1 | Page 

# Non

- Fire Carbon Monoxide Deaths

Associated with the Use of Consumer Products

20 1 0 Annual Estimates

Matthew V. Hnatov

U.S. Consumer Product Safety Commission

Directorate for Epidemiology

Division of Hazard Analysis

4330 East West Highway

Bethesda, MD 20814

January 20 1 4

This analysis was prepared by the CPSC staff, and it has not been reviewed or approved by, and may not

necessarily reflect the views of, the Commission.2 | Page 

### Table of Contents

Executive Summary

................................ ................................ ................................ ................................ ....................... 3

Introduction

................................ ................................ ................................ ................................ ................................ ... 6

National Estimat es of Non

- Fire CO Poisoning Deaths Associated with Consumer Products

................................ ....... 7

Table 1: Estimated Non

- Fire Carbon Monoxide Poisoning Dea ths by Associated Fuel

- Burning Consumer

Product, 2001

– 2010

................................ ................................ ................................ ................................ ................. 11

Table 2: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associ ated with Consumer Products Organized

by Fuel Type, 2001

– 2010

................................ ................................ ................................ ................................ ........ 14

Table 3: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Engine

- Driven Tools, 2001

–

2010

................................ ................................ ................................ ................................ ................................ ......... 17

Figure 1: Comparison of Trends in Consumer Product

- Related Carbon Monoxide Deaths

– 2001 to 2010

.......... 18

Table 4: Number of Carbon Monoxide Poisoning Incidents Reported to CPSC by Number of Deaths Per Inciden t,

2001

– 2010

................................ ................................ ................................ ................................ ............................... 19

Table 5: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Location of Death, 2001−2010

................. 20

Table 6: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Month and Year of the Fatality, 2001

– 2010

................................ ................................ ................................ ................................ ................................ ................. 21

Figure 2: Estimated Number of Consumer Product

- Related Carbon Monoxide Deaths by Month of Death, 2001

–

2010

................................ ................................ ................................ ................................ ................................ ......... 22

Demographics of Fatalities from Non

- Fire Carbon Monoxide Poisoning Associated with the Use of Consumer

Products

................................ ................................ ................................ ................................ ................................ ....... 23

Table 7: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Age of Victim, 2001

– 2010

....................... 23

Table 8: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Gender of Victim, 2001

- 2010

.................. 24

Table 9: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Race/Ethnicity, 2001−2010

...................... 25

Table 10: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Population Density of Place of Death,

2001

– 2010

................................ ................................ ................................ ................................ ............................... 27

Table 11: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Geographical Region of Incident, 2001

–

2010

................................ ................................ ................................ ................................ ................................ ......... 28

Appendix A: Methodology

................................ ................................ ................................ ................................ ......... 29

Table A.1.a: Initial Categorizatio n for 2008 Data

................................ ................................ ................................ ... 31

Table A.1.b: Initial Categorization for 2009 Data

................................ ................................ ................................ .. 31

Table A.1.c: Initial Categorization for 2010 Data

................................ ................................ ................................ .. 31

Table A.2.a: Calculation Detail of the Final Computed 2008 Estimate of Non

- Fire CO Poisoning Deaths

Associated with Consumer Products

................................ ................................ ................................ ....................... 32

Table A.2.b: Calculation Detail of the Final Computed 2009 Estimate of Non

- Fire CO Poisoning Deaths

Associated with Consumer Products

................................ ................................ ................................ ....................... 33

Table A.2.c: Calculation Detail of the Final Computed 2010 Estimate of Non

- Fire CO Poisoning Deaths

Associated with Consumer Products

................................ ................................ ................................ ....................... 33

Table A.3: CO Fatality Cases and Weighting Factors Used to Calculate the Estimates for the Years 2001

– 2010 34

Appendix B: National Estimates of Consumer Product

- Related CO Poisoning Deaths, 1980 to 2010

...................... 36

Figure B.1: Estimated Non

- Fire CO Poisoning Deaths Associated with Consumer Products: 1980

– 2010

........... 36

Table B.1: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer Products,

1980−2010

................................ ................................ ................................ ................................ ............................... 37

Table B.2: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Generators, 1999−2010

... 38

Table B.3: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer Products, 1999

– 2010 (Excluding Generator

- Related Deaths)

................................ ................................ ................................ ........... 39

Table B.4: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Generators and Other

Engine

- Driven Tools,1999

– 2010

................................ ................................ ................................ ............................. 40

Table B.5: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer Products,

1999−2010 (Excluding Generator

- and Other Engine

- Driven Tool

- Related Deaths)

................................ .............. 41

Appendix C: Regional Definitions

................................ ................................ ................................ ............................. 42

References

................................ ................................ ................................ ................................ ................................ ... 433 | Page 

### Executive Summary

This report provides information about the estimated number of unintentional non

- fire

deaths attributed to carbon monoxide (CO) poisoning that were associated with the use of

consumer products in 20 1 0

, and companion statistics since 2001

. C onsumer P roduct S afety

C ommission staff continue s to receive reports of CO poisoning fatalities

, and the 2010 estimates

may change in subsequent reports.

Some of the key findings in this report are:

For 20 1 0 :

• T here were an estimated 1 6 1 unintentional non

- fire CO poisoning deaths associated with

consumer products under the CPSC’s jurisdiction. The estimated annual average from

200 8 to 20 1 0 was 1 6 2 deaths

. 1



### • Heating Systems were associated with the largest percentage of non

- fire CO poisoning

fatalities at 3 6 percent ( estimated 58 deaths)

. Engine

- Driven Tools (EDT)

- related CO

fatalities were associated with nearly as many deaths as Heating Systems at 3 5 pe rcent of

non

- fire CO poisoning fatalities ( 5 7 deaths) . F our other product cate gories : [ Charcoal

Grills or Charcoal ( 17 deaths), Gas Ranges, Ovens ( 5 deaths )

, Other Products ( 7 deaths),

and Multiple Products ( 1 6 deaths)]

, combined were associated with a total of 28 percent

. In 20 10 , t here were no reported deaths in the remaining three categories : Grills, Camp

Stoves ; Gas Water Heaters ; and Lanterns

– LP Fueled

.

Generators & Other Engine

- Driven Tools 2 

### :

• There were an estimated 63 CO fatalities in 20 1 0 associated with E ngine

- Driven T ools

, including 6 of the 1 6 Multiple Products deaths i n which an EDT and another potential

CO

- producing product was also in use. Forty

- nine of the 6 3 EDT

- related deaths

( including all six of the multiple product deaths that involved an EDT ) involved

generators. Since 2005, portable generators have been associated with more non

- fire CO

fatalities than any other consumer product under CPSC jurisdiction.

Heating Systems:

• Of the estimated 58 H eating S ystem s

- related fatalities in 20 1 0

, 8 8 percent ( 51 deaths )

involved gas heating equipment

. Natural gas heating equipment accounted for 33 percent

( 1 9 deaths ) of all fuel types of heating system

- related fatalities ; l iquefied petroleum (LP

or propane) gas heating accounted for 4 7 percent ( 27 deaths ) ; and an additional 9 percent

( 5 deaths ) were identified as unspecified gas heating. Oil

- (1 death) and kerosene

- fueled

( 1 death ) heating systems accounted for a combined total of 3 percent. Five additional

1 Not all of these fatalities are addressable by an action the CPSC could take; however, it was not the purpose of this

report to evaluate the addressability of the incidents but rather to update the estimates of the number of consumer

products associated w ith CO poisoning deaths.

2 Numbers presented in this document represent national estimates of unintentional non

- fire deaths attributed to CO

poisoning that were associated with the use of consumer products and not observed counts as presented in the CPSC

r eport Incidents, Deaths, and In

- Depth Investigations Associated with Non

- Fire Carbon Monoxide from Engine

Driven Generators and Other Engine

- Driven Tools, 1999

– 20 12

. http://www.cps c.gov/library/foia/foia12/os/cogenerators.pdf

.4 | Page 

### fatalities ( 9 percent) were associated with heating system s

, where the fuel type could not

be ascertained from CPSC records.

Location/Demographics:

• CPSC staff is aware of 1 1 0 fatal non

- fire CO incidents involving consumer products in

20 1 0

. Eight y

- six percent ( 9 5 deaths ) of these incidents involved a single fatali ty

.

• Eigh ty

- five percent (1 37 deaths ) of the estimated 1 6 1 CO deaths in 20 1 0 occurred in a

home location. Of these 1 37 estimated fatalities, 5 occurred in an external structure

, such

as a shed or detached garage , a nd 7 occurred in a nonfixed location domicile ( e.g.

, camper trailer or boat used as homes ) used as a permanent home, or a structure not

designed for habitation ( e.g.

, s ea

- l and shipping container , metal shed). A dditionally, an

estimated 1 1 percent ( 1 8 deaths ) occurred in tents, camper trailer s

, and other temporary

shelters.

• More CO fatalities occur red in the cold months of the year. In 20 1 0

, 66 percent ( 106 of

1 6 1 estimated deaths) occurred during the cold months of November, December, January,

and February.

• In the three most recent years of this report ( 200 8

– 20 1 0 )

, adults 45 years and older

comprised an annual average of 60 percent of all non

- fire

, consumer product

- related CO

deaths

, while this age group makes up about 3 9 percent of the U.S. population.

Conversely, children younger than 15 years of age accounted for an annual average of 3

percent of the yearly CO poisoning deaths

, while this age group makes up about 20

percent of the U.S. population.

• In 20 1 0

, 7 7 percent ( an estimated 1 24 deaths) of CO poisoning victims were males

, and

2 3 percent ( 3 8 deaths) were females

.

• There is some s tatistical evidence that the proportion of fatalities by race/ethnicity differs

from the proportions of race/ethnicity in the U.S. population in the 200 8 through 20 1 0

time frame

. The proportion of Hispa nic victims (irrespective of race) is significantly

lower than the proportion of Hispanic Americans in the U.S. population (9% versus

1 6 %)

, while the proportion of Black or African American victims was significantly

greater than the U.S. population ( 20 % versus 12%) during th is time period

.

• The proportion of all CO poisoning fatalities that occur red in small towns or isolated

rural locations ( 19 percent in 200 8 through 20 1 0 ) is larger th a n the proportion of the U.S.

population living in these area s ( 9 percent ). The disparity is even higher at sma ll town

rural isolated non

- home locations

, which account for 33 percent of all CO fatalities

occurring at non

- home locations.5 | Page 

### Historical Data:

• Regression models indicate that there is insufficient statistical evidence to support a

conclusion that the trend in non

- fire CO fatalities from 2001 to 20 1 0 is increasing ;

al though the short

- term trend since hitting a peak in 2005 through 2007 appears to be

declining slightly

.

• The CO poisoning 3

- y ear average mortality rate for 200 8 through 20 1 0 associated with

consumer products ( 5. 29 per 10 million population) i s approximately 2 2 percent greater

than the 3

- year average for 2000 (expressed as the midpoint year of the 3

- year period

1999 to 2001) of 4.3 4 per 10 million population . However, for all consumer products

, excluding generators and other non

- engine

- driven tool products, the 3

- year average

mortality rate has decreased by 27 percent from 3. 44 ( the 2000 3

- year average ) down to a

2. 52 3

- year ave rage mortality rate in 200 9 (the average rate for 200 8 through 20 1 0)

. Conversely, the 3

- year average mortality rate of CO poisoning from engine

- driven tools

during the same time period more than tripled , increasing from 0. 72 for 2000

, up to 2. 35

for 200 9

. Details are given in Appendix B of this report.

• The data indicate that e ngine

- driven tools and generators, in particular, have had a

substantial impact on the CO poisoning mortality rate involving consumer products

.6 | Page 

### Introduction

Carbon monoxide (CO) is a colorless, odorless, and poisonous gas that results from the

incomplete combustion of fuels

, such as natural or liquefied petroleum (LP) gas, gasoline, oil,

wood, coal, and other fuels. The health effects related to CO depend upon its concentrat ion in

blood, which in turn

, depends up on its concentration in air, an individual’s duration of exposure,

and an individual’s general health. Carbon monoxide combines with the body’s hemoglobin

(Hb) with an affinity about 250 times that of oxygen, forming carboxyhemoglobin (COHb) and

interfering with oxygen transport, delivery, and utilization. Generally, there are no perceptible

health effects or symptoms in healthy individuals at COHb levels below 10 percent. Symptoms

associated with blood levels at or above 10 percent COHb include : headache, fatigue, nausea,

and cognitive impairment. Loss of consciousness, coma, and death can occur at COHb levels

greater than 20 percent ; although for healthy adults

, CO fatalities typically require levels above

50 perc ent COHb

. 3



### Some symptoms of CO poisoning may mimic common illnesses, such as influenza or

colds; thus, there likely is a high incidence of initial misdiagnosis by physicians and victims

(Long and Saltzman, 1995). Frequently, p atients are unaware of exp osures, and health care

providers may not always consider CO poisoning a cause of such nonspecific symptoms. COHb

formation is reversible, as are some clinical symptoms of CO poisoning. However, some

delayed neurological effects that develop following se vere poisonings, especially those involving

prolonged unconsciousness, may not be reversible. Prompt medical attention is important to

reduce the risk of permanent damage.

