1 | Page 

# Non

- Fire Carbon Monoxide Deaths

Associated with the Use of Consumer Products

200 9 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

December 20 1 2

This analysis was prepared by the CPSC staff, 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 Estimates of Non

- Fire CO Poisoning Deaths Associated with Consumer Products

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

Table 1: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Associated Fuel

- Burning Consumer

Product, 1999

– 2009

................................ ................................ ................................ ................................ ................. 10

Table 2: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer Products Organized

by Fuel Type, 1999

– 2009

................................ ................................ ................................ ................................ ........ 13

Table 3: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Engine

- Driven Tools, 1999

–

2009

................................ ................................ ................................ ................................ ................................ ......... 16

Figure 1: Comparison of Trends in Consumer Product

- Related Carbon Monoxide Deaths

– 1999 to 2009

.......... 18

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

1999

– 2009

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

Table 5: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Location of Death, 1999

- 2009

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

Table 6: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Month of Year of the Fatality, 1999

– 2009

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

Figure 2: Estimated Number of Consumer Product

- Related Carbon Monoxide Deaths by Month of Death, 1999

–

2009

................................ ................................ ................................ ................................ ................................ ......... 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, 1999

– 2009

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

Table 8: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Gender of Victim, 1999

- 2009

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

Table 9: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Race/Ethnicity, 1999

- 2009

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

Table 10: Estimated Non

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

1999

– 2009

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

Appendix A: Methodology

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

Table A.1.a: Initial Categorization for 2007 Data

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

Table A.1.b: Initial Categorization for 2008 Data

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

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

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

Table A.2.a: Calculation Detail of the Final Computed 2007 Estimate of Non

- Fire CO Poisoning Deat hs

Associated with Consumer Products

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

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

- Fire CO Poison ing Deaths

Associated with Consumer Products

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

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

- Fire C O Poisoning Deaths

Associated with Consumer Products

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

Table A.3: CO Fatality Cases and Weighting Factors Used to Calculate the Estimates for the Years 1999

– 2009 34

Appendix B: National Estimates of Consumer Product

- Related CO Poisoning Deaths, 1980 to 2009

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

Figure B.1: Estimated Non

- Fire CO Poisoning Deaths Associated with Consumer Products: 1980

– 2009

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

Table B.1: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer Products, 1980

-

2009

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

Table B.2: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Generators, 1999

- 2009

.... 38

Table B.3: Estimated Non

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

– 2009 (Excluding Generator

- Related Deaths)

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

Table B.4: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Generators and Other

Engine

- Driven Tools, 1999

– 2009

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

Table B.5: Estimated Non

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

- 2009 (Excluding Generator

- and Other Engine

- Driv en 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 200 9

, and companion statistics since 1999

. It should be noted that CPSC

staff continue s to receive reports of CO poisoning fatalities

, and the estimates may change in

subsequent reports.

Some of the key findings in this report are:

For 200 9 :

• T here were an estimated 1 46 unintentional non

- fire CO poisoning deaths associated with

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

200 7 to 200 9 was 1 69 deaths

. 1



### • Engine

- Driven Tools (EDT) were associated with the largest percentage of non

- fire CO

poisoning fatalities at 53 percent ( estimated 7 7 deaths)

. Heating Systems

- related CO

fatalities were associated with 27 pe rcent ( 40 deaths)

, and the remaining s ix product

categories [ Charcoal Grills or Charcoal ( 7 deaths), Ranges, Ovens ( 3 deaths)

, Water

Heaters ( 5 deaths), Lanterns

– LP Fueled ( 1 death), Other Products ( 2 deaths), and

Multiple Products ( 1 1 deaths)]

, combined were associated with a total of 20 percent

. In

200 9 , t h ere were no reported deaths in the Grills, Camp Stoves categor y

.

Generators & Other Engine

- Driven Tools 2 

### :

• There were an estimated 79 CO fatalities in 200 9 that were associated with E ngine

Driven T ools

, including 2 of the 1 1 Multiple Products deaths i n which an EDT and

another potential CO

- producing product was also in use. Six ty

- seven of the 79 EDT

related deaths ( including both of the multiple product de aths that involved an EDT )

involved generators.

Heating Systems:

• Of the estimated 40 H eating S ystem s

- related fatalities in 200 9

, 85 percent ( 34 deaths )

involved gas heating equipment

. Natural gas heating equipment accounted for 33 percent

( 13 deaths ) of all fuel types of heating system

- related fatalities ; l iquefied petroleum (LP

or propane) gas heating accounted for 48 percent ( 19 deaths ) ; and an additional 5 percent

( 2 deaths ) were only identified as unspecified gas heating. Oil

- ( 3 deaths ) and wood

fueled ( 2 death s ) heating systems accounted for a total of 1 3 percent. Three additional

fatalities ( 8 percent) were associated with heating system s

, where the fuel type could not

be ascertained from CPSC records.

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 11

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

.4 | Page 

### Location/Demographics:

• CPSC staff is aware of 1 1 5 fatal non

- fire CO incidents involving consumer products in

200 9

. Seven ty

- nin e percent ( 91 deaths ) of these incidents involved a single fatality

.

• Seven ty

- nine percent (1 16 deaths ) of the estimated 1 46 CO deaths in 200 9 occurred in a

home location. Of these 1 16 estimated fatalities, 7 occurred in an external structure

, such

as a shed or detached garage , a nd 1 occurred in a nonfixed location domicile ( e.g.

, camper trailer , boat ) 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 2 percent ( 1 8

deaths ) occurred in tents, camper trailer s

, and other temporary shelters.

• More CO fatalities occur red in the colder months of the year. In 200 9

, 58 percent ( 8 4 of

1 46 deaths) occurred during the colder months of November, December, January, and

February

.

• In the three most recent years of this report ( 200 7

– 200 9 )

, adults 45 years and older

comprised an annual average of 5 9 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 less than 15 years of age accounted for an annual average of 5

percent of the yearly CO poisoning deaths

, while this age group makes up about 20

percent of the U.S. population.

• In 200 9

, 73 percent ( an estimated 1 07 deaths) of CO poisoning victims were males

, and

2 7 percen t ( 3 9 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 2007 through 2009

time frame

. The proportion of Hispanic victims (irrespective of race) is significantly

lower than the proportion of Hispanic Americans in the U.S. population (9% versus 15%)

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

greater of the U.S. population (17% versus 12%) during th i s time period

.

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

rural locations ( 20 percent in 200 7 through 200 9 ) 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 isolated non

home locations

, which account for 2 9 percent of all CO fatalities occurring at non

- home

locations.5 | Page 

### Historical Data:

• Regression models indicate that there is a statistically significant increasing trend in non

fir e CO fatalities from 1999 to 200 9

, al though the short

- term trend since 2005 appears to

have leveled off

, or perhaps, ha s even been declining

.

