For decades, carbon monoxide (CO) poisoning has been a public health concern. To strengthen efforts to combat such poisoning, a surveillance system for carbon monoxide poisoning in metropolitan France has been established by Santé publique France, in collaboration with the Directorate General for Health (DGS) and the French High Council for Public Health (CSHPF).

The specific objectives of the system are:

• to alert authorities to CO poisoning incidents so that immediate risk management measures can be taken by removing exposed individuals from the source(s) of CO emissions and to prevent recurrence by conducting technical investigations at the site of the poisoning and, where necessary, prescribing corrective work

• to describe the spatial and temporal distribution of CO poisoning cases, the circumstances under which these cases occur, and their risk factors

• to assess the overall effectiveness of the prevention policy by tracking the spatial and temporal trends of CO poisonings reported to the surveillance system

The implementation of the surveillance system has provided a better understanding of the risk factors for carbon monoxide poisoning and has contributed to the development of prevention messages. Discussions are currently underway to optimize its operation.

Epidemiological Surveillance of Carbon Monoxide Poisoning

Santé publique France coordinates the carbon monoxide poisoning surveillance system. The objective of the surveillance system is to collect data on the circumstances surrounding carbon monoxide poisonings and their severity. In this context, any report of suspected or confirmed carbon monoxide (CO) poisoning is promptly forwarded to local stakeholders in the surveillance system.

The scope of surveillance covers accidental or intentional (suicide attempts) poisonings occurring in the home, in public buildings, in the workplace, or in connection with the use of an internal combustion engine (including vehicles) or a combustion system, but excludes poisonings resulting from fires.

Two investigations may be initiated:

• a medical investigation, conducted in accordance with regional protocols by the Regional Health Agency (ARS) or the Poison Control and Toxicovigilance Centers (CAPTV);

• an environmental investigation in the case of accidental CO poisoning in the home or in a public building, conducted by environmental technicians from the ARS, municipal health and hygiene services, or the Central Laboratory of the Paris Police Prefecture (LCPP, for Paris and the Île-de-France region).

Preventive measures against carbon monoxide poisoning

Santé publique France’s analysis of the epidemiological data collected aims to guide public health initiatives to reduce the risk of carbon monoxide poisoning.
Santé publique France produces:

• information or alert notices addressed to the Directorate General of Health

• tools (brochures, infographics, audio files) to inform and raise awareness among the general public about the risk of carbon monoxide poisoning, help people understand the dangers of carbon monoxide, identify appliances and systems that may emit CO, and provide practical advice on how to prevent poisoning.