Any fuel

- burning appliance can be a potential source of fatal or hazardous CO levels.

Fuels, such as natural and LP gas, kerosene, oil, coal, and wood can produce large amounts of

CO when there is insufficient oxygen available for combustion. Consumer products that burn

kerosene, oil, coal

, or wood (such as wood stoves, oil boiler s, and kerosene heaters) produce an

irritating smoke that can alert the victim to a potentially hazardous situation. Engine

- driven tools

(EDTs) powered by gasoline engines produce large amounts of CO

, even when they are run

where there is sufficient oxyge n available for combustion ; yet E ngine

- D riven T ool s may not

emit an irritating exhaust smoke

. Other fuels , such as charcoal briquettes and pressed wood

- chip

logs produce relatively smokeless fires, even at tim es of inefficient combustion. In these cases,

v ictims receive no obvious sensory warning that high CO levels are present. Another hazard

scenario is present when gas appliances are not vented properly or are malfunctioning. Natural

and LP gas burn more efficiently and cleanly

, compared with other f orms of fuel. In

circumstances of poor maintenance, inadequate ventilation, or faulty exhaust pathways, natural

and LP gas appliances may emit potentially lethal amounts of CO without any irritating fumes.

Again, many victims may be unaware of a potentia l problem.

3 Inkster S.E. Health hazard assessment of CO poisoning associated with emissions from a portable, 5.5 kilowatt,

gasoline

- powered generator . Washington, D.C.: U.S. Consumer Product Safety Commission, 2004.7 | Page 

### National Estimates of Non

- Fire CO Poisoning Deaths Associated with Consumer Products

The n ational e stimates presented in this report are based on death certificate records

obtained from 50 states, the District of Columbia, and New York City directly, augmented by

information collected in CPSC ’s In

- Depth Investigations (IDIs) and, to a lesser extent

, news

articles and Medical Examiner’s reports contained in the CPSC Injury or Potential Injury

Incident (IPII) database

. Death certificate data from some states

, for a partial year or even an

entire year

, can lag for months or even years and may not be available in time for use in this

report. The estimates presented in this report are based on reporting as of July 23, 2013 of

consumer product

- re lated CO poisoning fatalities that occurred through 20 1 0

. The National

Center for Health Statistics (NCHS) has records of every death certificate filed in the United

States and its territories. A comparison of CPSC records to NCHS records indicates that CPSC

records have data on about 7 7 percent of all the fatal CO poisoning deaths that occurred in 20 1 0

, in the United States. By comparison, f or the nine years covered in this report prior to 20 1 0

, CPSC records contain approximately 9 3 percent of all the f atal CO poisoning deaths that

occurred in the United States reported to NCHS. From this comparison, CPSC anticipates that

lagged reporting for incidents that occurred in 2010 will continue. Future reports should be

based on a higher percentage of the act ual number of CO fatalities as lagged data become

available to CPSC staff. Therefore, it is anticipated that the estimate s may change noticeably in

future reports as more data is obtained by CPSC. Appendix A of this report describes the

process used to g enerate the n ational es timates presented in this report.

During 2010, there were an estimated 161 CO poisoning deaths associated with the use of

a consumer product under the jurisdiction of the CPSC. C O poisoning deaths referred to in this

report do not include those where the CO gas resulted from a fire or a motor vehicle

, were

intentional in nature

, or were directly work related

.

Although there can be multiple factors contributing to a CO poisoning fatality, the source

of CO is virtually always a fuel

- burning product. As mentioned earlier, poor product

maintenance by professionals or consumers, inadequate ventilation, faulty exhaust pathways, and

poor user judgment in operating these products can result in fatal scenarios. CPSC staff

produces the CO e stimates by associated consumer products to identify product groups involved

in fatal CO scenarios and to monitor this distribution over time. It is within the individual,

product

- specific CPSC projects that additional analysis is done to consider whether

improvements are warranted in the areas of product design, ventilation safeguards, or user

information and education.

The annual CO estimates for the years 2001 through 20 1 0 are presented in two formats:

by product category (Table 1) and by product within fuel type (Table 2). The data are presented

as yearly estimates for each of the 1 0 years covered by this report and as an average of the most

recent 3

- year period (200 8 through 20 1 0 ). D ata collection was on ly partially complete for 20 1 0

, and e stimates for th i s year may change in the future when additional data become available

. T herefore, data for 2010 are reported using italic font in the tables

.

Estimated n umbers presented in this document represent national estimates of

unintentional non

- fire deaths attributed to CO poisoning associated with the use of consumer

products. Generator and other EDT death estimates would not be expected to match observed

fatali ty counts presented in this report or in the CPSC report

, “Incidents, Deaths, and In

- Depth

Investigations Associated with Non

- Fire Carbon Monoxide from Engine

- Driven Generators and8 | Page 

### Other Engine

- Driven Tools, 1999

– 20 1 2

. ”



### Table 1 (pages 10

− 11) presents th e consumer product distribution of CO poisoning

deaths. The estimate for Heating Systems , historically a large percentage of the consumer

product estimate, is broken down into heater system subcategories and is further distributed

among the various fuel types. Fatality estimates for t he Engine

- Driven Tools category w ere

further distributed between generators and other engine

- driven tools. The consumer product

estimate and product distributions were derived u sing the methodology described in Appendix A.

O f the estimated 1 6 1 CO poisoning deaths associated with a consumer product that

occurred between January 20 1 0 and December 20 1 0

, H eating S ystems were associated with 58

deaths ( 36 % of the total consumer product estimate). Of the 58 estimated deaths associated with

heating systems, the majority ( 8 8 % or 51 fatalities) involved g as heating systems

. A mong gas

heating systems, natural gas heating was associated with an estimated 1 9 dea ths ( 33 % of heating

system

- related deaths)

. Liquid Petroleum gas (LP gas) 4 

### heating was associated with an

estimated 27 deaths ( 4 7 % of heating system

- related deaths) ; and unspecified gas heating was

associated with an estimated 5 deaths ( 9 % of heating system

- related deaths). Oil

- fueled heating

w as associated with an estimated 1 death ( 2 % of heating system

- related deaths)

. There w as an

estimated 1 death ( 2 % of heating system

- related deaths) associated with a kerosene

- burning

heater. There are no reported wood

- , coal

- , or d iesel

- fueled heating system fatalities in the 20 1 0

data

. A dditional ly, in 20 1 0

, there w ere an e stimated 5 CO death s ( 9 % of heating system

- related

deaths) associated with heating system s with un sp e cified fuel sources

. Note that the estimates

for individual categories may not sum to that of the broader category due to rounding effects.

Of the estimated 1 9 deaths in 20 1 0 that were associated with natural gas heating systems,

all 1 9 involved installed furnaces

- 3 ( 16 % ) o f which were described as being a wall or floor

furnace

. Of the estimated 27 deaths in 20 1 0 that were associated with LP gas heating systems,

19 ( 70 % ) involved unvented portable propane heaters. These unvented portable propane heaters

were fueled by a propane tank and were not a component of an installed heating system.

Unvented portable propane heaters were either camping heaters that used disposable propane

tanks, 1

- pound propane bottles, or tank top heaters that used bulk tanks larg er than 1 pound.

Table 1 indicates that i n 20 1 0 , an estimated 17 CO deaths ( 11 % of the 1 6 1 total consumer

product estimate) were associated with charcoal or charcoal grills

─ this is the highest estimated

annual total during the 10 years that this report covers . A dditionally, in 2010, an estimated 5

deaths ( 3 %) were associated with gas ranges or ovens; an estimated 1 death ( 1 %) w as associated

with a coal

- burning fireplace ; an estimated 3 death s were associated with other LP gas

- fueled

product s ; and an estimated 3 deaths were associated with other unidentified consumer products

. Additionally, in 20 1 0 , an estimated 1 6 deaths were associated with multiple appliances ( 10 % of

the total consumer product estimate). The Multiple Product s category includes all incidents

where multiple fuel

- burning products were used simultaneously

, such that a single source of the

CO could not be determined

.

An estimated 5 7 CO poisoning deaths ( 3 5 % of the estimated total f o r 20 1 0 ) were

associated with the category of Engine

- Driven Tools , which includes generators, riding mowers

or garden tractors, snow blowers/throwers

, and other engine

- driven equipment . Additionally, 6

of the 1 6 Multiple Product fatalities were associated with a generator being used in conjunction

wi th another fuel

- burning product for an estimated total of 6 3 CO fatalities associated with the

4 In this document, references to liquid petroleum gas, or LP gas, also include p ropane and b utane gases, the two

primary components of LP gas.9 | Page 

### use of an engine

- driven tool ( 40 % of the estimated total for 20 1 0) . Generator

- associated deaths

comprise d the majority of this category. An estimated 4 7 CO poi soning deaths were associated

with a generator

, including all of the Multiple Product fatalities involving an engine

- driven tool

in 20 1 0 ( 7 3 % of all engine

- driven tool fatalities and 2 9 % of the total consumer product

estimate).

In recent years, the E ngine

- D riven T ools category has been associated with more CO

fatalities than any other category. The estimated average number of CO fatalities associated with

engine

- driven tool s ( 7 2 , not including multiple product incidents) for 2008 through 2010

, is

gre ater than the average number associated with heating system s ( 52 deaths). Beginning in

2005

, each year there has been a far greater number of CO fatalities associated with engine

driven tools than with heating systems , primarily due to an increase in gene rator

- related CO

fatalities

. In 2005, there were more than double the estimated numbers of CO fatalities related to

the use of generators from the previous year (88 versus 41 , respectively ). This may have been

due to the large number of power outages across parts of the country from a number of severe

hurricanes (including Hurricanes Katrina, Rita, and Wilma) and a series of snow/ice storms in

the Carolinas and the Midwest. The number of generator

- related CO fatalities in the subsequent

4 years remained greater than in any year prior to 2005. There have been an estimated combined

total of 501 engine

- driven tool

- related CO fatalities from 2005 through 20 1 0

, compared to 323

deaths combined for heating systems. From 2001 through 200 4

, there were 70 percent more

heating system

- related CO fatalities ( 316 ) than engine

- driven tool

- related fatalities ( 185 )

. (Note:

These figures exclude fatalities associated with multiple products because these possibly could

be categorized into both categories.) Stated differently , while heating system

- related CO

fatalities have dropped by 3 2 percent from an approximate estimated average of 7 9 per year from

2001 through 2004

, to an average of nearly 5 4 per year from 2005 through 20 1 0, the estimated

annual average number of engine

- driven

, tool

- related CO fatalities ha s increased by 8 3 percent

over the same time period

, from 46 to 84

. Notably, in 2010, the estimated number of heat ing

systems

- related CO de aths was approximately equal to the number of engine

- driven tools CO

deaths (58 versus 57, respectively).

Table 1 shows the estimated average annual number of CO poisoning deaths associated

with various consumer product s for 200 8 to 20 1 0 . The average yea rly total number of CO

deaths for this 3

- year period is estimated to be 1 6 2 (with a standard error of approximately 8

. 7 ).

The 95 percent confidence interval 5 

### for this estimated average ranged from 1 25 to 2 00 deaths.

Appendix B contains a graph and the data point values for the annual estimates of CO poisoning

deaths associated with a consumer product for 1980 through 20 1 0

.

The availability of d etailed information regarding the condition of products associat ed

with CO fatalities varie s widely. However, information collected often describe d conditions

regarding compromised vent systems, flue passageways, and chimneys for furnaces, boilers, and

other heating systems. Vent systems include the portion of piping that either connects the flue

outlet of the appliance and exhausts air to the outside through a ceiling or sidewall, or connect s

to a chimney. Some products had vents that became detached or were installed or maintained

improperly . Vents were also somet imes blocked by soot caused by inefficient combustion,

which

, in turn

, may have been caused by several factors, such as leaky or clogged burners, an

over

- firing condition, or inadequate combustion air.

