Temporal trends and demographic risk factors for hospital admissions due to carbon monoxide poisoning in England
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Published version
OA Location
Author(s)
Type
Journal Article
Abstract
Unintentional non-fire related (UNFR) carbon monoxide (CO) poisoning is a preventable cause of morbidity and mortality. Epidemiological data on UNFR CO poisoning can help monitor changes in the magnitude of this burden, particularly through comparisons of multiple countries, and to identify vulnerable sub-groups of the population which may be more at risk. Here, we collected data on age- and sex- specific number of hospital admissions with a primary diagnosis of UNFR CO poisoning in England (2002–2016), aggregated to small areas, alongside area-level characteristics (i.e. deprivation, rurality and ethnicity). We analysed temporal trends using piecewise log-linear models and compared them to analogous data obtained for Canada, France, Spain and the US. We estimated age-standardized rates per 100,000 inhabitants by area-level characteristics using the WHO standard population (2000–2025). We then fitted the Besag York Mollie (BYM) model, a Bayesian hierarchical spatial model, to assess the independent effect of each area-level characteristic on the standardized risk of hospitalization. Temporal trends showed significant decreases after 2010. Decreasing trends were also observed across all countries studied, yet France had a 5-fold higher risk. Based on 3399 UNFR CO poisoning hospitalizations, we found an increased risk in areas classified as rural (0.69, 95% CrI: 0.67; 0.80), highly deprived (1.77, 95% CrI: 1.66; 2.10) or with the largest proportion of Asian (1.15, 95% CrI: 1.03; 1.49) or Black population (1.35, 95% CrI: 1.20; 1.80). Our multivariate approach provides strong evidence for the identification of vulnerable populations which can inform prevention policies and targeted interventions.
Date Issued
2020-07-01
Date Acceptance
2020-04-23
Citation
Preventive Medicine, 2020, 136
ISSN
0091-7435
Publisher
Elsevier
Journal / Book Title
Preventive Medicine
Volume
136
Copyright Statement
© 2020 Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Sponsor
Medical Research Council (MRC)
Public Health England
Grant Number
MR/L01341X/1
6509268
Subjects
Age standardisation
Carbon monoxide
Epidemiology
Ethnicity
Hospital Episode Statistics
Incidence risk ratio
International comparison
Prevention policies
Sociodemographic status
1106 Human Movement and Sports Sciences
1117 Public Health and Health Services
Public Health
Publication Status
Published
Article Number
ARTN 106104
Date Publish Online
2020-04-27