Global, regional, and national mortality due to unintentional carbon monoxide poisoning, 2000-2021: results from the Global Burden of Disease Study 2021

Abstract

Background Unintentional carbon monoxide poisoning is a largely preventable cause of death that has received insufficient attention. We aimed to conduct a comprehensive global analysis of the demographic, temporal, and geographical patterns of fatal unintentional carbon monoxide poisoning from 2000 to 2021. Methods As part of the latest Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), unintentional carbon monoxide poisoning mortality was quantified using the GBD cause of death ensemble modelling strategy. Vital registration data and covariates with an epidemiological link to unintentional carbon monoxide poisoning informed the estimates of death counts and mortality rates for all locations, sexes, ages, and years included in the GBD. Years of life lost (YLLs) were estimated by multiplying deaths by remaining standard life expectancy at age of death. Population attributable fractions (PAFs) for unintentional carbon monoxide poisoning deaths due to occupational injuries and high alcohol use were estimated. Findings In 2021, the global mortality rate due to unintentional carbon monoxide poisoning was 0 center dot 366 per 100 000 (95 uncertainty interval 0 center dot 276-0 center dot 415), with 28 900 deaths (21 700-32 800) and 1 center dot 18 million YLLs (0 center dot 886-1 center dot 35) across all ages. Nearly 70 of deaths occurred in males (20 100 15 800-24 000), and the 50-54-year age group had the largest number of deaths (2210 1660-2590). The highest mortality rate was in those aged 85 years or older with 1 center dot 96 deaths (1 center dot 38-2 center dot 32) per 100 000. Eastern Europe had the highest age-standardised mortality rate at 2 center dot 12 deaths (1 center dot 98-2 center dot 30) per 100 000. Globally, there was a 53 center dot 5% (46 center dot 2-63 center dot 7) decrease in the age-standardised mortality rate from 2000 to 2021, although this decline was not uniform across regions. The overall PAFs for occupational injuries and high alcohol use were 13 center dot 6% (11 center dot 9-16 center dot 0) and 3 center dot 5% (1 center dot 4-6 center dot 2), respectively. Interpretation Improvements in unintentional carbon monoxide poisoning mortality rates have been inconsistent across regions and over time since 2000. Given that unintentional carbon monoxide poisoning is almost entirely preventable, policy-level interventions that lower the risk of carbon monoxide poisoning events should be prioritised, such as those that increase access to improved heating and cooking devices, reduce carbon monoxide emissions from generators, and mandate use of carbon monoxide alarms. Funding Bill & Melinda Gates Foundation. Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.