5 The confidence interval is based on a t

- distribution with two degrees of freedom.10 | Page 

### Other conditions related to furnaces included comprom ised heat exchangers or filter

doors or covers that were removed or not sealed. Some products were old and apparently poorly

maintained

, such that there were several factors involved in generating and exacerbating the

amount of CO produced. Other inciden ts mentioned a backdraft condition, large amounts of

debris in the chimney, and the use of a product that was later red

- tagged by the utility company

(taken out of commission by the utility company and designated not to be turned on until

repaired).11 | Page 

### Table 1 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Associated Fuel

- Burning Consumer Product, 2001

– 20 1 0

2008

– 2010 +

Consumer Product Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

Total 1 62 100% 121 181 153 168 190 180 186 17 8 148 16 1

Heating Systems 5 2 3 2 % 71 93 67 85 51 49 66 58 41 5 8

Furnaces (inc l . Boilers) 25 1 5 % 26 47 29 43 14 30 29 29 16 30

Coal * * 1 1 * 1 * * * * * *

Liquid Petroleum (LP) Gas 3 2 % 7 16 3 8 1 9 * 3 1 6

Natural Gas 1 5 9% 10 21 19 23 6 19 20 18 10 16

Oil 2 1 % 3 3 1 * 2 * 5 1 3 1

Unspecified Gas 2 1% 1 1 2 4 2 * 4 2 1 4

Unspecified Fuel 3 2 % 3 4 4 8 3 2 * 5 1 3

Portable Heaters 1 4 9 % 17 26 25 20 23 14 17 13 8 20

Diesel * * * 1 * * * * * * * *

Kerosene 2 1% 1 4 5 4 2 3 3 4 * 1

Liquid Petroleum (LP) Gas 1 2 7 % 16 20 18 15 19 10 14 9 8 1 9

Natural Gas * * * * 2 * * * * * * *

Unspecified Gas * * * * * 1 1 * * * * *

Unspecified Fuel * * * * * * 1 1 * * * *

Wall/Floor Furnaces 5 3 % 18 9 4 6 2 2 9 3 6 5

Liquid Petroleum (LP) Gas 2 1 % 2 4 1 5 * * 4 1 5 1

Natural Gas 2 1 % 13 4 3 1 2 2 5 2 1 3

Oil * * 1 * * * * * * * * *

Unspecified Fuel < 1 < 1% 2 * * * * * * * * 1

Room/Space Heaters 5 3 % 9 10 8 12 8 1 6 5 9 1

Coal * * 3 * * 1 1 * * * * *

Liquid Petroleum (LP) Gas 3 2% 1 * 1 * * * 4 2 5 1

Natural Gas 1 1% 3 5 3 6 * 1 * 2 2 *

Wood 1 1% 1 1 2 * 2 * * 1 2 *

Unspecified Gas * * * 3 2 4 1 * 2 * * *

Unspecified Fuel * * * * * * 3 * * * * *

Unspecified Heater/System 4 2 % * 2 * 3 3 1 5 8 2 2

Liquid Petroleum (LP) Gas 1 1% * * * * * * 1 2 * *

Natural Gas * * * * * * * * 3 * * *

Unspecified Gas 1 1% * 1 * 2 * * * 2 1 1

Unspecified Fuel 2 1% * 1 * 1 3 1 1 4 1 1

Charcoal Grills, Charcoal 10 6% 10 11 8 3 6 10 8 7 7 1712 | Page 

### Table 1 (continued)

2008

– 2010 +

Consumer Product Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

Engine

- Driven Tools 7 2 4 4 % 21 52 56 56 102 104 79 8 3 76 5 7

Generators 6 1 38 % 20 42 49 41 88 85 68 7 6 64 4 3

Other Engine

- Driven Tools 11 7% 1 10 7 15 13 18 11 7 12 1 4

Gas Ranges or Ovens 3 2 % 9 3 3 4 6 * 6 * 4 5

Liquid Petroleum (LP) Gas < 1 < 1% 2 * * 1 1 * 1 * * 1

Natural Gas 2 1% 1 3 * 2 1 * 2 * 2 3

Unspecified Gas 1 1% 6 * 3 1 3 * 3 * 2 1

Gas Water Heaters 4 2 % * 1 7 2 6 4 2 6 5 *

Liquid Petroleum (LP) Gas 1 1% * * 3 1 2 * 1 1 2 *

Natural Gas 1 1% * 1 3 * * 3 * 1 1 *

Oil < 1 < 1% * * * * * * * 1 * *

Unspecified Gas 1 1% * * 1 1 3 1 1 1 1 *

Unspecified Fuel 1 1% * * * * * * * 2 1 *

Lanterns

- Liquid Petroleum (LP)

Gas Fueled 2 1% * 2 1 3 6 3 * 4 1 *

Grills, Camp Stoves * * 1 4 1 4 * 2 2 * * *

Kerosene * * * * * 1 * * * * * *

Liquid Petroleum (LP) Gas * * 1 4 1 3 * 1 1 * * *

Unspecified Fuel * * * * * * * 1 1 * * *

Other Products 5 3 % * 2 2 3 3 * 2 5 2 7

Chimney

– Unspecified Fuel * * * * * * 1 * * * * *

Fireplace

– Unspecified Gas * * * * * * * * 1 * * *

Fireplace

– Wood * * * 2 * 2 * * 1 * * *

Fireplace

– Coal < 1 < 1% * * * * * * * * * 1

Other Products

–

Liquid Petroleum (LP) Gas 2 1% * * 2 * 1 * * 3 1 3

Other Products

– Natural Gas < 1 < 1% * * * * 1 * * * 1 *

Unidentified Product 1 1% * * * 1 * * * * * 3

Unidentified Product

– LP Gas 1 1% * * * * * * * 2 * *

Multiple Products 1 3 8% 8 13 8 7 12 8 20 12 11 1 6

+ Data collection for 2010 is only partially complete and data are shown in italics . Italicized estimates may change in the future if more reports of fatalities are received.

* No reports received by CPSC staff.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC Injury or Potential Injury Incident File, CPSC In

- Depth Investigation File,

National Center for Health Statistics Mortality File, 2001

– 2010

. Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding.13 | Page 

### Table 2 (beginning on page 13) organizes the estimates by product with in fuel type. The

three major fuel types include : Gas

- Fueled Products (natural gas and liquid petroleum [LP

including propane and butane ] gas ); Solid

- Fueled Products (charcoal, coal

, and wood); and

Liquid

- Fueled Products (gasoline, kerosene

, and oil). Of these fuel types, Liquid

- Fueled

Products were associated with 63 of th e 1 6 1 ( 39 %) estimated CO fatalities in 20 10

. Gas

- Fueled

Products were associated with 69 (43%) estimated fatalities and Solid

- Fueled Products were

associated with 18 ( 11 %) estimated fatalities in the same time period, respectively. An

additional four ( 2 %) fatalities were associated with multiple products

, where there were two or

more different categories of fuel used. ( Multiproduct cases

, where the fuel types were the same

, are counted in their respective category summary. ) T here w ere also eight ( 5 %) f atalit ies in 20 1 0

associated with consumer products where the fuel type was unknown

.

In the Gas

- Fueled Products category, the majority of CO fatalities in 20 1 0 were

associated with heating

- related products. Of the estimated 69 gas

- fueled appliance fatalities in

20 10

, 50 ( 72 %) were associated with heating systems or heaters

, including furnaces, portable

heaters, wall or floor heaters

, room or space heaters , or fireplaces

. Additionally, of the estimated

seven fatalities in the Multip le Gas

- Fueled Products category

, all seven involved some type of

gas heater. Of the estimated 6 2 liquid

- fueled appliance

- related fatalities in 20 1 0

, 5 4 ( 8 7 %) were

associated with engine

- driven tools ( e.g.

, generators, lawn mowers /garden tractors , power

washers). Generators accounted for 4 0 of the estimated 6 2 fatalities ( 6 5 %) in the Liquid

- Fueled

Products category for 20 1 0

. Additionally, all of the estimated five fatalit ies in the Multiple

Liquid

- Fueled Products category also involved a genera tor.

In 20 1 0

, there were an estimated eighteen fatalities in the Solid

- Fueled Products

category

. Seven teen of these were associated with charcoal or charcoal grills and o ne with a

wood

- burning fireplace

. Additionally, t here were an estimated four CO fatalities associated with

multiple products of different fuel types

— all four involved portable heaters ( kerosene

- or LP

fueled )

.14 | Page 

### Table 2 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer Produ cts Organized by Fuel Type, 2001

– 2010

2008

– 2010 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

Total 162 100% 121 181 153 168 190 180 186 178 148 161

Gas

- Fueled Products 60 37% 66 92 70 87 53 51 80 58 53 69

Natural Gas 22 14% 28 35 30 32 10 26 30 28 17 21

Furnace (inc l . Boilers) 15 9% 10 21 19 23 6 19 20 18 10 16

Pool Heater * * * * * * 1 * * * * *

Portable Heater * * * * 2 * * * * * * *

Range/Oven 2 1% 1 3 * 2 1 * 2 * 2 3

Room/Space Heater 2 1% 3 5 3 6 * 1 * 3 2 *

Wall/Floor Furnace 2 1% 13 4 3 1 2 2 5 3 1 3

Water Heater 1 1% * 1 3 * * 3 * 1 1 *

Unspecified Heater * * * * * * * * 3 * * *

Other Appliance < 1 < 1% * * * * * * * * 1 *

Liquid Petroleum (LP) Gas 29 18% 30 47 31 37 30 23 26 31 23 34

Furnace (inc l . Boilers) 3 2% 7 16 3 8 1 9 * 3 1 6

Generator 1 1% * * * * * * * * * 3

Grill/Camp Stove * * 1 4 1 2 * 1 1 * * *

Lantern 2 1% * 2 1 4 6 3 * 4 1 *

Other Products 3 2% * * 1 * * * * 3 1 1

Portable Heater 12 7% 16 20 18 15 19 10 14 9 8 19

Range/Oven < 1 < 1% 2 * * 1 1 * 1 * * 1

Refrigerator < 1 < 1% * * 1 * 1 * * * * 1

Room/Space Heater 3 2% 1 * 1 * * * 4 3 5 1

Unspecified Heater/System 1 1% * * * * * * 1 3 * *

Wall/Floor Furnace 2 1% 2 4 1 5 * * 4 1 5 1

Water Heater 1 1% * * 3 1 2 * 1 1 2 *

Unspecified Gas 5 3% 7 5 8 15 11 1 11 3 5 6

Furnace (inc l . Boilers) 2 1% 1 1 2 5 2 * 4 2 1 4

Portable Heater * * * * * 1 1 * * * * *

Range/Oven 1 1% 6 * 3 1 3 * 3 * 2 1

Room/Space Heater * * * 3 2 4 1 * 2 * * *

Fireplace * * * * * * * * 1 * * *

Water Heater 1 1% * * 1 1 3 1 1 2 1 1

Unspecified Heater 1 1% * 1 * 2 * * * 1 1 *

Multiple Gas

- Fueled Products 6 4% 2 4 1 3 2 1 13 2 8 715 | Page 

### Table 2 (continued)

2008

– 2010 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

Liquid

- Fueled Products 80 49% 28 64 66 61 108 108 89 95 81 6 2

Gasoline

- Fueled 71 44% 21 52 56 56 102 104 78 82 77 5 4

Generator 60 37% 20 42 49 41 88 85 68 76 64 4 0

Other Engine

- Driven Tools 11 7% 1 10 7 15 13 18 11 6 12 14

Kerosene

- Fueled 2 1% 1 4 5 5 2 3 3 4 * 1

Grill/Camp Stove * * * * * 1 * * * * * *

Portable Heater 2 1% 1 4 5 4 2 3 3 4 * 1

Oil

- Fueled 2 1% 5 3 1 * 2 * 5 2 3 1

Furnace (inc l . Boilers) 2 1% 3 3 1 * 2 * 5 1 3 1

Water Heater < 1 < 1% * * * * * * * 1 * *

Wall/Floor Furnace * * 1 * * * * * * * * *

Diesel

- Fueled < 1 < 1% * 1 * * * * * 1 * *

Portable Heater * * * 1 * * * * * * * *

Water Heater < 1 < 1% * * * * * * * 1 * *

Multiple Liquid

- Fueled

Products 4 2% 1 4 4 * 2 1 2 5 1 5

Solid

- Fueled Products 12 7% 16 15 10 8 9 10 9 8 9 18

Charcoal

- Fueled 10 6% 10 11 8 3 6 10 8 7 7 17

Charcoal / Charcoal Grills 10 6% 10 11 8 3 6 10 8 7 7 17

Coal

- Fueled * * 5 1 * 2 1 * * * * *

Furnace (inc l . Boilers) * * 1 1 * 1 * * * * * *

Room/Space Heater * * 3 * * 1 1 * * * * *

Chimney / Fireplace < 1 < 1% * * * * * * * * * 1

Wood

- Fueled 1 1% 1 3 2 2 2 * 1 1 2 *

Chimney/Fireplace * * * 2 * 2 * * 1 * * *

Room/Space Heater 1 1% 1 1 2 * 2 * * 1 2 *16 | Page 

### Table 2 (continued)

2007

– 2009 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

Unspecified Fuel Products 7 4% 6 5 4 9 12 6 2 11 3 8

Chimney * * * * * * 1 * * * * *

Furnace (inc l . Boilers) 3 2% 3 4 4 6 3 2 * 5 1 3

Grill/Camp Stove * * * * * * * 1 1 * * *

Portable Heater * * * * * * 1 1 * * * *

Room/Space Heater * * * * * * 3 * * * * *

Unspecified Heater 2 1% * 1 * 1 3 1 1 4 1 1

Wall/Floor Furnace < 1 < 1% 2 * * * * * * * * 1

Unidentified Product 1 1% * * * 1 * * * * * 3

Water Heater 1 1% * * * * * * * 2 1 *

Multiple Product

- Different

Fuels 4 2% 5 4 4 2 8 6 5 5 2 4

Gas & Liquid 2 1% 5 4 3 2 7 6 5 3 1 1

Gas & Solid < 1 < 1% * * * * 1 * * * 1 *

Liquid & Solid 1 1% * * 1 * * * * 1 * 3

Gas & Liquid & Unspecified 1 1% * * * * * * * 2 * *

+ Data collection for 2010 is only partially complete . Italicized estimates may change in the future if more reports of fatalities are received.

