Spatial and temporal trends and risk factors for intentional carbon monoxide poisoning hospitalizations in England between 2002 and 2016

Aina Roca-Barceló, Helen Crabbe, Rebecca Close, Helena Fahie, Giovanni S. Leonardi, Frédéric B. Piel*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Suicide and mental health disorders are a recognized increasing public concern. Most suicide prevention rely on evidence from mortality data, although suicide attempts are a better predictor for completed suicides. Understanding spatio-temporal patterns and demographic profiles of people at risk can improve suicide prevention schemes, including for carbon monoxide (CO) poisoning, a common method for gas-related suicides. 

Objective: Describe spatio-temporal patterns of intentional CO poisoning hospitalization rates in England between 2002 and 2016, and identify population sub-groups at risk. 

Methods: We used NHS Digital's Hospital Episode Statistics (HES) routinely collected data on hospital admissions for intentional CO poisoning. We estimated age-standardised rates (ASR) by year, gender and residential small-area characteristics, including rural/urban, deprivation and ethnic composition. Temporal trends were assessed through linear regression and joinpoint regression analysis. Regional differences were explored. 

Results: On average, we identified 178 hospital admissions for intentional CO poisoning per year. The ASR decreased substantially over the study period, particularly among males (average annual percent change of −7.8 % (95 % CI: −11.0; −4.6)), in comparison to 3.9 % (95%CI, −6.4; −1.4) among females. Most admissions (81 %) occurred in males. White men aged 35–44 years were particularly at risk. The ASR in London (0.08/100,000) was almost six times lower than in the South-West (0.47/100,000). 

Conclusions: This study provides novel insights into attempted suicides by intentional CO poisoning. Further prevention interventions, targeting sub-groups at risk (i.e. white men in their 30s/40s), need to be developed and implemented to reduce the burden of suicides and of CO poisoning.

Original languageEnglish
Pages (from-to)168-175
Number of pages8
JournalJournal of Affective Disorders
Volume329
Early online date24 Feb 2023
DOIs
Publication statusPublished - 15 May 2023

Bibliographical note

Funding Information:
This study was part funded by the National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Chemical and Radiation Threats and Hazards and the NIHR HPRU in Environmental Exposures and Health (grants # NIHR200992 and # NIHR200880), two partnerships between the UK Health Security Agency (UKHSA) and Imperial College London. FBP and ARB acknowledge infrastructure support for the Department of Epidemiology and Biostatistics provided by the NIHR Imperial Biomedical Research Centre (BRC). FBP is a member of the MRC Centre for Environment & Health, funded by the UK Medical Research Council (MRC, grant #MR/S019669/1).

Funding Information:
This study was part funded by the National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Chemical and Radiation Threats and Hazards and the NIHR HPRU in Environmental Exposures and Health (grants # NIHR200992 and # NIHR200880 ), two partnerships between the UK Health Security Agency (UKHSA) and Imperial College London . FBP and ARB acknowledge infrastructure support for the Department of Epidemiology and Biostatistics provided by the NIHR Imperial Biomedical Research Centre (BRC). FBP is a member of the MRC Centre for Environment & Health, funded by the UK Medical Research Council (MRC, grant # MR/S019669/1 ).

Publisher Copyright:
© 2023 The Author(s)

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