• The CO poisoning 3

- y ear average mortality rate for 200 7 through 200 9 associated with

consumer products ( 5.56 per 10 million population) i s approximately 28 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 non

- engine

- driven tool

products, the mortal ity rate has decreased by 20 percent from 3. 62 ( the 2000 3

- year

average ) down to a 2.91 average mortality rate in 200 8 (the average rate for 200 7 through

200 9 )

. Conversely, the mortality rate of CO poisoning from engine

- driven tools during

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

, up to a 3

- year

average of 2.65 for 200 8

. Details are given in Appendix B of this report.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 concentration in

blo od, which in turn

, depends up on its concentration in air, the 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 (CO Hb) 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 percent COHb

. 3



### Some sym ptoms 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 exposures, and health car e

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 severe poisonings, espec ially 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 boilers, and kerosene heaters) produce an

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

- driven tools

powered by gasoline engines produce large amounts of CO

, even when they are run where there

is sufficient oxygen available for combustion

, yet they 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 th at 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 forms of fuel. In circumstances of poor mainte nance, 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 potential

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 Comm ission, 2004.7 | Page 

### National Estimates of Non

- Fire C O Poisoning Deaths Associated with Consumer Products

During 200 9

, there were an estimated 1 46 carbon monoxide (CO) poisoning deaths

associated with the use of a consumer product under the jurisdiction of the U.S. Consumer

Product Safety Commission (CPSC)

. The estimates presented in this report are based on n early

complete reporting of consumer product

- related CO poisoning fatalities that occurred in 200 9

. 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 near ly 97 percent of all the fatal CO poisoning deaths that

occurred in 200 9

, in the U nited States. For the 10 years covered in this report prior to 200 9

, CPSC records contain approximately 9 1 percent of all the fatal CO poisoning deaths that

occurred in the United States reported to NCHS. Carbon monoxide poisoning deaths referred to

in t his 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 exhau st pathways, and

poor user judgment in operating these products can result in fatal scenarios. It should be noted

that CPSC staff produces the CO estimates by associated consumer products in order 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 further analysis is done to consider

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

user informatio n and education.

The annual CO estimates for the years 1999 through 200 9 are presented in two formats:

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

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

recent 3

- year period (200 7 through 200 9 ). At the time this report was prepared, data collection

wa s nearly complete for 200 9

. E stimates for th i s year may change in the future

, if additional

data become available

. T herefore, they are reported using italic font in the tables

.

It should be noted that n umbers 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. Generator and other EDT death estimates would not be expected to match

obser ved fatality counts presented in the CPSC report

, “Incidents, Deaths, and In

- Depth

Investigations Associated with Non

- Fire Carbon Monoxide from Engine

- Driven Generators and

Other Engine

- Driven Tools, 1999

– 20 1 1

. ”



### Table 1 (pages 10

− 11) presents the 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 var ious 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 using the methodology described in Ap pendix A

.8 | Page 

### O f the estimated 1 46 CO poisoning deaths associated with a consumer product that

occurred between January 200 9 and December 200 9

, H eating S ystems were associated with 40

deaths ( 27 % of the total consumer product estimate). Of the 40 deaths associated with heating

systems, the majority ( 8 5 % or 3 4 fatalities) involved g as heating systems

. A mong gas heating

systems, natural gas heating was associated with an estimated 13 deaths ( 33 % of heating system

related deaths)

. Liquid Petroleum gas (LP gas) 4 

### heating was associated with an estimated 19

deaths ( 48 % of heating system

- related deaths) ; and unspecified gas heating was associated with

an estimated t wo deaths ( 5 % of heating system

- related deaths). Oil

- fueled heating w as

associated with an estimated three deaths ( 8 % of heating system

- related deaths)

. There w ere an

estimated two death s ( 5 % of heating system

- related deaths) associated with a wood

- burning

heater. There are no reported kerosene

- , coal

- , or d iesel

- fueled heating system fatalities in the

2009 data

. A dditional ly, in 2009

, there w as an e stimated one CO death ( 3 % of heating system

related deaths) associated with heating system s with unknown 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 13 deaths in 200 9 that were associated with natural gas heating systems,

11 ( 8 5 %) involved installed furnaces

— on e ( 8 % ) of which w as d escribed as being a wall or floor

furnace

. In a ddition to the 11 furnace

- related deaths

, two deaths ( 1 5 % ) were described as being

associated with natural gas

- fueled room or space heaters

. Of the estimated 19 deaths in 200 9

that were associated with LP gas heating systems, eight ( 42 % ) 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 pr opane heaters were

either camping heaters that used disposable propane tanks, one

- pound propane bottles, or tank

top heaters that used bulk tanks larger than one pound.

In 200 9 , an estimated seven CO deaths ( 5 % of the 1 46 total consumer product estimate )

were associated with charcoal or charcoal grills; an estimated five deaths ( 3 %) were associated

with water heaters; an estimated 3 deaths (2%) were associated with gas ranges or ovens; an

estimated one death ( 1 %) w as associated with LP

- fueled lanterns ; and an estimated 2 death s

were associated with other gas

- fueled product s . Additionally, in 200 9 , an estimated 11 deaths

were associated with multiple appliances ( 8 % of the total consumer product estimate). The

Multiple Products category includes all in cidents where multiple fuel

- burning products were

used simultaneously

, such that a single source of the CO could not be determined

.

An estimated 78 CO poisoning deaths ( 53 % of the estimated total f o r 200 9 ) were

associated with the category of Engine

- Dri ven Tools , which includes generators, riding mowers

or garden tractors, snow blowers/throwers

, and other engine

- driven equipment . Additionally, 2

of the 1 1 Multiple Product fatalities were associated with some type of engine

- driven tool being

used in conjunction with another fuel

- burning product for an estimated total of 8 0 CO fatalities

associated with the use of an engine

- driven tool (5 5 % of the estimated total f o r 200 9 ) . Generator

associated deaths comprise the majority of this category. An estima ted 67 CO poisoning deaths

were associated with a generator

, including both of the Multiple Product fatalities involving an

engine

- driven tool in 200 9 ( 84 % of all engine

- driven tool fatalities and nearly half of the total

consumer product estimate).

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 

### In recent years, the E ngine

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

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

driven tool s ( 7 8 , not including multiple product incidents) in 200 9

, is greater than the number

associated with heating system s ( 40 deaths). Since 2005

, there have been a far greater number of

CO fatalities associated with engine

- driven tools than with heating systems. There have been an

estimated combined total of 448 en gine

- driven tool

- related CO fatalities from 2005 through

200 9

, compared to 2 60 deaths combined for heating systems. From 1999 through 200 4

, there

were twice as many heating system

- related CO fatalities (448) than engine

- driven tool

- related

fatalities (224 )

. (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 30 percent from an approximate estimated average

of 75 per year from 1999 through 2004

, to an average of 5 2 per year from 2005 through 200 9

, the estimated annual average number of engine

- driven

, tool

- related CO fatalities have increased

by 14 0 percent over the same time period

, from 37 to 9 0

.

Table 1 (pages 10

− 11 ) shows the estimated average annual number of CO poisoning

deaths associated with a consumer product for 200 7 to 200 9 . The average yearly total number of

CO deaths for this 3

- year period is estimated to be 1 69 (with a standar d error of approximately

12 .0 ). The 95 percent confidence interval 5 

### for this estimated average ranged from 1 18 to 221

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 200 9

.