* No reports received by CPSC staff.

# In 2010, there were an estimated three CO fatalities associated with an LP

- fueled welder/generator being used as a generator.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC Injury or Potential Injury Incident File, CPSC In

- Depth Investigation File,

National Center for Health Statistics Mortality File, 2001

– 2010

. Note: Reported annual estimates and esti mated averages and percentages may not add to subtotals or totals due to rounding.17 | Page 

### Table 3 (below) shows a break down of the fatalit y estimates for the 1 0

- year period from

2001 through 20 1 0 in the Engine

- Driven Tools categor y. During 20 1 0 , engine

- driven tools were

associated with an estimated 6 4 carbon monoxide poisoning deaths ( 40 % of the total consumer

product estimate). Table 3 totals differ from those in Tables 1 and 2 in that they also include

fatalities associated with multiple potential CO

- producing products

, where at least one product

was an engine

- driven tool. In 20 1 0 , there were six such deaths

— all associated with a generator

and some other product ( in both cases, some type o f h eater)

. An estimated 4 9 of the 6 3 engine

driven tool

- related CO poisoning deaths ( 78 %) were associated with generators

, or generators in

conjunction with another fuel

- burning product . In 20 1 0 , the other engine

- driven

, tool

- related CO

fatalities included an estimated eight deaths that were associated with some type of lawn mower,

one with an ATV

, three with welders, and two wer e a ssociated with other types of engine

- driven

products

.

Table 3 : Estimated Non

- Fire Carbon Monoxide Poison ing Deaths Associated with

Engine

- Driven Tools, 2001

– 2010

Engine

- Driven Tools 2008

- 2010 +

Average

Estimate Average

Percentage Annual Estimate

2001 2002 2003 2004 2005 2006 2007 2008 + 2009 2010 +

Total 7 8 100% 27 5 9 63 59 110 10 6 85 9 2 7 8 6 3

Generators 60 7 6 % 20 41 50 41 88 85 68 7 6 6 4 4 3

Gasoline

- fueled 20 41 50 41 88 85 68 76 64 40

LP

- fueled * * * * * * * * * 3

Other Engine

- Driven

Tools (OEDTs) 1 2 1 5 % 1 10 7 15 13 18 11 6 1 2 1 4

Lawn Mowers 5 6 % 1 5 6 8 9 11 5 2 6 8

Riding Mowers 4 5% 1 5 6 5 9 8 4 2 6 5

Walk Behind Mowers * * * * * 1 * * * * * *

Unspecified Mowers 1 1% * * * 1 * 3 1 * * 3

Power Washer < 1 < 1% * * * 2 3 1 1 * 1 *

Snow Blower/Thrower 1 1 % * * * 1 * 1 2 * 3 1

ATV 2 3 % * 1 * 1 1 * * 2 * 1

Water Pump < 1 < 1% * * * 1 * 1 1 * * 1

Welder 1 1% * 2 1 * * * 1 1 * 3

Air Compressor * * * * * 1 * 1 * * * *

Concrete Saw < 1 < 1% * 1 * 1 * * * 1 * *

Tiller < 1 < 1% * * * * * * * * 1 *

Go

- Cart < 1 < 1% * * * * * * * * 1 *

Small Engine * * * * * * * 1 * * * *

Snowmobile * * * * * * * 1 * * * *

Multiple Product: Engine

Driven Tools Involved 6 8 % 6 8 6 3 9 3 6 10 2 6

Generator + OEDT * * 1 * * * * * * * * *

Generator + other

Product 5 6 % 5 6 5 2 9 3 6 8 2 6

Multiple OEDT 1 1% * * * * * * * 2 * *

OEDT + other product * * * 1 1 1 * * * * * *

+ Data collection for 2010 is only partially complete

, and data are shown in italics . Italicized estimates may change in the future if more reports of fatalities are

received.

* No reports received by CPSC staff.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC Injury or Potential Injury Incident File, CPSC In

- Depth Investigation File,

National Center for Health Statistics Mortality File, 2001

– 2010

. Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding.18 | Page 

### Figure 1 provides a graphic representation o f the CO fatalit y trends related to : (1) all

consumer products ; (2) engine

- driven tools alone, and (3) non

- generator products

. A re gression

analysis of the estimated number of all non

- fire, consumer product

- related CO poisoning

fatalities from 2001 to 20 1 0

, indicates that there is insufficient evidence to conclude that there is

an upward trend in the data (p

- value = 0. 4579 )

. D ue to reporting delays, national estimates for

recent years, especially 20 1 0, most likely will change in subsequent reports. As can be seen in

F igure 1 , the estimated number of non

- generator CO fatalities fluctuates from year

- to

- year, but

appears to be fairly s teady across time . Conversely, the estimated number of generator CO

fatalities has shown a steady rise

, to peak level s in 2005 and 2006. The estimated number of

generator CO fatalities in 2007 through 2010 is below the peak 2005 and 2006 levels, but grea ter

than the years prior to 2005. D ata from recent years, especially 2010, should be considered

incomplete

, and the numbers are expected to change.

Figure 1: Comparison of Trends in Consumer Product

- Related Carbon Monoxide

Deaths

– 2001 to 2010



### Lawnmowers were associated with 55 percent ( 6 1 of 1 1 0 ) of the deaths in the Other

Engine

- Driven Tools category for the 1 0

- year period. There were two other fatalities associated

with a lawnmower and another product in this time period

— one with a generator and the other

with a propane heater. There was an estimated average of f ive lawnmower

- related CO fatalities

per year in 200 8 to 20 1 0 (1 6 deaths)

. CO fatalities related to ATV exhaust were in the next

largest subcategory with an estimated nine deaths fro m 2001 to 2010, and six occurred from 0 20 40 60 80 100 120 140 160 180 200

2000 2002 2004 2006 2008 2010 2012

Generators Non-generator Products All Products19 | Page 

### 2008 through 2010. Additionally, power washers, snow blower s /thrower s, and welders were

each associated with eight CO fatalities over the 10

- year period.

Table 4 shows that in 20 1 0

, 95 CO incidents ( 86 percent of fatal CO incidents reported to

the CPSC ) involved a single death. Table 4 accounts for only the fatally injured victims in each

CO poisoning incident. It is not uncommon for CO incidents involving one or more fatalities

also to result in one or more nonfatal CO poisoning injuries, but they were not quantified for

analysis in this report. T hese are the incidents reported in CPSC databases and do not represent

the national estimates of fatalities per CO incident. Death certificates do not incl ude information

about other fatalities for the same incident. The number of fatalities for a particular incident is

based on CPSC In

- Depth Investigation files and may include fatalities for which CPSC staff does

not have death certificates. Some addition al multiple fatality incidents were identified by

matching date of death and location of death on death certificates

, while others were identified

from news article s contained in the CPSC Injury or Potential Injury Incident (IPII) database.

Over the 1 0

- ye ar period covered by this report, CPSC records indicate that 1 8 percent (2 29 of

1

, 250 incidents) resulted in multiple fatalities

, including 1 4 incidents resulting in four or more

CO fatalities.

Table 4: Number of Carbon Monoxide Poisoning Incidents Repo rted to CPSC by Number of

Deaths per Incident, 2001

– 2010

Number of

Deaths Reported

in Incident 2008−2010 + Annual Incidents

Annual

Average Average

Percent 2001 2002 2003 2004 2005 # 2006 2007 2008 2009 2010 +

Total Incidents 123 100% 88 130 121 127 146 123 147 141 117 110

1 102 83% 71 101 96 105 123 93 125 119 93 95

2 16 13% 15 24 21 14 17 22 13 15 19 13

3 3 2% 2 1 3 7 5 6 8 5 4 1

4 1 1% * 2 * 1 * 1 1 2 1 1

5 * * * 2 1 * * 1 * * * *

6 * * * * * * 1 * * * * *

+ Data c ollection for 2010 is only partially complete

, and data are shown in italics. Italicized estimates may change in the future if more reports

of fatalities are received

. Note: Percentages do not add to 100% due to rounding.

Source: U.S. Consumer Product Safety Commission/EPHA

.



### Table 5 shows that in 20 1 0

, an estimate d 1 37 CO poisoning deaths occurred in home

locations , including an estimated five deaths in detached structures at r e sidential locations ( i.e.

, sheds

, detached garages) and seven in structures not intended originally as a permanent residence

( i.e. , camper trailers, sea

- land shipping containers) . From 200 8 to 20 1 0

, an annual average of

1 3 2 CO poisoning deaths ( 8 1 % of all CO fatalities ) occurred at home location s. In 20 1 0 , an

estimated 1 8 deaths took place in temporary shelters, such as tents, ice fishing sheds , and boat s.

For 200 8 to 20 1 0 , an annual average of 19 CO poisoning deaths ( 1 2 %) took place in temporary

shelters

. In 20 1 0

, CO deaths in tempora ry shelters were most commonly associated with heating

sources, generators

, or lanterns

. An estimated 8 of 1 8 ( 44 %) CO deaths in temporary shelters

were associated with LP

- fueled products

, including portable heaters and water heaters

. In 20 1 0

, an estimated eight death s ( 44 %) in temporary shelters involved charcoal grills

.20 | Page 

### A consistently small percentage of deaths due to CO poisoning involving a consumer

product occurred in vehicles

, such as passenger vans, trucks, automobiles , recreational vehicles,

campers, or boats

. In 20 1 0 , there were an estimated 5 ( 3 %) CO fatalities in this category

─ 4

deaths were associated with generators, and 1 with portable LP heaters . For 200 8 to 20 1 0 , an

annual average of 9 CO poisoning deaths ( 6 %) took place in vehicles

.

Table 5: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Location of Death, 2001−2010

Location of Death 2008−2010 + Annual Estimate

Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

Total 1 62 1 00 % 121 181 153 168 190 180 186 17 8 148 1 61

Home 1 11 9 7 3 % 78 121 109 121 120 119 138 12 4 109 12 5

Home

– External

Structure 2 8 5 % 8 15 11 10 16 14 11 1 3 7 5

Home

– But Not

House 3 5 3% 5 8 2 * 6 4 4 6 1 7

Temporary Shelter 1 9 1 2 % 17 32 22 22 32 36 22 20 18 1 8

Vehicles (including

boats) 9 6 % 13 4 9 8 14 6 8 9 12 5

Other 1 1% * * * 8 2 1 2 3 * 1

Unknown 1 1% * * 2 * * * * 2 * *

+ Data collection for 2010 is only partially complete , and data are shown in italics

. Italicized estimates may change in the future if more

reports of fatalities are received.

* No reports received by CPSC staff

. Note: Percentages do not add to 100% due to rounding.

1 Traditional home ( e.g., detached house, townhouse, apartment, mobile home)

2 External structure at residential locations ( e.g., detached garage, shed)

3 Non

- fixed structure or structure not o riginally designed for permanent occupation ( e.g., camper trailer, van, converted sea

- land shipping

container )

. Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, National Center

for Health Statistics Mortality File, 2001

– 2010.



