sources of carbon
monoxide in and around the home
include fuel-burning appliances such as
furnaces, gas or wood fireplaces, hot
water heaters/boilers, stoves,
barbeques, portable fuel-burning
heaters, lawnmowers, generators as
well as automobiles. Low-level shortterm exposure to CO can cause
symptoms similar to the flu, just
without the fever. These symptoms
include headache, nausea, tiredness,
shortness of breath and/or impaired
motor function. Prolonged exposure can
lead to dizziness, chest pain, poor
vision and difficulty thinking while
high-level exposure can lead to brain
damage and/or death.2
Engineering
There are many changes one can make
to the immediate environment to
prevent CO poisoning.
• Install CO alarms around sleeping
area of the home, especially in
the vicinity of fuel-burning
appliances or the garage. Replace
batteries to ensure that the CO
alarm is functional at all times.3
• Maintain all fuel burning
appliances in proper working
condition and have them
inspected regularly by a qualified
professional to prevent hazardous
CO emission.3
Rate per 100,000
Number of Visits
9.79
250
10
7.64
200
5.77
150
5.48
8
6.33
4.56
100
4
50
0
6
237
145
Central East Central West
114
78
123
129
Eastern
Northern
South West
Toronto
2
ED Visit Rate
Among the 6 public health regions in
Ontario, the Central East region had the
highest count of 237 ED visits related to
carbon monoxide poisoning in 2015,
followed by Central West at 145 and
Toronto at 129. (Figure 3) While the
Northern region accounted for the
lowest ED visit count (78), crude rate
analysis reveals that it had the highest
rate of ED Visit Rate at 9.79 per 100,000
of the population. (Figure 3)
FIGURE 3. ED visits for CO Poisoning, by Public Health Regions, NACRS, Ontario, 2015
ED Visit Count
Regional Distribution
0
Public Health Regions
•
CO poisoning related injuries and
deaths spike each winter in
Canada. Ensure proper ventilation
within and outside the home,
when using a fuel-burning
appliance, and avoid idling the car
inside a garage.3
Enforcement
Bill 77 also known as the Hawkins Gignac Act [Carbon Monoxide Safety]
requires the use of CO alarms in all
homes in Ontario. The amended Ontario
Fire Code of 2014 now includes requirements to lessen the risk created
by the presence of unsafe levels of CO
within single dwelling and multi-unit
buildings. Learn more here. Failure to
comply with CO alarm requirements
outlined in the Ontario Fire Code could
result in a ticket of $360, or a fine of up
to $50,000 for individuals and $100,000
for corporations.4
Methodology
ED visit data were obtained from the
National Ambulatory Care Reporting
System (NACRS) at CIHI. Data are from
calendar year 2015 (January 1, 2015 December 31, 2015). These data, as well
as population estimates for calculating
rates, were accessed using IntelliHEALTH
ONTARIO through the Ministry of Health
and Long-Term Care. ICD-10-CA coding
was used to isolate carbon monoxide
poisoning (T58).
References
1. Newsroom: Government of Ontario.
Backgrounder Carbon Monoxide Awareness
Week. Retrieved from: https://
news.ontario.ca/mcscs/en/2015/11/carbonmonoxide-awareness-week-1.html
2. Health Canada. (2016). Prevent Carbon
Monoxide Poisoning. Retrieved from:
https://www.canada.ca/en/health-canada/
services/air-quality/indoor-aircontaminants/keep-carbon-monoxide-outyour-home.html
3. Parachute. (n.d.). Home Safety: Around the
House. Retrieved from: http://
www.parachutecanada.org/injury-topics/
item/home-safety-around-the-house
4. Ontario Ministry of Community Safety and
Correctional Services. Carbon Monoxide
Alarm Questions and Answers. Retrieved
from: http://www.mcscs.jus.gov.on.ca/
english/FireMarshal/
CarbonMonoxideAlarms/
QuestionsandAnswers/
OFM_COAlarms_QandA.html
Suggested citation: Ravikumar, S. (2017). Injuries
from Carbon Monoxide Poisoning in Ontario. Ontario
Injury Compass, Issue 15, March 2017. Toronto:
Parachute.
Produced by the
Ontario Injury Prevention Resource Centre
Operated by Parachute
150 Eglinton Ave. E., Suite 300
Toronto, ON M4P 1E8
P: 647-776-5100 TF: 1-888-537-7777
[email protected]
www.oninjuryresources.ca
www.parachutecanada.org
The Ontario Injury Prevention Resource Centre is supported by Public Health Ontario, the Ministry of Health and Long-Term Care and the Province of Ontario. The views expressed in this publication do not necessarily reflect the views of Public Health Ontario, the Ministry of Health and Long-Term Care or the Province of Ontario.