Detailed information regarding the condition of products associated with fatalities was

not reliably collected, and the availability of such information in the CPSC’s files varied widely.

However, information collected often describe d conditions regarding compromised vent systems,

flue passageways

, and chimneys for furnaces, boilers, and ot her heating systems. Vent systems

include the portion of piping that connects the flue outlet of the appliance and exhausts air to the

outside through a ceiling or sidewall, or connects to a chimney . Some vented products had vents

that became detached or were installed or maintained improperly . Vents were also sometimes

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

combus tion air.

Other conditions related to furnaces included compromised 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 incidents mentioned a backdraft condition, large amounts of

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

- tagged by the uti lity company

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

repaired).

5 The confidence interval is based on a t

- distribution with two degrees of freedom.10 | Page 

### Table 1 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Associated Fuel

- Burning Consumer Product, 1999

– 200 9

200 7

– 2009 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 +

Total 1 69 100% 108 138 121 181 153 168 190 180 18 6 1 76 146

Heating Systems 55 33% 50 82 71 93 67 85 47 49 66 58 40

Furnaces 25 1 5 % 22 37 26 47 29 43 14 30 29 3 0 16

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

Liquid Petroleum (LP) Gas 1 1 % 5 7 7 16 3 8 1 9 * 3 1

Natural Gas 16 9 % 15 25 10 21 19 23 6 19 2 0 19 10

Oil 3 2 % * 4 3 3 1 * 2 * 5 1 3

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

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

Portable Heaters 1 3 8 % 16 20 17 26 25 20 23 14 1 7 1 3 8

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

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

Liquid Petroleum (LP) Gas 1 0 6 % 12 14 16 20 18 15 19 10 14 9 8

Natural Gas * * 1 2 * * 2 * * * * * *

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

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

Wall/Floor Furnaces 6 4 % 6 15 18 9 4 6 2 2 9 3 6

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

Natural Gas 3 2% 2 10 13 4 3 1 2 2 5 2 1

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

Unspecified Fuel * * * * 2 * * * * * * * *

Room/Space Heaters 7 4 % 6 9 9 10 8 12 4 1 6 5 9

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

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

Natural Gas 1 1% 1 7 3 5 3 6 * 1 * 2 2

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

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

Unspecified Fuel * * * 1 * * * * 3 * * * *

Unspecified Heater/System 4 2% * 1 * 2 * 3 3 1 5 7 1

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

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

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

Unspecified Fuel 2 1% * * * 1 * 1 3 1 1 4 *11 | Page 

### Table 1 ( continued 

### )

200 7

– 200 9 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 200 8 2009 +

Engine

- Driven Tools 81 4 8 % 13 26 21 52 56 56 102 104 7 9 85 7 7

Generators 7 0 41 % 7 19 20 42 49 41 88 85 68 77 65

Other Engine

- Driven Tools 1 1 7% 6 8 1 10 7 15 13 18 11 8 13

Charcoal Grills, Charcoal 8 5 % 17 8 10 11 8 3 6 10 8 8 7

Gas Ranges or Ovens 3 1% 6 12 9 3 3 4 6 * 6 * 3

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

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

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

Gas Water Heaters 4 2% 1 3 * 1 7 2 6 4 2 6 5

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

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

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

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

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

Lanterns

- Liquid Petroleum (LP)

Gas Fueled 2 1 % 8 3 * 2 1 3 6 3 * 4 1

Grills, Camp Stoves 1 1% 5 1 1 4 1 4 * 2 2 * *

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

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

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

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

Chimney

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

Fireplace

– Unspecified Gas < 1 < 1 % * * * * * * * * 1 * *

Fireplace

– Wood < 1 < 1 % * * * 2 * 2 * * 1 * *

Other Products

–

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

Other Products

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

Unidentified Product * * * * * * * 1 * * * * *

Unidentified Product

– LP Gas 1 1% * * * * * * * * * 2 *

Multiple Products 1 4 8 % 6 2 8 13 8 7 12 8 20 1 1 11

+ Data collection for 200 9 is nearly 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 Injury or Potential Injury Incident File, CPSC In

- Depth Investigation File,

National Center for Health Statistics Mortality File, 1999

– 200 9

. Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding.12 | 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 8 1 of th e 1 46 ( 5 5 %) estimated CO fatalities in 200 9

. Gas

- Fueled

Products and Solid

- Fueled Products were associated with 52 ( 3 6 %) and 9 ( 6 %) estimated

fatalities in the same time period, respectively. An additional two ( 1 %) 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 two ( 1 %) fatalit ies in 200 9 associated with consu mer products where

the fuel type was unknown

.

In the Gas

- Fuele d Products category, the majority of CO fatalities in 200 9 were

associated with heating

- related products. Of the estimated 52 gas

- fueled appliance fatalities in

200 9

, 34 ( 65 %) were associated with heating systems or heaters

, including furnaces and boilers,

portable heaters, wall or floor heaters

, room or space heaters , or fireplaces

. Additionally, five of

the estimated eight fatalities in the Multiple Gas

- Fueled Products category involved some type

of gas heater. Of the estimated 8 1 liquid

- fueled appliance

- related fatalities in 200 9

, 77 ( 9 5 %)

were associated with engine

- driven tools ( e.g.

, generators, lawn mowers /garden tractors , power

washers). Generators accounted for 65 of the estimated 8 1 fatalities ( 8 0 %) in the Liquid

- Fueled

Products category for 200 9

. Additionally, the estimated o ne fatalit y in the Multiple Liquid

Fueled Products category also involved a generator.

In 200 9

, there were an estimated nine fataliti es in the Solid

- Fueled Products category

. Seven of these were associated with charcoal or charcoal grills and two with a wood

- burning

room heater

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

products of different fuel types

— both involved portable LP heaters (gas

- fueled), one involved a

generator (liquid

- fueled)

, and one involved charcoal ( solid

- fueled )