### CPSC data indicate that there were more CO fa talities attributable to incident s that

occurred in the cold months than in the warm months. This is most likely because of the use of

furnaces and portable heaters in the cold months. Additionally, generators are often used in the

cold months because of power outages due to snow and ice storms. Table 6 shows the annual

estimated CO fatalities categorized by month of death for the 1 0 years covered by this report. In

20 1 0

, 106 of the 1 6 1 estimated CO fatalities ( 66 %) are attributable to incidents that occurred

during the cold months of November, December, January

, and February. An estimated 37

fatalities (2 3 %) are attributable to incidents that occurred during the transition months of March,

April, September

, and October ; and an estimate d 1 8 fatalities (1 1 %) in the warm months of May,

June, July

, and August. Over the 1 0 years this report spans , an estimated 5 9 percent of CO

fatalities are attributable to incidents that occurred during the cold months; an estimated 2 7

percent are attributable to incidents that occurred during the transition months; and an estimated

1 3 percent of fatalities occurred in the warm months.21 | Page 

### Table 6: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Month and

Year of the Fatality, 20 01

– 2010

Month of Death 2008−2010 + Annual Estimate

Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 20 1 0 +

Total 1 62 100% 121 181 153 168 190 180 186 17 8 148 16 1

Cold Months 100 62% 86 94 96 107 98 95 109 1 1 0 85 10 6

November 19 12% 13 27 32 26 18 23 21 2 8 12 1 8

December 2 6 16% 24 26 30 27 33 38 25 2 5 20 3 3

January 33 2 0 % 26 20 22 34 37 14 43 3 1 29 40

February 2 2 1 4 % 23 21 12 20 10 20 20 2 6 24 15

Transition

Months 3 7 23% 28 67 39 41 62 56 49 34 41 3 7

March 1 5 9% 3 28 8 10 19 19 19 7 12 2 5

April 7 4% 13 9 13 8 9 16 15 7 8 6

September 5 3% 5 5 9 14 17 7 1 7 4 3

October 11 7% 7 25 9 9 17 14 14 13 17 3

Warm Months 2 4 1 5 % 7 19 19 19 31 29 29 32 21 1 8

May 10 6% 5 4 3 5 4 9 9 16 5 9

June 8 5% * 5 7 6 9 3 4 8 10 5

July 3 2% * 2 6 4 12 4 5 3 4 3

August 3 2% 2 8 3 4 6 13 11 5 2 1

+ Data collection for 2010 is only partially complete . Italicized estimates may change in the future if more reports of fatalities are received.

* No reports received by CPSC staff.

Source: U.S. Consumer Product Safety Commission / EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, National Center for Health

Statistics Mortality File, 1999

– 20 1 0.

Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding.



### Figure 2 illustrates the relationship between the time of year and the estimated number of

CO poisoning fatalities. The total estimated number of CO poisoning fatalities is presented on

the radar graph by month of death . The shaded area represents the estimated total number of

fatalities for 2001 through 20 10

, for each month. Notably, more CO deaths occur in the cold

months, pa rticular ly, November, December

, and January , than in warm months

. Additionally, as

the months after the summer get colder

, the number of CO fatalities increases. Conversely, as

the months after the winter get warmer, the number of fatalities decreases.22 | Page 

### Figure 2: Estimated Number of Consumer Product

- Related Carbon Monoxide

D eaths b y Month of Death

, 2001

– 2010

0 50 100 150 200 250 300 Jan

Feb

Mar

Apr

May

Jun

Jul Aug Sep Oct Nov Dec 

# Deaths23 | Page 

### Demographics of Fatalities from Non

- Fire Carbon Monoxide Poisoning Associated with the

Use of Consumer Products

Table 7 shows the estimated number of CO poisoning fatalities categorized by victim age

for the 1 0 most recent years of data ( 2001

– 2010 ). From the data , it appears that consumer

product

- related CO fatalities are skewed toward older individuals. For the three most recent

years ( 200 8

– 20 1 0 ), children younger than 15 years of age accounted for an annual average of 4

percent (an estimated 6 of 1 6 2 ) of the yearly CO poisoning deaths

, while this age group

represents an average of about 20 percent of the U.S. populati on . The annual average percentage

of deaths represented by adults 45 years and older was 60 percent ( 9 7 of 1 6 2 ) in 200 8 to 20 1 0

, while only about 3 9 percent of the U.S. population is over 45 year s old . In 200 8 to 20 1 0

, adults

age 65 years and older accounted for an annual average percentage of 19 percent of CO

poisoning fatalities , al though this age group is about 1 3 percent of the U.S. population

. 6 

### Chi

square goodness

- of

- fit test results indicate that there is a statistically significant difference (p

value = < 0 .0001) between the proportion of CO victims in each age grou p from that of the

general U.S. population

. E ach age group was analyzed separately

, versus the expected

proportion of the respective age group

, based on U.S. population figures, assuming there was no

age group effect on the CO poisoning fatality rate, to determine which age group proportions

were significantly different from expectation. Binomial tests indicate that all individual groups

, with the exception of the “25

- 44” group, were found to be significantly different tha n what

would be expected if there was no population group effect :

1. The “Under 15” group 7 

### was significantly lower (< 0.0001) ;

2. The “15

– 24” group was significantly lo wer (0.0494);

3. The “45

– 64” group was significantly higher (< 0.0001) ; and

4. The “65 and older” group was significantly higher (0.0367)

.

Table 7: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Age of Victim, 2001

– 2010

Age 200 8

– 200 10 + Estimated

Perc entage

of U.S.

Population # Annual Estimate

Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010+

Total 1 62 100% 100% 121 181 153 168 190 180 186 17 8 148 1 61

Under 5 2 1% 7% 3 2 6 3 * 2 8 2 3 1

5

- 14 4 2% 13% 6 9 9 11 7 4 6 8 2 1

15

- 24 1 4 9 % 14% 16 11 17 4 17 21 18 15 14 1 2

25

- 44 4 6 28% 27% 23 56 46 43 46 59 34 5 4 43 40

45

- 64 6 7 41% 26% 39 51 55 68 86 58 70 6 8 59 7 4

65 and

over 30 1 9 % 13% 33 51 21 39 34 36 49 30 27 3 3

+ Data collection for 2010 is only partially complete . Italicized estimates may change in the future if more reports of fatalities are received.

* No reports received by CPSC staff.

# Based on average estimated U.S. population statistics for 200 8 to 20 10

. Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, National Center for Health Statistics

Mortality File, 1999

- 20 1 0.

U.S. Census Bureau, Statistical Abstract of the United States: 2012.

Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding.

6 U.S. Census Bureau, Statistical Abstract of the United States: 2012

. 7 “Under 5” and “5

– 14” groups were combined due to small sample sizes.24 | Page 

### Table 8 presents the distribution of estimat ed CO fatalities categorized by gender. In

20 1 0

, 7 7 percent of CO poisoning victims were males

, and 2 3 percent were females. The s e

percentage s varied slightly from year to year over the 1 0 years of this report

, but every year there

are many more male CO fatalities than female

. Over the years

, 2001 through 20 1 0 , the average

percentage of male CO victims was 7 4 percent

, and the average percentage of female victims

was 2 6 percent. By contrast, about 49 percent of the U.S. population is male

, and 51 percent are

female

. 8 

### Chi

- square goodness

- of

- fit test results indicate that there is a statistically significant

difference (p

- value = < 0 .0001) between the proportion of CO victims by gender group and that

of the general U.S. population

.

Table 8: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Gender of Victim, 2001

- 2010

Gender 200 8 −20 1 0 + Estimated

Percentage of

U.S. Population # Annual Estimate

Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010+

Total 162 100% 100% 121 181 153 168 190 180 186 17 8 148 16 1

Male 12 4 77% 49% 82 126 118 123 140 145 132 1 40 109 12 4

Female 3 8 23% 51% 39 54 37 45 50 36 53 3 6 39 3 8

+ Data collection for 2010 is only partially complete . Italicized estimates may change in the future if more reports of fatalities are received.

# Based on average estimated U.S. population statistics for 200 8 to 20 1 0.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, National Center for Health Statistics

Mortality File, 2001

– 2010.

U.S. Census Bureau, Statisti cal Abstract of the United States: 2012.

Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding.



### Table 9 provides a summary of CO fatality victims characterized by race/ethnicity for the

years 200 1 through 20 1 0 . Because of the growing proportion of the U.S. population of Hispanic

descent, Hispanic victims were categorized separately, irrespective of their race. E stimates of

the percentage of the U.S. population categorized into the various r ace/ e thnicity groupings were

based on single

- race characterizations

, as represented in the U.S. Census Bureau reports.

Multirace population counts were omitted from the calculations because death certificates, the

primary source of race/ethnicity designation s

, often list only a single race/ethnicity designation.

The es timated percentage of the 200 8

– 20 1 0 annual average of non

- Hispanic white CO

fatalities closely mirrors the percentage of the U.S. population 9 

### at 6 1 percent and 6 4 percent

, respectively

. However, there appears to be a disproportionate number of Black or African

American victims of CO poisoning

, comprising 20 percent of all CO poisoning fatalities

, even

though Blacks or African Americans represent only about 12 percent of the U.S. populat ion. By

contrast, the proportion of the CO poisoning fatalit y victim s who were of Hispanic ethnicity

( 9 %) is b elow the percentage of Hispanics in the U.S. population (1 6 %). Chi

- square goodness

of

- fit test results indicate that there is a significant stat istical difference (p

- value = 0 .0 018 )

between the proportion of CO victims categorized by race/ethnicity from that of the general U.S.

population. Each race/ethnicity group was analyzed separately

, versus the expected proportion

of the respective race/eth nicity group based on U.S. population figures, assuming there was no

race/ethnicity group effect on the CO poisoning fatality rate, to determine which race/ethnicity

group proportions were significantly greater than or less than the expectation. Binomial tests

8 Average of 2012 U.S. Census estimates for 2008 through 2010 for the U.S. population.

9 The “percentage of the U.S. population” is de fined here as the average of the 2012 U.S. Census estimates for 2008

through 2010 for the U.S. population.25 | Page 

### indicate that two race/ethnicity group s were statistically significantly different from the expected

proportion based on the U.S. population

. The observed proportion of Hispanic CO fatalities was

significantly lower (p

- value < 0.05) than th e proportion of Hispanics in the U.S. population.

Additionally, t he observed proportion of Black or African American CO fatalities was

significantly higher (p

- value < 0. 0 5 ) than the proportion of Black or African Americans in the

U.S. population

.

Tab le 9: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Race/Ethnicity, 2001 −20 1 0

Country of Origin 200 8 −20 1 0 + Estimated

Percentage

of U.S.

Population # Annual Estimate

Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 20 1 0 +

Total 1 62 100% 100% 121 181 153 168 190 180 186 17 8 148 16 1

White (non

- Hispanic) 9 9 61% 6 4 % 86 138 102 116 134 107 122 1 22 93 82

Black or

African American 3 2 20 % 12% 19 20 26 27 36 36 35 30 20 4 6

Hispanic (All races) 14 9% 1 6 % 9 14 14 20 15 19 23 14 11 1 8

Asian / Pacific 3 2% 5% 1 4 10 2 2 13 3 1 3 4

American Indian 4 2 % 1% 3 2 2 * * 6 1 5 1 5

Unknown / Other 10 6% 2 % 1 1 * 2 2 * 2 4 19 8

+ Data collection for 2010 is only partially complete . Italicized estimates may change in the future if more reports of fatalities are received.

* No reports received by CPSC staff.

# Based on e stimated U.S. population statistics the mid

- range 2009.

Source: U.S. Consumer Product Safety Commission / EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, National Center for Health Statistics

Mortality File, 2001

– 2010.

U.S. Census Bureau, Statistical Abstract of the United States: 2012.

Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding

.



### Table 1 0 provides a breakout of the CO poisoning fatalities characterized by population

density of the incident location. The table is presented as three sections: ( 1) incidents occurring

at all incident locations; ( 2) incidents occurring in locations identified as a permanent home ( e.g

., house, apartment, mobile home) ; and ( 3) incidents occurring only in non

- home locations ( e.g

., camper trailer, tent, motel room)

. Please note that “Home Locations” and “Non

- Home

Locations” sum to “All Locations

. ”

All fatal incidents were designated as o ccurring in one of four rural/urban categories

based on the Rural

- Urban C ommuting A rea (RUCA) codes developed by the Economic

Research Service (ERS) of the U .S. Department of Agriculture (USDA) . The categories are

based on theoretical concepts used by the U.S. Office of Management and Budget (OMB) to

define county

- level metropolitan and micropolitan areas

. 10 

### This 33

- category classification

system is based on measures of population density, urbanization, and daily commuting. The

OMB methodology is based on a county

- level delineation. ERS refined the methodology by

applying it to smaller census tracts. The WWAMI Rural Health Research Center at the

University of Washington 11 

### further delineated the characterization by cross

- referencing each zip

code in the Un ited States to its RUCA code classification. The zip code cross

- reference was

10 2010 Standards for Delineating Metropolitan and Micropolitan Statistical Areas; Notice, Federal Register, June

28, 2010, Part IV

.

11 The WWAMI name is derived from the first letter of each of the five cooperating states in a partnership between

the University of Washington School of Medicine and the states of Wyoming, Alaska, Montana, and Idaho.26 | Page 

### used to characterize each of the CO fatalities into one of four broad categories: Urban Core

, Sub

Urban, Large Rural Town, and Small Town/ Rural Isolated.

