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About CO Poisoning Data

co poisoning

Tracking carbon monoxide, or CO, poisoning involves collecting data about the number of deaths, hospitalizations or emergency room visits due to CO poisoning.

This page provides general information about carbon monoxide data and measures developed by the Iowa Public Health Tracking program. Contact Us for more information about these data.

Information on this page:

What do these data tell us?

  • The numbers and rates of unintentional carbon monoxide (CO) poisoning hospitalizations, emergency department (ED) visits, or deaths by year, gender, or age group in Iowa.
  • The numbers and rates of unintentional CO poisoning hospitalizations, emergency department (ED) visits, or deaths based on if the CO poisoning was related to a fire, non-fire, or undetermined exposure.
  • If a measure is going up or down over time.
  • If a segment of a population is at higher risk for hospitalization, a visit to the ED, or death resulting from unintentional CO poisoning in Iowa.

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How can we use these data?

  • To inform the public about unintentional CO poisoning hospitalizations, ED visits, and deaths in Iowa.
  • State and local partners can use these data for program planning and evaluation.

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What can these data not tell us?

  • What the source of exposure is for CO poisoning
  • The total burden of CO poisoning in a population
  • Information about cases where the CO exposure was intentional (suicide, assault).
  • The number of people hospitalized or who visited the ED for CO poisoning. Because personal identifiers are removed from the hospital discharge data before analysis, individuals who have multiple hospitalizations cannot be identified.

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What are the sources of the data?

  • Hospitalization and emergency department data are collected by the Iowa Hospital Association on behalf of IDPH in accordance with Iowa Code section 135.166.
  • Deaths data are collected along with other vital events such as births and marriages. In Iowa, official registration of all vital events are recorded and maintained by local registrars located in county recorders offices, and with the IDPH Bureau of Vital Statistics.
  • Bridged-race population estimates from the National Center for Health Statistics and US Census. Data from 2000 to 2009 are based on intercensal population estimates and 2010-most current year are based on the postcensal population estimates.

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What time period of data is available?

  • The Iowa Public Health Tracking portal displays hospitalization data from the year 2000 through the most recent year of data available.
  • The Iowa Public Health Tracking portal displays Emergency Department visit data from the year 2003 through the most recent year of data available.
  • There is usually a two-year lag period before hospitalization and emergency department visit data are available.
  • The Iowa Public Health Tracking portal displays mortality data from the year 2000 through the most recent year of data available.
  • Mortality measures are published on the IPHT portal annually following the release of population estimates. This creates a six-month lag before data are available.

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How are CO poisoning hospitalizations, emergency department (ED) visits, and deaths identified?

  • Hospitalizations are defined as Iowa residents who are discharged from a hospital in Iowa.
  • Emergency Department visits are defined as Iowa residents who are treated and released or subsequently admitted to a facility in Iowa.
  • CO poisoning hospitalizations/ED visits are defined as having a diagnosis of acute, unintentional CO poisoning
  • CO poisoning is defined as the International Classification of Disease 9th Revision, Clinical Modification (ICD-9-CM) codes that begin with 986.
  • CO poisoning is defined as the International Classification of Disease 10th Revision, Clinical Modification (ICD-10-CM) codes that begin with T58.
  • Additional diagnosis code detail is used to exclude cases of intentional exposure, and classify the exposure as fire, non-fire, or undetermined.
  • Deaths are defined as Iowa residents with ICD-10 code T58 (toxic effect of CO) listed as a contributing cause of death on the death certificate record, and uses additional contributing cause of death codes listed to exclude cases of intentional exposure, and classify the exposure as fire, non-fire, or undetermined.

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What is the difference between a number and a rate, and how to use them:

Number:

  • If you want to understand the magnitude or how big the overall burden is, then use the number.
  • The number indicates the total number of hospitalizations, ED visits, or deaths, but not the number of unique individuals hospitalized or admitted to the ED.
  • To protect an individual's privacy, counts of 5 or less are suppressed.

Crude Rate:

  • If you want to understand the probability or what is the underlying risk in a population, then use a rate.
  • In our analysis a rate is calculated using a numerator, the number of CO poisoning hospitalizations, ED Visits, or deaths during a period of time, divided by a denominator, the number of people in a population during the same period of time. This fraction is then multiplied by 100,000 to provide a more recognizable value.
  • To protect an individual's privacy, rates based on counts of 5 or less are suppressed.

Age-adjusted rate:

  • Age-adjusted rates are useful when comparing the rates of two population groups that have different age distributions.
  • A weighted average, called the direct method, is used to adjust for age in this analysis. Age specific rates in a given population are adjusted to the age distribution in a standard population by applying a weight. The U.S. 2000 Standard population is used as the basis for weight calculations.
  • To protect an individual's privacy, rates based on counts of 5 or less are suppressed.

Age-specific rate:

  • A rate of an event (such as disease or death) measured within a particular age group. It is similar to a crude rate but is calculated within an age group (e.g. an age-specific rate of asthma hospitalizations in adults 35-44 years of age).
  • To protect an individual's privacy, rates based on counts of 5 or less are suppressed.

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What are the limitations of the data?

  • Symptoms of CO poisoning are nonspecific and can be easily misdiagnosed, resulting in uncounted hospitalizations or ED visits. CO poisoning deaths may be misclassified and attributed to other causes.
  • Since only those with the most severe or acute symptoms of CO poisoning are hospitalized, treated at emergency departments, or die, these data are not appropriate for estimating the total burden of CO poisoning in a population.
  • Multiple hospital or emergency department admissions by the same patient cannot be identified, and are not excluded.
  • Iowa residents discharged from hospitals in surrounding states are not included, so hospitalization and emergency department visit rates for counties in which residents are likely to receive care in a surrounding state may be underestimated. Rates for counties in which residents are likely to visit hospitals that do not submit data to the Iowa Hospital Association (e.g., Veteran's Administration, Indian Health Services hospitals, and institutionalized populations) may also be artificially low.
  • There is usually a two-year lag period before hospitalization and ED data are available.

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Where can I find more technical information about the data?

More detailed documentation of the carbon monoxide data can be found in the following documents:

Indicator Profiles

Emergency Department Visits for CO Poisoning pdf
Hospitalizations for CO Poisoning pdf
Mortality from CO Poisoning pdf

Descriptive Metadata

Emergency Department Visits for CO Poisoning pdf
Hospitalizations fo CO Poisoning pdf
Mortality from CO Poisoning pdf

Contact Us to learn more about carbon monoxide data, or any of the measures displayed on the Iowa Public Health Tracking Portal.

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