.13 | Page 

### Table 2 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with Consumer Products Organized by Fuel Type, 1999

– 200 9

200 7

– 200 9 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 +

Total 1 69 100% 108 138 121 181 153 168 190 180 18 6 1 76 146

Gas

- Fueled Products 62 37% 72 93 66 92 70 87 53 51 80 55 52

Natural Gas 25 15% 23 51 28 35 30 32 10 26 30 28 16

Furnace 16 9% 15 25 10 21 19 23 6 19 20 19 10

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

Portable Heater * * 1 2 * * 2 * * * * * *

Range/Oven 1 1% 2 5 1 3 * 2 1 * 2 * 1

Room/Space Heater 2 1% 1 7 3 5 3 6 0 1 * 3 2

Wall/Floor Furnace 3 2% 2 10 13 4 3 1 2 2 5 3 1

Water Heater 1 1% 0 2 0 1 3 * * 3 * 1 1

Unspecified Heater 1 1% * * * * * * * * 3 * *

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

Liquid Petroleum (LP) Gas 27 16% 40 34 30 47 31 37 30 23 26 31 23

Furnace 1 1% 5 7 7 16 3 8 1 9 * 3 1

Grill/Camp Stove < 1 < 1% 5 1 1 4 1 2 * 1 1 * *

Lantern 2 1% 8 3 * 2 1 4 6 3 * 4 1

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

Portable Heater 10 6% 12 14 16 20 18 15 19 10 14 9 8

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

Refrigerator * * 1 * * * 1 * 1 * * * *

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

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

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

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

Unspecified Gas 6 4% 3 7 7 5 8 15 11 1 11 3 5

Furnace 2 1% 1 * 1 1 2 5 2 * 4 2 1

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

Range/Oven 2 1% * 5 6 * 3 1 3 * 3 * 2

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

Fireplace < 1 < 1% * * * * * * * * 1 * *

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

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

Multiple Gas

- Fueled Products 8 5% 5 1 2 4 1 3 2 1 13 2 814 | Page 

### Table 2 (continued)

200 7

– 200 9 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 +

Liquid

- Fueled Products 88 52% 16 35 28 64 66 61 108 108 89 95 81

Gasoline

- Fueled 80 47% 13 26 21 52 56 56 102 104 78 85 77

Generator 70 41% 7 19 20 42 49 41 88 85 68 77 65

Other Engine

- Driven Tools 11 7% 6 8 1 10 7 15 13 18 11 8 13

Kerosene

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

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

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

Oil

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

Furnace 3 2% * 4 3 3 1 * 2 * 5 1 3

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

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

Diesel

- Fueled * * * * * 1 * * * * * * *

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

Multiple Liquid

- Fueled

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

Solid

- Fueled Products 9 5% 17 10 16 15 10 8 9 10 9 9 9

Charcoal

- Fueled 8 5% 17 8 10 11 8 3 6 10 8 8 7

Charcoal / Charcoal Grills 8 5% 17 8 10 11 8 3 6 10 8 8 7

Coal

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

Furnace * * * 1 1 1 * 1 * * * * *

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

Wood

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

Chimney/Fireplace < 1 < 1% * * * 2 * 2 * * 1 * *

Room/Space Heater 1 1% * 1 1 1 2 * 2 * * 1 215 | Page 

### Table 2 (continued)

200 7

– 200 9 + Annual Estimates

Consumer Product Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 200 9 +

Unspecified Fuel Products 5 3% 1 1 6 5 4 9 12 6 2 11 2

C himney * * * * * * * * 1 * * * *

Furnac e 2 1% 1 * 3 4 4 6 3 2 * 5 1

Grill/ Camp Stove < 1 < 1% * * * * * * * 1 1 * *

Portab le Heater * * * * * * * * 1 1 * * *

Room/S pace Heater * * * 1 * * * * 3 * * * *

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

Wall/F loor Furnace * * * * 2 * * * * * * * *

Uniden tified Product * * * * * * * 1 * * * * *

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

Multiple Product

- Different

Fuels 4 2% 1 * 5 4 4 2 8 6 5 5 2

G as & Liquid 3 2% 1 * 5 4 3 2 7 6 5 3 1

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

Liquid & Solid < 1 < 1% * * * * 1 * * * * 1 *

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

+ Data collection for 200 9 is nearly 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 Injury or Potential Injury Incident File, CPSC In

- Depth Investigation File,

National Center for Health Statistics Mortality File, 1999

– 200 9

. Note: Reported annual estimates and estimated averages and percentages may not add to subtotals or totals due to rounding.16 | Page 

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

- year period from

1999 through 200 9 in the Engine

- Driven Tools cat egory. During 200 9 , engine

- driven tools were

associated with an estimated 79 carbon monoxide poisoning deaths ( 5 4 % 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 200 9 , there were two such deaths

— both associated with a

generator and some other product ( in both cases, some type of h eater)

. An estimated 67 of the 79

engine

- driven tool

- related CO poisoning deaths ( 85 %) were associated with generators

, or

generators in conjunction with another fuel

- burning product . In 200 9 , the other engine

- driven

, tool

- related CO fatalities inclu ded an estimated six deaths that were associated with riding lawn

mowers, t hree with snow blowers

, and four wer e a ssociated with other types of engine

- driven

products

.

Table 3 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with

Engine

- Driven Tools, 1999

– 200 9

Engine

- Driven Tools 2007

- 2009 +

Average

Estimate Average

Percentage Annual Estimate

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 + 200 9 +

Total 86 100% 14 27 27 58 63 59 110 107 85 93 79

Generators 70 81% 7 19 20 41 50 41 88 85 68 77 6 5

Other Engine

- Driven

Tools (OEDTs) 10 12% 6 8 1 10 7 15 13 18 11 6 13

Lawn Mowers 4 5% 6 7 1 5 6 8 9 11 5 2 6

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

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

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

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

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

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

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

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

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

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

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

Go

- Cart 1 1% * * * * * * * * * * 2

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

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

Multiple Product: Engine

Driven Tools Involved 6 7% 1 1 6 8 6 3 9 3 6 9 2

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

Generator + other

Product 5 6% * 1 5 6 5 2 9 3 6 8 2

Multiple OEDT < 1 < 1% * * * * * * * * * 1 *

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

+ Data collection for 200 9 is nearly 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 Injury or Potential Injury Incident File, CPSC In

- Depth Investigation File,

National Center for Health Statistics Mortality File, 1999

– 2009.

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

### In 2009, there were an estimated 77 CO fatalities associated with engine

- driven tools ( 79

, if the two multiproduct incident s invol v ing an engine

- driven tool are include d )

. As can be seen

in Table 3, the estimated numbers of fatalities associated with engine

- driven tools increased

dramatically in 2005 and 2006

, over previous years

. The large incr ease in the number of engine

driven tool fatalities in 2005 can partially be explained by the large increase of generator

- related

deaths associated with severe weather events. An unusually severe hurricane season and ice

storms in the South and the Midwes t caused widespread power outages

, prompting consumers to

resort to the use of generators, often unsafely, as an alternative source of power. It is unclear

why the number of generator fatalities remained high in 2006

, which was a relatively mild

weather e vent year. From 2007 through 2009 , the re were an estimated average of 86 CO

fatalities associated with engine

- driven tools

, slightly lower than the peak 2005/ 20 06 levels (an

estimated of 109) , but still in excess of the pre

- 2005/ 20 06 levels.