Table 1 0 a lso include s the estimated percentage of the U.S. population

, per population

density designation category

. As can be seen in the All Locations section, the estimated average

percentage of CO fatalities during the 3

- year period 200 8 through 20 1 0

, in urban locations

( 5 3 %)

, is smaller than the percentage of the U.S. population living in urban core locations ( 7 2 %).

The difference is offset by the larger percentages the other three categories: sub

- urban locations

(1 1 % versus 9 % of the U.S. population), l arge rural town locations ( 1 7 % versus 10 %)

, and small

town/rural isolated locations ( 19 % versus 9 %). A look at the section, Non

- Home Locations

, helps to identify some of the disparity. An average of 33 percent of all non

- home CO fatalities

occurred in small town/rural isolated locations

, even though the U.S. population living in isolated

locations is only 9 percent. In 200 8 through 20 1 0

, an estimated average of 10 of 3 0 CO

poisoning fatalities in non

- home locations occurred in small town/rural isolated locations . Two

factors may help to explain the relatively high proportion of small town/ isolated rural location

CO fatalities. Many non

- home locations where CO fatalities occurred were tents, camper

trailers, or cabins in isolated locations

, used during hunting o r camping activities where no local

power utility is available. In these cases, individuals often resort to generators for power and use

portable LP heaters , lanterns

, and stoves

.

Another possible factor in the elevated percentage of small town/ isolated rural location

CO fatalities is the i solated nature of these locations. Being isolated from friends, family, and

neighbors , victims often have little day

- to

- day interaction with others

, so discovery is often days

later

, instead of perhaps, hours

, which could make the difference between life and death

. Small

towns or isolated rural location s may also be a factor when it comes to rescue and hospital

services

, which may be very far away.27 | Page 

### Table 10: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Population Density

of Place of Death, 2001

– 2010

RUCA Population

Density Designation 2008−2010 + Estimated

Percentage of

U.S. Population # Annual Estimate

Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

All Locations 1 62 100% 100% 121 181 153 168 190 180 186 17 8 148 16 1

Urban Core

Sub

- Urban

Large Rural Town

Small Town/

Rural Isolated 86

18

28

30 53%

11%

17%

19% 72 %

9 %

10%

9% 68

22

16

15 100

24

31

26 110

11

8

25 112

27

14

15 119

21

20

30 122

22

12

23 110

19

18

39 95

19

36

27 74

23

13

38 89

13

3 4

26

Home Locations 13 2 100% 100% 90 144 121 131 141 139 153 1 42 117 13 7

Urban Core

Sub

- Urban

Large Rural Town

Small Town/

Rural Isolated 75

14

23

20 57%

11%

17%

15% 72 %

9 %

10%

9% 52

17

11

10 86

19

27

12 92

11

8

10 91

21

10

9 89

19

18

15 107

16

8

8 93

16

16

28 80

17

28

17 62

16

13

26 83

10

27

17

Non

- Home Locations 30 100% 100% 31 36 32 36 48 43 32 3 4 30 2 5

Urban Core

Sub

- Urban

Large Rural Town

Small Town/

Rural Isolated 10

4

5

10 33 %

13 %

17 %

33 % 72 %

9 %

10%

9% 16

5

5

5 14

4

4

14 17

*

*

15 20

5

4

7 30

2

2

14 16

7

4

16 17

3

2

10 15

2

8

9 11

7

*

12 5

3

8

9

+ Data collection for 2010 is only partially complete . Italicized estimates may change in the future if more reports of fatalities are received.

* No reports received by CPSC staff.

# Estimated 2010 U.S. population categorized by Rural Urban Commuting Area ( RUCA ) designation. U.S. population estimates by RUCA classification were determined by cross

referencing the WWAMI RUCA zip code table with the 2010 U.S. Census populat ion estimates by zip code area, the most current census data available by zip code area.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, National Center for Health Statistics

Mortality File, 2001

– 2010.

U.S. Census Bureau, Statistical Abstract of the United States: 201 2

.



### Table 11 provides a breakout of the CO poisoning fatalities characterized by geographic

region where the incident occurred . As can be seen in the table, for the most part, the percentage

of CO fatalities in each of the regions reflects the percentage of the U.S. population living in

these regions. This would indicate that geographic location has little effect on the likelih ood of

fatal CO poisoning incidents. There are, however, a few exceptions that should be pointed out.

The Midwest region

, as a whole

, exhibited a far greater than expected number of CO deaths.

Thirty

- three percent of the estimated CO fatalities in 200 8 through 20 1 0 occurred in Midwest

states where only 22 percent of the U.S. population live s . Conversely, the South A tlantic states

of the South region accounted for 1 3 percent of the CO deaths where 19 percent of the U.S.

population live s

. The Middle Atla ntic states of the North East region accounted for 8 percent of

the CO deaths where 13 percent of the U.S. population live s . And t he Pacific states of the West

region also accounted for fewer CO deaths than expected ( 10 % of the deaths, 16% of the

populati on )

.28 | Page 

### Table 11: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Geographical Region of

Incident, 2001

– 2010

Region ‡ 2008

– 2010 + Estimated

Percentage of

US Population # Annual Estimates

Average

Estimate Average

Percent 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 +

Total 162 100% 100% 121 181 153 168 190 180 186 178 148 161

North e ast 21 13% 18% 11 18 24 16 33 24 44 28 14 21

New England 7 4% 5% 1 6 3 7 7 8 10 12 5 5

Middle Atlantic 13 8% 13% 10 12 21 10 26 16 34 16 9 15

South 54 33% 37% 38 69 53 58 74 57 61 51 55 56

East South Central 14 9% 6 % 6 12 15 16 9 10 9 10 19 13

South Atlantic 21 13% 19 % 11 38 25 21 41 26 25 21 13 28

West South Central 20 12% 12% 21 19 12 21 24 21 27 21 23 15

Midwest 53 33% 22% 28 58 41 49 46 54 47 58 48 52

East North Central 36 22% 15% 14 38 34 30 31 40 25 39 28 42

West North Central 16 10% 7% 14 20 7 19 15 14 22 18 20 10

West 34 21% 23% 44 33 33 37 33 46 33 40 31 32

Mountain 17 10% 7% 24 21 12 20 18 21 17 25 16 9

Pacific 17 10% 16% 20 12 20 16 15 24 17 15 14 23

‡ Region designation is based on U.S. Census Bureau reporting practices. See Appendix C for identification of specific regi onal designation of state of occurrence.

+ Data collection for 2010 is only partially complete . Italicized estimates may change in the future if more reports of fatalities are received.

# Based on estimated 2009 U.S. population statistics. This is the latest available data for this Density Designation characterization and represents a midpoint value in

the 2008 to 2010 range.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, National Center for Health Statistics

Mortality File, 2001

– 2010.

U.S. Census Bureau, Statistical Abstract of the United States: 2012.

Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding

.29 | Page 

### Appendix A: Methodology

This appendix describes the data sources and methodology used to compute the national

estimate of non

- fire carbon monoxide ( CO ) poisoning deaths associated with the use of

consumer products and the estimates by product, victim age, and incident location.

All death certificates filed in the U nited S tates are compiled by the National Center for

Health Statistics (NCHS) into a multiple cause of mortality data file. The NCHS Mortality File

contains demographic and geographic information, as well as the Intern ational Statistical

Classification of Diseases and Related Health Problems codes for the underlying cause of death.

Data are compiled in accordance with the World Health Organization instructions, which request

that member nations classify causes of death by the current Manual of the International

Statistical Classification of Diseases and Related Health Problems. The International

Classification of Diseases, Tenth Revision (ICD

- 10) was implemented in 1999. Although the

NCHS data contain cause of death c odes that are helpful in identifying deaths due to CO

poisoning, the records do not contain any narrative information that might indicate the

involvement of a consumer product.

To complement the NCHS mortality data, CPSC staff purchases death certificate s from

the 50 states, the District of Columbia, and New York City. Specifically, CPSC staff purchases

death certificates with certain cause

- of

- death codes for which there is a high probability that

consumer products are involved. In addition to the cause

- of

- death codes and demographic and

geographic information, the death certificate contains information about the incident location and

a brief narrative describing the incident. Any references to consumer products are usually found

in these narratives. A s resources allow, CPSC staff conducts follow

- up I n

- D epth I nvestigations

(IDIs) on selected deaths to confirm and expand upon the involvement of consumer products.

ICD

- 10 classifies deaths associated with CO poisoning with the codes listed below. The

foc us of this report is accident al CO poisoning deaths and concentrates on deaths coded as X47

and Y17. That is, code X67

─ records of intentional CO poisonings

─ are excluded from this

analysis.

ICD

- 10 Code Definition

X47 Accidental

– Poisoning by and exposure to other gases and vapors.

Includes: carbon monoxide, lacrimogenic gas, motor (vehicle) exhaust gas,

nitrogen oxides, sulfur dioxide, utility gas

. X67 Intentional

– Poisoning by and exposure to other gases and vapors.

Includes: carbon monoxide, lacrimogenic gas, motor (vehicle) exhaust gas,

nitrogen oxides, sulfur dioxide, utility gas

. Y17 Undetermined intent

– Poisoning by and exposure to other gases and vapors.

Includes: carbon monoxide, lacrimogenic gas, motor (vehicle) exhaust gas,

nitrogen oxides, sulfur dioxide, utility gas

.

The first step in compiling the annual estimates is computing the total estimates of CO

poisoning deaths associated with consumer products. The CPSC’s Death Certificate (DTHS)30 | Page 

### File and the CPSC ’s Abbreviated Death Certificate (ABDT) File were searched for cases

associated with ICD

- 10 codes X47 and Y17.

Each death found in the CPSC’s DTHS File and coded as X47 or Y17 was reviewed by

an analyst and categorized as in scope, out of scope, or wheth er the source of the CO was

unknown or questionable. In

- scope cases are unintentional

, non

- fire CO poisoning deaths

associated with a consumer product under the jurisdiction of the CPSC. Out

- of

- scope cases are

cases that involve CO sources that are not u nder the jurisdiction of the CPSC (including motor

vehicle exhaust cases), fire or smoke

- related exposures, or intentional CO poisonings. Examples

of out

- of

- scope cases include : poisonings due to gases other than CO ( i.e

. , natural gas, ammonia,

butane) ; motor vehicle exhaust

- or boat exhaust

- related poisonings ; and work

- related exposures.

The source of CO was classified as unknown or questionable in cases where a consumer product

was possibly associated with the incident

, but the exact source of CO was unknown.

Deaths found in the CPSC’s ABDT File a re ca tegorized as out

- of

- scope cases . The

ABDT File contain s death certificates for CO poisonings (X47 and Y17) that involve motor

vehicle exhaust, cases where the source of the CO is unknown, or where the death certificate

does not mention a consumer product

. Other e xamples of out

- of

- scope cases that may appear in

the abbreviated file are cases associated with farm accidents, smoke inhalation from a structural

fire, or other gas poisonings. Occasionally, new er information from CPSC IDI s may be matched

with ABDT cases that were classified as having no known source or did not mention a consumer

product. In the cases where the CPSC IDIs indicate the C O source was from a consumer product

and should be considered in scope

, it w as assumed that the death certificate was misclassified

, and the subject cases in the ABDT F ile w ere include d with the DTHS database file s

.

In previous years

, a small number of cases in the ABDT File were identified as in scope

, based on further information collected during IDIs

. The method used to identify three deaths in

1999

, and two deaths in 2000

, is found in Appendix A of th e 1999 and 2000 Annual Estimat e

R eport (Vagts, 200 3 ) . For 2001 data , no ABDT F ile cases were reclassified as in scope

, based

on additional information

. For the 2002 data , additional information on one incident in the

ABDT File resulted in the incident being reclassified a s in scope

. T his fatality wa s not included

in the NCHS file

. Because the incident was not included in the NCHS data, it was also removed

from the ABDT F ile ; thus

, t he incident was not used in calculations for the weights. For the

2003 data

, there were seven recla ssified in

- scope cases in the ABDT F ile and five in 2004. For

the 2005 data, one case from the ABDT File was reclassified as an in

- scope case. For the 2006

data, three cases from the ABDT were reclassified. And for 200 7 , three more cases were

reclassified. For 2008

, 2009

, and 2010 , no ABDT records were reclassified as in scope.

