Ambient temperature as a proxy indicator for carbon monoxide poisoning risk: deriving exploratory reference points for public health monitoring in Chengdu, China.
Extreme cold was associated with five-fold higher risk of carbon monoxide poisoning visits.
Ambient temperature as a proxy indicator for carbon monoxide poisoning risk: deriving exploratory reference points for public health monitoring in Chengdu, China.
Low ambient temperature is associated with increased carbon monoxide (CO) poisoning incidents, likely through behavioral pathways such as heating device use and reduced ventilation.
This study examines the association between daily mean temperature and CO poisoning emergency medical service (emergency medical service) responses in Chengdu, explores potential population susceptibility, estimates the attributable burden, and proposes exploratory temperature reference points for public health monitoring.
A time-stratified case-crossover design combined with distributed lag nonlinear models (DLNMs; max lag = 5 days) was employed.
cold snaps sharply raise the odds of CO poisoning ER visits
A reverse "J"-shaped association was observed, with a cumulative lag 0-5 days minimum morbidity temperature (minimum morbidity temperature) of 14.9 °C.
Wind speed stratification indicated a 69% higher extreme cold risk on low-wind days (RR ratio = 1.69), though formal interaction testing was non-significant ( p = 0.94).
Non-optimal temperatures were statistically coincident with an estimated 32.9% of emergency medical service responses.
Nominal exploratory reference points of 7.3 °C and 6.0 °C were derived; bootstrap validation (1,000 resamples) yielded median estimates of 7.0 °C (95% CI: 6.0-8.0 °C) and 6.0 °C (95% CI: 4.3-6.7 °C).
Low ambient temperature serves as a measurable proxy indicator for conditions associated with elevated CO poisoning risk in Chengdu.
The proposed exploratory temperature reference points (7.3 °C and 6.0 °C) may inform targeted safety messaging during winter, though prospective validation is required before operational implementation in warning systems.