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

consumer products ; (2) to engine

- driven tools alone, and (3) to non

- engine

- driven tools

. A

regression analysis of the estimated number of all non

- fire, consumer product

- relat ed CO

poisoning fatalities from 1999 to 200 9

, indicates that there is statistical evidence of an upward

trend in the data (p

- value = 0.0 376 )

, even though the short

- term trend since 2005 appears to have

leveled off

, or perhaps, ha s even been declining

. It should be pointed out that due to reporting

delays, national estimates for recent years, especially 2009, most likely will change in

subsequent reports. As can be seen in the figure, the estimated number of non

- generator CO

fatalities fluctuates from year

- to

- year, but appears to be fairly steady though in 2009 , when there

were fewer non

- generator CO fatalities than any other year of this report . Conversely, the

estimated number of generator CO fatalities has shown a steady rise

, to peak level s in 200 5 and

2006. The estimated number of generator CO fatalities in 2007 through 2009 are below the peak

2005 and 2006 levels, but greater than the years prior to 2005.18 | Page 

### Figure 1: Comparison of Trends in Consumer Product

- Related Carbon

Monoxide Deaths

– 1999 to 200 9



### Lawnmowers were associated with 61 percent ( 6 6 of 108 ) of the deaths in the Other

Engine

- Driven Tools category for the 1 1

- year period. There were two other fatalities associated

with a lawnmower and another product in this time period

— on e with a generator, and the other

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

- related CO fatalities

per year in 200 7 to 200 9 (13 deaths)

. CO fatalities related to snow blower/thrower usage were in

the next largest subcategory

, with an estimated eight deaths from 1999 to 200 9

, and five

occurred from 2007 through 2009

.

Table 4 shows that in 200 9

, 79 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. It should be noted that these are the incidents reported in CPSC databases and do not

represent the national estimates of fatalities per CO incident. Death certificates do not include

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

inci dent are based on CPSC In

- Depth Investigation files and may include fatalities for which 0 20 40 60 80 100 120 140 160 180 200

1998 2000 2002 2004 2006 2008 2010

generator non-generator All products19 | Page 

### CPSC staff does not have death certificates. Some additional multiple fatality incidents were

identified by matching date of death

, and location of death on death cer tificates

, while others

were identified from news article s contained in the CPSC Injury or Potential Injury Incident

(IPII) database. Over the 11

- year period covered by this report, CPSC records indicate that 19

percent (24 7 of 1

, 3 04 incidents) resulted i n multiple fatalities

, including 15 incidents resulting in

four or more CO fatalities.

Table 4 : Number of Carbon Monoxide Poisoning Incidents Reported to CPSC b y

Number of Deaths Per Incident, 1999

– 2009

N umber of

Deaths Reported

in Incident 2007

− 2009 + Annual Incidents

Annual

Average Average

Percent 1999 2000 2001 2002 2003 2004 2005 # 2006 2007 200 8 2009 +

Total Incidents 133 100% 78 104 88 130 121 127 146 123 14 7 13 9 11 5

1 109 82% 63 82 71 101 96 105 123 93 12 5 11 8 91

2 16 12% 14 19 15 24 21 14 17 22 13 1 5 1 9

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

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

5 < 1 < 1% * * * 2 1 * * 1 * * *

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

+ Data collection for 2009 is nearly complete. Italicized estimates may change in the future if more reports of fatalities are received

. * No incident reports received by CPSC staff were for this time period

.

# 2005 data include o ne case where there were two CO fatalities

, but only one was considered in scope for this report due to the work

- related nature of the

incident (one worker, one non

- worker). Th i s incident is identified in this table as a two

- death incident , but on ly the non

- work

- related fatality is accounted for

elsewhere in the report

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

. CPSC Death Certificate File, CPSC In

- Depth Investigation File, CPSC Injury or Potential Injury Incident File, 1999

– 2009

.

Note 1 : Data in Table 4 do not add to totals presented in Table 1. Data presented in Table 4 are not national estimates derived f rom NCHS totals, but

reported deaths contained in the CPSC files. NCHS dat a do not contain enough detail to identify multiple victims of the same CO poisoning

incident. These figures include fatalities reported in CPSC In

- Depth Investigation files for which CPSC may not have a death certificate

.



### Table 5 sho ws that in 200 9

, an estimate d 1 16 CO poisoning deaths occurred in home

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

, sheds

, detached garages) and structures not intended originally as a permanent residence ( i.e.

, camper trailers, sea

- land shipping containers) . From 200 7 to 200 9

, an annual average of 1 38 CO

poisoning deaths ( 8 2 % of all CO fatalities ) occurred at home location s. In 200 9 , an estimated 1 8

deaths took place in temporary shelters, such as tents, ice fishing sheds , and boat s. For 200 7 to

200 9 , an annual average of 19 CO poisoning deaths ( 1 1 %) took place in temporary shelters

. In

200 9

, CO deaths in tempora ry shelters were most commonly associated wi th 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 200 9 , an

estimated eight death s ( 44 %) in temporary shelters involved generators

.

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 200 9

, there were an estimated 1 3 ( 9 %) CO fatalities in this category

— most commonly associated with generators (6 deaths), portable LP heaters ( 3 deaths) , and

charcoal grills (3 deaths) . For 200 7 to 200 9 , an annual average of 10 CO poisoning deaths ( 6 %)

took pla ce in vehicles

.20 | Page 

### Table 5 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Location of Death, 1999

− 2009

Location of Death 2007

− 2009 + Annual Estimate

Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 200 8 2009 +

Total 169 10 0 % 108 138 121 181 153 168 190 180 186 176 146

Home 1 124 7 3 % 58 87 78 121 109 121 120 119 138 126 108

Home

– External

Structure 2 10 6 % 7 8 8 15 11 10 16 14 11 13 7

Home

– But Not

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

Temporary Shelter 19 1 1 % 28 32 17 32 22 22 32 36 22 16 18

Vehicles (including

boats) 10 6 % 9 7 13 4 9 8 14 6 8 9 13

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

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

+ Data collection for 200 9 is nearly complete. Italicized estimates may change in the future if more reports of fatalities are received.

* No reports received by CPSC staff.

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 originally designed for permanent occupation ( e.g., camper trailer, van, converted se a

- land shipping)

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 H ealth Statistics Mor tality File, 1999

– 200 9

.



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

occurred in the colder months than in the warmer months. This is most likely because of the use

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

the winter months because of power outages due to snow and ice storms . Table 6 on the next

page shows the annual estimated CO fatalities categorized by month of death for the 1 1 years

covered by this report. In 200 9

, 8 4 of the 1 46 estimated CO fatalities ( 5 8 %) are attributable to

incidents that occurred during the colder months of November, December, January

, and

February. A n estimated 42 fatalities (2 9 %) are attributable to incidents that occurred during the

transition months of March, April, September

, and October ; and an estimated 21 fatalities (1 4 %)

in the warmer mont hs of May, June, July

, and August. Over the 1 1 years this report spans , an

estimated 5 9 percent of CO fatalities are attributable to incidents that occurred durin g the colder

months; an estimated 2 5 percent are attributable to incidents that occurred during the transition

months; and an estimated 1 6 percent of fatalities occurred in the warmer months.21 | Page 