Since the release of the previous annual report, additional records have been entered into

the CPSC databases

, and therefore, t he result ant initial categorization for 200 8 through 20 1 0 ha s

been recalculated and is presented in Table s A.1. a through A.1.c.31 | Page 

### Table A.1 .a : I nitial C ategorization for 200 8 D ata

ICD

- 10

Code NCHS

Total DTHS File

Total in

ABDT File Total in

CPSC

Databases 1 Number of

Cases to be

Imputed 2 In

- Scope Unknown

Scope Out

- of

Scope Total

X47 677 166 22 198 386 296 682 17

Y17 68 6 6 22 34 26 60 14

Total 745 172 28 220 420 322 742 31



### Table A.1.b: Initial Categorization for 200 9 Data

ICD

- 10

Code NCHS

Total DTHS File

Total in

ABDT File Total in

CPSC

Databases 1 Number of

Cases to be

Imputed 2 In

- Scope Unknown

Scope Out

- of

Scope Total

X47 734 145 17 237 399 387 786

- 35

Y17 72 2 4 25 31 25 56 20

Total 806 147 21 262 430 412 842

- 15



### Table A.1.c: Initial Categorization for 20 1 0 Data

ICD

- 10

Code NCHS

Total DTHS File

Total in

ABDT File Total in

CPSC

Databases 1 Number of

Cases to be

Imputed 2 In

- Scope Unknown

Scope Out

- of

Scope Total

X47 675 1 19 1 8 196 3 33 219 552 141

Y17 98 7 2 2 5 3 4 31 65 3 5

Total 773 1 26 2 0 2 21 367 250 617 176

1 “Total in ABDT File” cases

, plus “Total” from DTHS File

.

2 “NCHS Total” cases

, minus “Total in CPSC Database

, ” plus “Unknown Scope ” from DTHS

.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, Abbreviated Death Certificate File, National Center for Health

Statisti cs Mortality File, 20 08

– 20 10

.



### The proportion of death certificates found in the CPSC database a ssociated with non

- fire

unintention al X47 or Y17 deaths and associat ed with consumer products w as applied to the

NCHS totals to calculate the total estimated number of non

- fire CO poisoning deaths associated

with consumer products. In theory, the NCHS totals comprise all death certificates in the U nited

S tates, and the sa me proportion of in

- scope cases should exist in the death certificates that are

missing from the combined CPSC Death Certificate and Abbreviated Death Certificate files or

are from an unknown source . Applying the proportion of in

- scope cases to the NCHS database

totals

, therefore, should provide an estimate o f in

- scope cases nationwide. This was done in the

following way and was done for ICD

- 10 codes X47 and Y17

, separately :32 | Page 

### 1. The number of in

- scope deaths in the CPSC’s Death Certificate File coded as X47 or Y17

separately that were associated with an accidental non

- fire CO poisoning and a consumer

product were identified (n 1 

### ).

2. The total number of deaths in the CPSC’s Death Certificate File and the Abbreviated

Death Certificate File coded as X47 or Y17 were summed separately

, excluding cases with an

unknown or highly questionable source (n 2 

### ).

3. The total number of deaths in the NCHS data associated with X47 and Y17 was counted

(n 3 

### ).

4. The estimate of the number of non

- fire CO poisoning deat hs associated with consumer

products in code s X47 and Y17 was calculated separately

, using the formula:

N= (n 1 

### / n 2 

### ) * n 3



### The proportion (n 1 

### /n 2 

### ) represents the number of in

- scope cases found in the CPSC’s files

, divided by the total of in

- scope and out

- of

- scope cases.

5. The estimates of the number of non

- fire CO poisoning deaths associated

with consumer products in code s X47 and Y17 were summed to calculate the total

estimate of non

- fire CO poisoning deaths.

Total Estimate = N X47 

### + N Y17



### The ratio (n 3 

### / n 2 

### ) represents the weighting factor used to calculate the annual estimates.

The CPSC’s Death Certificate File does not contain death certificates for all deaths listed in the

NCHS file; therefore a weighting factor was calculated to account for deat h certificates that are

missing. The weighting factor allows the computation of national estimates of CO deaths by

consumer product s and by other characteristics collected by CPSC about each death.

Table A.2 contains the values for the variables used in the calculation

, as well as the final

computed 200 8 , 2009 and 2010 estimate s of CO poisoning deaths.

Table A.2 .a : Calculation Detail of the Final Computed 200 8 Estimate of Non

- Fire CO

Poisoning Deaths Associated with Consumer Products

Variable ICD

- 10 Code

X47 Y17

n 1 1 66 6

n 2 682

- 22 = 66 0 60

- 6 = 54

n 3 6 77 68

Weighting Factor (n 3 / n 2 ) 1.0 258 1. 2593

N 1 7 0. 2758 7.5556

Total Estimate {1 7 0. 2758 + 7.5556 = 1 77

. 8314 ~ 1 7 8}33 | Page 

### Table A.2.b: Calculation Detail of the Final Computed 200 9 Estimate of Non

- Fire CO Poisoning

Deaths Associated with Consumer Products

Variable ICD

- 10 Code

X47 Y17

n 1 1 45 2

n 2 786

- 17 = 7 69 5 6

- 4 = 5 2

n 3 734 72

Weighting Factor (n 3 / n 2 ) 1.0 000 + 1. 3846

N 145.0000 2

. 7 69 2

Total Estimate { 145.0000 + 2

. 7 69 2 = 1 4 7. 7 6 9 2 ~ 1 48 }

+ CPSC records contain more X47 records than NCHS does. This is possible since NCHS staff review s each death certificate and, occasionally,

reclassify the ICD

- 10 code. CPSC receives death certificates directly from the states and does not have access to any reclassification.

Therefore, since CPSC X47 records exceed NCHS X47 records, no scaling facto r is applied ( i.e., the weighting factor is set to unity).



### Table A.2.c: Calculation Detail of the Final Computed 20 10 Estimate of Non

- Fire CO Poisoning

Deaths Associated with Consumer Products

Variable ICD

- 10 Code

X47 Y17

n 1 1 19 7

n 2 552

- 1 8 = 5 34 6 5

- 2 = 63

n 3 675 98

Weighting Factor (n 3 / n 2 ) 1 .2640 1.5 556

N 1 50

. 4213 10 .8 889

Total Estimate {1 50.4213 + 10

. 8889 = 16 1 .3 102 ~ 16 1 }

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, Abbreviated Death Certificate File, National

Center for Health Statistics Mortality File, 20 1 0

.



### It should be noted that death certificates received by NCHS are routinely checked for

accuracy of state personnel identified ICD

- 10 coding. On occasion, NCHS staff will correct

codes before entering the data into their databases. The death certificate facsimiles or electronic

death certificates that CPSC receives are direct from the states

, and th erefore, have not been

correct ed per NCHS procedures. As a consequence, there may be slight discrepancies between

final NCHS counts and CPSC records , which are not due to CPSC simply not having the records

, but instead, may be due to corrections made at N CHS. Because CPSC receives the death

certificates directly from the states, CPSC records do not contain information from NCHS when

an ICD

- 10 code changed for a specific death certificate ; so CPSC staff has no way of correcting

CPSC records to come into ac cord with NCHS records. For this report, CPSC staff ha s made the

assumption that, over time, th e number of death certificates with ICD

- 10 codes changed by

NCHS staff to the codes of interest (X47 and Y17) would approximately equal those changed

from the c ode of interest.

Table A.3 s hows the weighting factors used to calculate the estimates for the years 2001

–

2010

, based on the information available to CPSC staff

.34 | Page 

### Table A.3 : CO Fatalit y Cases and Weighting Factors Used to Calculate the

Estimates for the Years 2001

– 2010

Year NCHS Total Total in

CPSC

Databases* In

- Scope

Cases + Weighting Factor

2001

X47 596 520 102 1.1462

Y17 79 62 3 1.2742

2002

X47 642 599 168 1.0718

Y17 71 61 1 1.1639

2003

X47 633 625 149 1.0128

Y17 89 75 2 1.1867

2004

X47 566 527 154 1.0740

Y17 86 72 2 1.1944

2005

X47 650 590 171 1.1017

Y17 92 70 1 1.3143

2006

X47 585 527 161 1.1101

Y17 74 53 1 1.3962

2007

X47 605 580 173 1.0431

Y17 89 68 4 1.3088

2008

X47 677 6 60 16 6 1.0 258

Y17 68 5 4 6 1.2 593

2009

X47 734 7 69 14 5 1.0000

Y17 72 52 2 1. 3846

20 1 0

X47 675 5 34 1 19 1. 2640

Y17 98 63 7 1.5556

+ For some years, the number of i n

- s cope c ases ha s changed slightly from the previous report

, due to either newly obtained

information or a recharacterization of a few cases.

* This is the total number of deaths in the Death Certificate File and Abbreviated Death Certificate File, excluding deaths associated

with an unknown or questionable source of CO.

Source: U.S. Consumer Product Safety Commission/EPHA.

CPSC Death Certificate File, CPSC In

- Depth Investigation File, Abbreviated Death Certificate File,

National Center for Health Statistics Mortality File, 2001

– 2010

.35 | Page 

### Incidents with unknown or highly questionable CO sources were excluded from the

denominator (the number of fatalities in the CPSC databases) of the weighting factor. The group

of cases with unknown or highly questionable sources was assumed to contain the same

proportio n of cases associated with a consumer product as the group of cases within the CPSC

database with known CO sources (this is the same assumption that is made for those cases where

the death certificate is missing). To include these cases within the denomin ator assumes that

these cases can be classified as in

- scope or out

- of

- scope cases

, when actually their scope status is

unknown. Therefore, for weighting purposes, cases where the source was unknown

, or highly

questionable

, were treated in the same way as missing cases were treated.

In

- scope cases were examined further to determine which product was associated with

the incident. Further information on the CO deaths was obtained from review of the CPSC’s I DI

File.

Reports of non

- fire CO poisoning deaths w ere retrieved from the DTHS and ABDT files

based on the following criteria: date of death between 1/1/ 2001 and 12/31/ 20 1 0

, and ICD

- 10

code of X47 or Y17. Death certificates entered into the CPSC’s database prior to July 2 3 , 20 1 3

, were included in th is analysis

. Whenever possible, e ach CO death was reviewed and coded by

the author

, according to the consumer product and type of fuel involved, incident location, and

whether multiple deaths result ed in the same incident

. If information about the product’ s

condition, venting system, or installation environment was provided in the IDI report, then this

information was coded for informational purposes.

In Table 1 of this report , the Heating S ystems category includes CO poisoning fatalities

from subcategories for furnaces and boilers (combined under the heading of Furnaces ) , vented

floor and wall heaters, unvented room/ space heaters, unvented portable heaters, and other

miscellaneous heating systems. Each subcategory is further delineated by fuel type used. Deaths

associated with charcoal being burned alone and in the absence of an appliance ( e.g ., in a pail or

in the sink) were presented with C harcoal G rills , even though this practice usually was done for

heating purposes. Examples of products historically included in the Other Products category

include LP gas refrigerator s and gas pool heater s

. LP gas grill, LP fish cooker

, and other LP gas

portable cooking appliance incidents are classified in the Grills, Camp Stove s category

. Deaths

where m ultiple fuel

- burning products were used simultaneously

, such that a single source of the

fatal CO could not be determined

, were classified under M ultiple Products

. Engine

- D riven

T

ools included generators and power gardening equipment, such as power lawn mowers, garden

tractors, concrete cutters

, gasoline

- powered water pumps

, and snow blowers . Generators that

were original equipment installed on a recreational vehicle (RV), trailer, ca mper, or boat were

considered out of scope, as they are outside the jurisdiction of the CPSC.36 | Page 

### Appendix B : National Estimates of Consumer Product

- Related CO Poisoning Deaths, 1980

to 20 1 0

Figure B.1 below graphically suggests a trend of the estimated CO fatalities from 1980 to

20 1 0

. Before the implementation of the ICD

- 10 coding in 1999 , the estimated number of non

fire

, consumer product

- related CO poisoning deaths decreased from the early 1980s to the late

1990s

, from a high o f 340 in 1982

, to a low of 180 in both 1997 and 1998

. In 1999

, there were

an estimated 10 8 consumer product

- related CO fatalities, well below the estimated 180 deaths in

each of the two previous years. The difference may be due

, in part

, to the change fr om ICD

- 9

coding to ICD

- 10 coding

, where product identification c ould be assessed more accurately

.

Figure B.1: Estimated Non

- Fire CO Poisoning Deaths Associated w ith

Consumer Product s : 1980

– 20 1 0

* Implementation of ICD

- 10.



### Table B.1 presents the annual estimate s from 1980 to 20 10

, and the 3

- year average

mortality rates associated with each year

, where 3 years of data were available. The 3

- year

average mortality rate is presented in the table for the mid

- point year. The estimated 3

- year

average mortality rate decreased from the 198 2 high of 1 4

. 02 per 10 million population

, to a 3

- year average rate of 4.34 per 10 million in 2000, a reduction of 69 percent. Subsequently, the 3

-

year average rate has been increasing annually through 2006

, to a rate of 6. 21

. Since 2006, the

rate has been slowly dropping to t he current 200 9 estimate of 5. 29. B ut the 2009 estimate is still

2 2 percent above the 2000 low average

. The year 200 9 is the last year for which data are

available to calculate a 3

- ye ar average. 0 50 100 150 200 250 300 350 40019801981198219831984198519861987198819891990199119921993199419951996199719981999*20002001200220032004200520062007200820092010 

### ICD

- 9 ICD

- 1037 | Page 

### Table B.1: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated

with Consumer Produc ts, 1980

− 20 1 0

Year Estimate U.S. Population

Estimates

(thousands) 3

- Year Average

Mortality Rate per 10

Million Population

1980 282 227,225

1981 311 229,466 13.55

1982 340 231,664 14.02

1983 323 233,792 13.38

1984 275 235,825 12.47

1985 284 237,924 11.19

1986 240 240,133 10.49

1987 232 242,289 9.77

1988 238 244,499 10.44

1989 296 246,819 10.49

1990 243 249,623 10.53

1991 250 252,981 9.27

1992 211 256,514 8.77

1993 214 259,919 8.31

1994 223 263,126 8.08

1995 201 266,278 8.02

1996 217 269,394 7.40

1997 180 272,647 7.05

1998 180 275,854 5.66

1999* 108 279,040 5.09

2000 138 282,172 4.34

2001 121 285,082 5.15

2002 181 287,804 5.27

2003 153 290,326 5.76

2004 168 293,046 5.81

2005 190 295,753 6.06

2006 180 298,593 6.21

2007 186 301,580 6.01

2008 178 304,375 5.51

2009 148 307.007 5.29

2010 16 1 30 8 ,7 46

Note: The 3

- year average mortality rate is report ed at the mid

- point year.

* The Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD

- 10) was

implemented.

Source: U.S. Consumer Product Safety Commission/EPHA.

U.S. Census Bureau, Statistical Abstract of the United Sta tes: 20 1 2 (excluding Armed Forces overseas)

.



### Prior to implementation of ICD

- 10 in 1999 , it was not possible to generate estimates for

an important category of products: generator s and other engine

- driven tools

. 12 

### With the advent

of ICD

- 10 coding, it is now possible to generate estimates of fatalities associated with generators

12 See Appendix B of Mah (2001) for details.38 | Page 

### and other engine

- driven tools. This category has been observed to have a statistically significant

upward trend in the estimated number of associated CO poisoning fatalities since 1999 (pages

13

– 14)

. This increasing trend appears to be having an impact on the mortality rate of consumer

product

- related CO poisoning fatalities. Table B.2 shows that the 200 9

, 3

- year average mortality

rate ( 1.99 ) for generators alone was more than three and a half times greater than for the 2000

, 3

-

year average rate ( 0

. 5 4 )

, and the estimated 3

- year average rate has increased each year from

2000 through 2006

, before decreas ing each year through 200 9

. Over the 5

- year period 2005

through 2009

, there were more CO fatalities associated with engine

- driven tools than with

heating systems. These are the only years since the implementation of ICD

- 10 that there were

more EDT

- associated CO deaths th a n heating system

- associated CO deaths

. In 2010, estimated

heating systems

- related CO deaths barely exceeded EDT

- related deaths, 58 to 57, respectively.

Table B.2: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated

with Generators * , 1999

− 20 1 0

Year E stimate + U.S. Population

(thousands) 3

- Year Average

Mortality Rate per 10

Million Population

1999 7 279,040

2000 19 282,172 0.54

2001 20 285,082 0.95

2002 42 287,804 1.29

2003 49 290,326 1.52

2004 41 293,046 2.02

2005 88 295,753 2.41

2006 85 298,593 2.69

2007 68 301,580 2.21

2008 7 6 304,375 2.05

2009 6 4 307,007 1.99

2010 43 308 ,7 46

* Estimates are based on single source product incidents as multiple source incidents could be included

in multiple categories.

+ Estimates in this table do not include multiple product

- related deaths because a generator was not the

sole product associated with the fatality.

Note 1 : The 3

- year average mortality rate is reported at the mid

- year population estimates

. Note 2: Mortality rate changes from last year’s report are due to changes in CPSC C O death estimates

and changes in U.S. Census population estimates.39 | Page 

### Table B.3 shows the CO poisoning mortality rates associated with all consumer products

, excluding generators. The data indicate that , when generators are excluded , there does not

appear to be a trend in the mortality rate for consumer products . The 2000

, 3

- year annual

average mortality rate was 3. 60 . The 200 9

, 3

- year average mortality rate was 2.88 , a decrease of

20 percent. In fact, the 3

- year averages have dropped slightly each year since the 2003 high

point. With generators included, the mortality rate increased from 4.3 4 per 10 million to 5. 29 in

th e same ti me span, an increase of 2 2 percent.

Table B. 3 : Estimated Non

- Fire Carbon Monox ide Poisoning Deaths Associated with

Consumer Products, 1999

– 2010 (E xcluding Generator

- Related Deaths) *

Year Estimate U.S. Population

(thousands) 3

- Year Average

Mortality Rate per 10

Million Population

1999 95 279,040

2000 11 7 282,172 3. 60

2001 93 285,082 3.93

2002 1 26 287,804 3. 65

2003 96 290,326 3.93

2004 12 0 293,046 3. 48

2005 90 295,753 3. 3 5

2006 87 298,593 3. 07

2007 9 8 301,580 3. 0 4

2008 90 304,375 2.97

2009 73 307,007 2.88

20 10 1 02 308,746

* Estimates are based on single source product incidents as multiple source incidents could be included

in multiple categories.

+ Excludes estimates of deaths associated with a generator only.

Note 1: The 3

- year average mortality rate is reported at the mid

- year population estimates.

Note 2: Mortality rate changes from last year’s report are due to changes in CPSC C O death estimates

and changes in U.S. Census population estimates.40 | Page 

### Table B.4 shows the 3

- year average mortality rates of all engine

- driven tools, including

generators

, through 2009 . Even though the average mortality rate s for 2007 through 200 9 have

dropped slightly since the 2006 high (3.18)

, i t can be seen in the table that the average mortality

rate has more th a n tri pled from the 2000

, 3

- year average rate ( 0

. 72 )

, to the average rate for 200 9

( 2. 3 5 )

.

Table B.4: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with

Generators and Othe r Engine

- Driven Tools, 1999

– 2010 *

Year Estimate U.S. Population

(thousands) 3

- Year Average

Mortality Rate per 10

Million Population

1999 13 279,040

2000 26 282,172 0.72

2001 22 285,082 1.17

2002 52 287,804 1.51

2003 56 290,326 1.88

2004 56 293,046 2.43

2005 102 295,753 2.95

2006 104 298,593 3.18

2007 79 301,580 2. 6 2

2008 83 304,375 2.41

2009 76 307,007 2.35

20 1 0 57 308,746

* Estimates are based on single source product incidents as multiple source incidents could be included

in multiple categories.

+ Estimates in this table do not include multiple product

- related deaths because an EDT was not the sole

product associated with the fatality. The one exception to this is the 2001 estimate that includes one

estimated death associated with a generator and another EDT.

Note 1: The 3

- year average mortality rate is reported at the mid

- year population estimates.

Note 2: Mortality rate changes from last year’s report are due to changes in CPSC C O death estimates

and changes in U.S. Census population estimates.41 | Page 

### Table B.5 shows the CO mortality rates associated with all consumer products

, excluding

generators and other engine

- driven tools. The data indicate that the annual average

, 3

- year

mortality rate decreased by 27 percent of non

- engine

- driven tool consumer product s ( i.e.

, excluding generator and other engine

- driven tools) , with the 2000 average mortality rate of 3. 44

and 2. 5 2 in 200 9 . When all consumer products are included, there has been a 2 2 percent increase

in the CO mortality rate from the 2000 average rate

, increasing from 3

- year average mortality

rate of 4.34 in 2000

, to 5. 29 in 200 8 , as shown in Table B.1. E ngine

- driven tools and generators

, in particular

, have ha d a substantial impact on th e CO poisoning mortality rate involving

consumer products.

Table B.5 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer

P roduc ts, 1999

− 20 1 0 * (E xcluding Generator

- and Other Engine

- Driven Tool

- Related Deaths)

Year Estimate U.S. Population

(thousands) 3

- Year Average

Mortality Rate per 10

Million Population

1999 89 279,040

2000 11 0 282,172 3. 44

2001 9 2 285,082 3. 72

2002 1 16 287,804 3. 44

2003 89 290,326 3. 56

2004 1 05 293,046 3. 07

2005 76 295,753 2.81

2006 6 8 298,593 2.58

2007 8 7 301,580 2.63

2008 83 304,375 2.61

2009 61 307,007 2. 52

2010 88 308,746

* Estimates are based on single source product incidents as multiple source incidents could be included in

multiple categories.

+ Excludes estimates of deaths associated with EDTs only. Multiproduct

- associated incidents are

included here because an EDT could not be identified as the only product involved. The one exception to

this is the 2001 estimate

, which excludes one estimated death associated with a generator and another

EDT.

Note 1: The 3

- year average mortality rate is reported at the mid

- year population estimates.

Note 2: Mortality rate changes from last year’s report are due to changes in CPSC C O death estimates

and changes to U.S. Census estimates.42 | Page 

### Appendix C: Regional Definiti ons

1) Northeast comprises New England and Middle Atlantic states.



### a) New England: Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and Connecticut.



### b) Middle Atlantic: New York, New Jersey, and Pennsylvania.



### 2) Midwest comprise s East North Central and West North Central states.



### a) East North Central: Ohio, Indiana, Illinois, Michigan, and Wisconsin.



### b) West North Central: Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas.



### 3) South comprises South Atlantic, Eas t South Central and West South Central states.



### a) South Atlantic: Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South

Carolina, Georgia, and Florida.



### b) East South Central: Kentucky, Tennessee, Alabama, and Mississippi.



### c) We st South Central: Arkansas, Louisiana, Oklahoma, and Texas.



### 4) West comprises Mountain and Pacific states.



### a) Mountain: Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, and Nevada.



### b) Pacific: Washington, Oregon, California, Alaska, and Hawaii



### Sour ce: U.S. Census Bureau 2012 Statistical Abstract

http://www.census.gov/compendia/statab/cats/population.html43 | Page 

### References

Carlson , S., Non

- Fire Carbon Monoxide Deaths Associated with the Use of Consumer Products

2001 Annual Estimates. Washington, D.C.: U.S. Consumer Product Safety Commission. 2004.

< https://www.cpsc.gov/librar y/co04.pdf >

Hnatov, Matthew V.

, Non

- F ire Carbon Monoxide Deaths Associated with the Use of Consumer

Products 200 9 Annual Estimates. Washington, D.C.: U.S. Consumer Product Safety

Commission. 20 1 2

. 

### < http://www.cpsc.gov//PageFiles/136146/co12.pdf

Hnatov, Matthew V

., Incidents, Deaths, and In

- Depth Investigations Associated with Non

- Fire

Carbon Monoxide from Engine

- Driven Generators and Other Engine

- Driven Tools, 1999

– 2011

. Washington, D.C.: U.S. Consumer Product Safety Commission. 2012

. 

### http://www.cpsc.gov/library/foia/foia12/os/cogenerators.pdf

.

Inkster S.E. Health hazard assessment of CO poisoning associated with emissions from a

portable, 5.5 kilowatt, gasoline

- powered generator . Washington, D.C.: U.S. Consumer Product

Safety Commission, 2004.

Long, K., Saltzman, L. (1995). Non

- fire Carbon Monoxide Incidents: Morbidity and Mortality

Related to the Use of Household Appliances. Washington, D.C. : U.S. Co nsumer Product Safety

Commission.

Mah, J., Non

- Fire Carbon Monoxide Deaths Associated with the Use of Consumer Products

1998 Annual Estimates. Washington, D.C.: U.S. Consumer Product Safety Commission. 2001.

http://www.cpsc.gov//PageFiles/109652/co01.pdf

U.S. Census Bureau

. Statistical Abstract of the United States: 20 1 2

. http://www.census.gov/compendia/statab/2012edition.html U.S. Department of Agriculture

. Briefing Rooms: Measuring Rurality . 7 Nov. 2008

< http://www.ers.usda.gov/briefing/Rurality/ >

U.S. Office of Budget and Management

. 2010 Standards for Delineating Metropolitan and

Micropolitan Statistical Areas ; Notice Federal Register, June 28, 2010, Part IV

< http://www.whitehouse.gov/sites/default/files/omb/assets/fedreg_2010/06282010_metro_standa

rds

- Complete.pdf >

University of Washington, WWAMI Rural Health Research Center . Rural

- Urban Commuting

Area Codes (version 2. 0 ). 5 Jan. 2009 < http://depts.washington.edu/uwruca/ >

Vagts, S., Non

- Fire Carbon Monoxide Deaths Associated with the Use of Consumer Products

1999 and 2000 Annual Estimates. Washington, D.C. : U.S. Consumer Product Safety

Commission. 2003.

< https://www.cpsc.gov/library/co03.pdf >