### Table 6: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Month and

Year of the Fatality, 1999

– 2009

Month of Death 2007

− 2009 + Annual Estimate

Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 200 9 +

Total 169 100% 108 138 121 181 153 168 190 180 186 176 146

Cold Months 100 59% 59 89 86 94 96 107 98 95 109 107 84

N ovember 20 12% 7 28 13 27 32 26 18 23 21 28 12

D ecember 22 13% 16 33 24 26 30 27 33 38 25 22 19

January 34 20% 28 17 26 20 22 34 37 14 43 31 29

F ebruary 23 14% 8 11 23 21 12 20 10 20 20 26 24

Trans ition

Months 42 25% 31 31 28 67 39 41 62 56 49 36 42

M arch 13 8% 17 9 3 28 8 10 19 19 19 7 13

April 10 6% 2 3 13 9 13 8 9 16 15 8 8

S eptember 4 2% 6 7 5 5 9 14 17 7 1 7 4

October 15 9% 6 12 7 25 9 9 17 14 14 14 17

Warm Months 27 16% 18 18 7 19 19 19 31 29 29 32 21

M ay 10 6% 3 7 5 4 3 5 4 9 9 17 5

J une 7 4% 5 3 * 5 7 6 9 3 4 7 10

J uly 4 2% 5 5 * 2 6 4 12 4 5 3 4

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

+ Da ta collection for 2009 is nearly 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

– 2009

. 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 1999 through 200 9

, for each month. It can be seen clearly that more CO deaths

occur in the colder months, part icular ly, November, December

, and January , than in warmer

months

. It also can be seen that 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 , 1999

– 200 9

0 50 100 150 200 250 300 350 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 1 most recent years of data (1999

– 200 9 ). From the summary, it appears that consumer

product

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

years ( 200 7

– 200 9 ), children younger than 15 years of age accounted for an annual average of 5

percent (an estimated 9 of 1 69 ) of the yearly CO poisoning deaths

, while this age group

represents an average of about 20 percent of the U.S. populat ion . The annual average percentage

of deaths represented by adults 45 years and older was 5 9 percent ( 99 of 1 69 ) in 200 7 to 200 9

, while only about 37 percent of the U.S. population is over 45 year s old . In 200 7 to 200 9

, adults

age 65 years and older accounted for an annual average percentage of 2 0 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 t hree groups were

f

ound 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;

2. The “45

– 64” group was significantly higher; and

3. The “65 and older” group was significantly higher.

Table 7: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Age of Victim, 1999

– 2009

Age 2007

– 2009 + Estimated

Percentage of

U

. S

. Population # Annual Estimate

Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 200 9 +

Total 169 100% 100% 108 138 121 181 153 168 190 180 186 176 146

Under 5 4 2% 7% * 3 3 2 6 3 * 2 8 2 3

5

- 14 5 3% 13% 7 3 6 9 9 11 7 4 6 8 2

15

- 24 16 9% 14% 8 10 16 11 17 4 17 21 18 16 14

25

- 44 44 26% 2 7 % 31 42 23 56 46 43 46 59 34 55 43

45

- 64 65 38% 2 6 % 45 57 39 51 55 68 86 58 70 66 59

65 and

over 34 20% 1 3 % 16 23 33 51 21 39 34 36 49 29 25

+ Data collection for 2009 is nearly 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 7 to 200 9

. 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

- 2009.

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

. 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: 2010

. 7 “Under 5” and “5

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

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

200 9

, 73 percent of CO poisoning victims were males

, and 2 7 percent were females. The s e

percentage s v ar ied slightly from year to year over the 1 1 years of this report

, but every year there

are many more male CO fatalities than female ones

. Over the years

, 1999 through 200 9 , the

average percentage of male CO victims was 7 5 percent

, and the average percentage of female

victims was 2 5 percent

. By contrast, about 49 perce nt 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, 1999

- 2009

Gender 2007

− 2009 + Estimated

Percentage of

U

. S

. Population # Annual Estimate

Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 200 9 +

Total 1 69 100% 100% 108 138 121 181 153 168 190 180 18 6 176 146

Male 1 27 7 5 % 49% 86 105 82 126 118 123 140 145 132 14 2 107

Female 42 2 5 % 51% 22 34 39 54 37 45 50 36 53 34 39

+ Data collection for 2009 is nearly 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 7 to 200 9

. Source: U.S. Consumer Product Safety Commission/ E PHA.

CPSC Death Certificate File, CPSC In

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

Mortality File, 1999

– 2009

.

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

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



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

years 1999 through 200 9 . Because of the growing proportion of the U.S. population of Hispanic

descent, Hispanic victims were categorized separately, irrespective of their race. It should be

noted that estimates of the percentage of the U.S. population categorized into the various

r ace/ e thn icity groupings were based on single

- race characterizations

, as represented in the U.S.

Census Bureau reports. Multirace population counts were omitted from the calculations. The

reason for this modification is because death certificates, the primary sou rce of race/ethnicity

designation s

, often list only a single race/ethnicity designation.

The estimated percentage of the 200 7

– 200 9 annual average of non

- Hispanic white CO

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

### at 6 7 percent and 6 6 percent

, respectively

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

American victims of CO poisoning

, comprising 1 7 percent of all CO poisoning fatalities

, even

though Blacks or African Americans represent only about 12 percent of the U.S. population. 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 (15%). Chi

- square goodness

of

- fit test results indicate that there is a marginally non

- significant statistical difference (p

- value

= 0 .0 898 ) 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/ethnicity group based on U.S. population figures, assuming

8 Average of 2012 U.S. Census estimates for 2007 through 2009 for the U.S. population.

9 The “percentage of the U.S. populatio n” is defined here as the average of the 2012 U.S. Census estimates for 2007

through 2009 for the U.S. population.25 | Page 

### there was no race/ethnicity group effect on the CO poisoning fatality rate, to determine which

race/et hnicity group proportions were significantly greater than or less than the expectation.

Binomial tests indicate that one race/ethnicity group w as 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 the proportion of Hispanics in the U.S.

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

was marginally significantly h igher (p

- value < 0.10) than the proportion of Black or African

Americans in the U.S. population

.

Table 9 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Race/Ethnicity, 1999

− 2009

Country of Origin 2007

− 2009 + Estimated

Percentage of

U

. S

. Population # Annual Estimate

Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 200 9 +

Total 169 100% 100% 108 138 121 181 153 168 190 180 186 176 146

White (non

- Hispanic) 113 67% 6 6 % 57 101 86 138 102 116 134 107 122 123 93

Black or

African American 28 17% 12% 30 22 19 20 26 27 36 36 35 30 20

H ispanic (All races) 16 9% 15% 13 10 9 14 14 20 15 19 23 15 11

Asian / Pacific 2 1% 5 % 6 2 1 4 10 2 2 13 3 1 3

American Indian 1 1% 1% 2 2 3 2 2 0 0 6 1 2 1

Unknown / Other 8 5% 1 % 0 1 1 1 0 2 2 0 2 4 19

+ Data collection for 200 9 is nearly 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 7 to 200 9

. 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

– 200 9

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

. 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. 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 10 

### further delineated the characterization by cross

- referencing each zip code in the

Uni ted States to its RUCA code classification. The zip code cross

- reference was used to

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

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

### 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 7 through 200 9

, in urban locations

( 5 5 %)

, is smaller than the percentage of the U.S. population living in urban core locations ( 7 1%).

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

- urban locations

( 1 2 % versus 10 % of the U.S. population)

, l arge rural town l ocations ( 14 % versus 10 %)

, and

small town/rural isolated locations ( 20 % versus 9 %). A look at the Non

- Home Locations section

helps to identify some of the disparity. An average of 2 9 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 7 through 200 9

, an estimated average of 9 of 33 CO poisoning

fatalities in small town/rural isolated locations occurred in non

- home locations. Two f actors 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 or campin g 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 itself. 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 diffe rence between life and death

. Small towns

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

, which may be very far away.27 | Page 

### Table 1 0 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Population

Dens ity of Place of Death, 1999

– 200 9

RUCA Population

Density Designation 2007

− 2009 + Estimated

Percentage of

U

. S

. Population # Annual Estimate

Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 200 9 +

All Locations 1 69 100% 100% 10 8 138 121 181 153 16 8 19 0 180 18 6 1 76 1 46

Urban Core

Sub

- Urban

Large Rural Town

Small Town /

Rural Isolated 93

21

23

33 55 %

12 %

14 %

20 % 7 1%

10 %

10 %

9 % 60

7

20

22 83

20

11

25 68

22

16

15 100

24

31

26 110

11

8

25 112

27

14

15 119

21

20

30 122

22

12

23 1 10

19

1 8

39 96

20

3 7

23 72

2 3

13

38

Home Locations 138 100% 100% 70 101 90 144 121 131 141 139 153 1 4 5 116

Urban Core

Sub

- Urban

Large Rural Town

Small Town /

Rural Isolated 78

17

19

24 5 7%

12 %

14 %

17 % 71%

10 %

10%

9% 53

3

8

6 70

16

7

8 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

1 6

28 81

18

28

18 61

16

13

26

Non

- Home Locations 31 100% 100% 37 37 31 36 32 36 48 43 32 3 0 31

Urban Core

Sub

- Urban

Large Rural Town

Small Town /

Rural Isolated 15

4

3

9 47 %

13 %

11 %

29 % 71%

10 %

10%

9% 7

3

12

15 13

3

4

17 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

5 12

7

*

12

+ Data collection for 200 9 is nearly 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 RUCA designation. U.S. population estimates by RUCA classification were determ ined from by cross

- referencing the

WWAMI RUCA zip code table with the 2010 U.S. Census population estimates by zip code a rea, 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, 1999

– 200 9

. U.S. Census Bureau, Statistical Abstract of the United States: 2010.

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

.



### 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 t he U.S. population living in

these regions. This would indicate that geographic location has little effect on the likelihood 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 percent of the estimated CO fatalities in 2007 through 2009 occurred in Midwest states

where only 22 percent of the U.S. population live. The Mountain states of the West region also

had a greater than expected number of CO deaths compromising 11 percent of the deaths

, yet

home to only seven percent of the population. Conversely, the South A tlantic states of the South

region accounted for 12 percent of the CO deaths where 19 percent of th e U.S. population live.

The Pacific states of the West region also accounted for fewer CO deaths than expected (9% of

the deaths, 16% of the population )

.28 | Page Table 1 1 : Estimated Non

- Fire Carbon Monoxide Poisoning Deaths by Geographical Region

of Incident , 1999

– 2009

Region ‡ 2007

– 2009 + Estimated

Percentage of

US Population # Annual Estimates

Average

Estimate Average

Percent 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 +

Total 169 100% 100% 108 138 121 181 153 168 190 180 186 176 146

North East 28 17% 18% 12 20 11 18 24 16 33 24 44 27 12

New England 9 5% 5% 1 1 1 6 3 7 7 8 10 11 5

Middle Atlantic 19 11% 13% 10 19 10 12 21 10 26 16 34 16 7

South 56 33% 37% 37 49 38 69 53 58 74 57 61 52 55

South Atlantic 20 12% 19% 28 17 11 38 25 21 41 26 25 21 13

East South Central 13 8% 6% 3 8 6 12 15 16 9 10 9 10 19

West South Central 24 14% 12% 6 24 21 19 12 21 24 21 27 21 23

Midwest 51 30% 22% 28 46 28 58 41 49 46 54 47 59 48

East North Central 31 18% 15% 17 37 14 38 34 30 31 40 25 40 28

West North Central 20 12% 7% 10 9 14 20 7 19 15 14 22 19 20

West 34 20% 23% 31 24 44 33 33 37 33 46 33 37 31

Mountain 19 11% 7% 20 17 24 21 12 20 18 21 17 22 17

Pacific 16 9% 16% 12 7 20 12 20 16 15 24 17 16 15

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

occurrence

.

+ Data collection for 2009 is nearly complete. Italicized estimates may change in the future if more reports of fatalities are received.

# Based on estimated 2006 U.S. population statistics. This is the latest available data for this Density Designation characterization and represents a midpoint value in the

2006 to 2008 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, 1999

– 2009

. U.S. Census Bureau, Statistical Abstract of the United States: 2010.

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

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

focus of this report is unintentional 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.

In cludes: 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 whether 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 under the jurisdiction of the CPSC (including motor

vehicle exh aust 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 tego rized 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

. Ot her 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 In

- Depth

Investigations (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

CO source was from a consumer product and should be considered in scope

, it w as assumed tha t

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 Estimate

R eport (Vagts, 2001) . 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

, and thus

, it was not used in calculations for the weights. For the 2003 data

, there were seven reclassified 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 and 2009, no ABDT records were reclassified as in

- sco pe.

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 7 through 2009 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 7 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 605 173 10 235 418 172 590 25

Y17 89 4 4 34 42 30 72 21

Total 694 177 14 269 460 202 662 46



### Table A.1 .b: Initial C ategorization for 2008 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 677 161 22 198 381 290 671 28

Y17 68 6 6 22 34 25 59 15

Total 745 167 28 220 415 315 730 43



### Table A.1 .c: Initial C ategorization for 2009 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 734 143 16 230 389 361 750 0

Y17 72 2 5 23 30 22 52 25

Total 806 145 21 253 419 383 802 25

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, 2007

– 2009

.



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

- fire

unintention al X47 or Y17 deaths and associated 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 same proportion of in

- scope cas es 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, sh ould 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 deaths associated with consumer

pr oducts 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 esti mates 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 death certificates that are

m issing. 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 estimate of CO poisoning deaths.

Table A.2 .a : Calculation Detail of the Final Computed 200 7 Estimate of Non

- Fire CO

Poisoning Deaths Associated with Consumer Products

Variable ICD

- 10 Code

X47 Y17

n 1 173 4

n 2 590

- 10 = 580 72

- 4 = 68

n 3 605 89

Weighting Factor (n 3 / n 2 ) 1.0431 1.3088

N 180.4569 5.2353

Total Estimate {180.4569 + 5.2353 = 185.6922 ~ 186}33 | Page 

### Table A.2. b : 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 1 161 6

n 2 671

- 22 = 649 59

- 6 = 53

n 3 677 68

Weighting Factor (n 3 / n 2 ) 1.0431 1.283

N 167.9461 7.6981

Total Estimate {167.9461 + 7.6981 = 175.6442 ~ 176}



### Table A.2. c : 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 1 143 2

n 2 750

- 16 = 734 52

- 5 = 47

n 3 734 72

Weighting Factor (n 3 / n 2 ) 1 1.5319

N 143.0000 3.0638

Total Estimate {143 + 3.0638 = 146.0638 ~ 146}

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, 2008

.



### 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 NCHS. 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 cor recting

CPSC records to come into accord with NCHS records. For this report, CPSC staff have 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 approxi mately equal those changed

from the code of interest.

Table A.3 s hows the weighting factors used to calculate the estimates for the years 1999

–

2009

, 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 1999

– 200 9

Year NCHS Total Total in

CPSC

Databases* In

- Scope

Cases + Weighting Factor

1999

X47 542 469 92 1.1557

Y17 80 66 1 1.2121

2000

X47 600 551 126 1.0889

Y17 76 70 1 1.0857

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 677 649 161 1.0431

Y17 68 53 6 1.2830

2009

X47 734 734 143 1.0000

Y17 72 47 2 1.5319

+ 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 dea ths 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 Statisti cs Mortality File, 1999

– 200 9

.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

proportion 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 mis sing). To include these cases within the denominator 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 high ly

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 were retrieved from the DTHS and ABDT files

based on the following criteria: date of death between 1/1/ 1999 and 12/31/ 200 9

, and ICD

- 10

code of X47 or Y17. Death certificates entered into the CPSC’s database prior to July 2 3 , 20 1 2

, 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 d one 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 multiple fuel

- burning products were used simultaneously

, such that a single source of the

fatal CO could not be determined

, were classi fied 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 ins talled on a recreational vehicle (RV), trailer, camper, 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 200 9

Figure B.1 below graphically suggests a trend of the estimated CO fatalities from 1980 to

200 9

. Before the implementation of the ICD

- 10 coding in 1999 , t he estimated number of non

fire

, consumer product

- related CO poisoning deaths decreased from the early 1980s to the late

1990s

, from a high of 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 differenc e may be due

, in part

, to the change from 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

– 200 9

* Implementation of ICD

- 10.



### Table B.1 presents the annual estimate s from 1980 to 200 9

, 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 reductio n of 69 percent. Subsequently, the 3

-

year average rate has been increasing annually through 2006

, to a rate of 6. 21 . The current 200 8

estimate of 5.56 is slightly less than the previous 2 year s , but still 28 percent above the 2000 low

average

. The year 200 8 is the last year for which data are available to calculate a 3

- year average.

0 50 100 150 200 250 300 350 40019801981198219831984198519861987198819891990199119921993199419951996199719981999*2000200120022003200420052006200720082009 

### ICD

- 9 ICD

- 1037 | Page 

### Table B.1: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated

with Consumer Produc ts, 1980

− 200 9

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 5.99

2008 176 304,375 5.56

2009 146 307,007

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. Ce nsus Bureau, Statistical Abstract of the United States: 20 1 2 (excluding Armed Forces overseas)

.



### Prior to 1999 with the implementation of ICD

- 10, it was not possible to generate

estimates for an important category of products: generator s and other engine

- driven tools

. 11



### With the advent of ICD

- 10 coding, it is now possible to generate estimates of fatalities associated

with generators and other engine

- driven tools. This category has been observed to have a

11 See Appendix B of Mah (2001) for details.38 | Page 

### 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 8

, 3

- year average mortality rate (2. 30 ) for generators alone was more than four 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

, with a slight decrease in 2007 a nd 2008

. In each of the last 5

years ( 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

.

Table B.2: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated

with Generators, 1999

− 200 9

Year Estimate + 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 2.43

2008 77 304,375 2.30

2009 65 307,007

+ 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 fr om 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 with the exclu sion of generators, there does not

appear to be a trend in the mortality rate for consumer product s . The 2000

, 3

- year annual

average mortality rate was 3. 7 9 . The 200 8

, 3

- year average mortality rate was 3. 26 , a decrease of

14 percent. In fact, the 3

- year averages have dropped slightly each year since the 2003 high

point. With generators included, the mortality rate i ncreased from 4.3 4 per 10 million to 5.56 in

th e same time span, an increase of 28 percent.

Table B. 3 : Estimated Non

- Fire Carbon Monox ide Poisoning Deaths Associated with

Consumer Produc ts, 1999

– 200 9 (E xcluding Generator

- Related Deaths)

Year Estimate U.S. Population

(thousands) 3

- Year Average

Mortality Rate per 10

Million Population

1999 101 279,040

2000 119 282,172 3.79

2001 101 285,082 4.20

2002 139 287,804 3.99

2003 104 290,326 4.25

2004 127 293,046 3.79

2005 102 295,753 3.65

2006 95 298,593 3.52

2007 118 301,580 3.45

2008 99 304,375 3.26

2009 81 307,007

+ 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 mortality rates of all engine

- driven tools, including generators

through 200 8 . Even though the average mortality rate in 200 7 and 2008 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 8 ( 2. 65 )

.

Table B.4: Estimated Non

- Fire Carbon Monoxide Poisoning Deaths Associated with

Generators and Othe r Engine

- Driven Tools, 1999

– 200 9

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 2.86

2008 85 304,375 2.65

200 9 78 307,007

+ 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 20 percent of non

- engine

- driven tool consumer product s, with the

2000 average mortality rate of 3.6 2 and 2.91 in 200 8 . When all products are included, there has

been a 28 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 .56 in 200 8

. 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

− 200 9 (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 95 279,040

2000 112 282,172 3.62

2001 99 285,082 3.98

2002 129 287,804 3.77

2003 97 290,326 3.88

2004 112 293,046 3.38

2005 88 295,753 3.11

2006 76 298,593 3.02

2007 107 301,580 3.03

2008 91 304,375 2.91

2009 68 307,007

+ 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

- yea r 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 Definitions

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 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 Sou th Atlantic, East 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) West 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



### Source: U.S. Census Bureau 2012 Statistical Abstract

http://www.census.gov/compendia/statab/cats/population.html43 | Page 

### References

Hnatov, Matthew V.

, Non

- F ire Carbon Monoxide Deaths Associated with the Use of Consumer

Products 200 8 Annual Estimat es. Washington, D.C.: U.S. Consumer Product Safety

Commission. 20 11

. 

### < http://www.cpsc.gov/library/foia/foia11/os/co10.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

.

Long, K., Saltzman, L. (1995). Non

- fire Carbon Monoxide Incidents: Morbidity and Mortality

Related to the Use of Household A ppliances. Washington, D.C. : U.S. Consumer 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.

< https://www.cpsc.gov/library/co98.pdf >

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 >

Vagts, 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/l ibrary/co04.pdf >

U.S. Census Bureau

. Statistical Abstract of the United States: 20 1 2

.

U.S. Census Bureau

. American Factfinder . < http://factfinder.census.gov >

U.S. Department of Agriculture

. Briefing Roo ms: Measuring Rurality . 7 Nov. 2008

< http://www.ers.usda.gov/briefing/Rurality/ >

University of Washington, WWAMI Rural Health Research Center

. R u ral

- U rban C ommuting

A rea C odes (version 2. 0 ) . 5 Jan. 2009 < http://depts.washington.edu/uwruca/ >