Epidemiologic investigation leads to multilingual carbon monoxide poisoning prevention campaign

In Brief

After more than 100 people were poisoned by carbon monoxide following a winter storm, the Connecticut Department of Public Health created educational materials that were tested by focus groups comprising urban residents, Spanish speakers, and people with low literacy levels. Materials in 10 languages are available online.


In 2011, a rare October Nor'easter in Connecticut knocked down numerous trees and power lines, causing power outages throughout the state. Outages affected more than 860,000 households, many of whom were without power for over a week.

Specific issue
  • Carbon monoxide poisoning. As people turned to alternate fuel sources following the power outages, hospitals saw 134 cases of carbon monoxide poisoning and 5 deaths. Approximately 87% of carbon monoxide cases occurred in urban settings.
The practice

The Connecticut Department of Public Health (CDPH) held focus groups with several target populations and developed educational materials on carbon monoxide poisoning prevention during power outages and winter storms.

After conducting an epidemiological investigation into the carbon monoxide poisoning cases that occurred following the week-long power outage, CDPH identified key target groups and messaging strategies on which to focus future prevention efforts. With these considerations in mind, CDPH worked with an external vendor to develop educational materials on appropriate alternate heating and cooking methods after storms. Materials on food safety during power outages were also created.

Based on epidemiologic data, educators decided to focus on proper use of generators and charcoal grills. For instance, educational materials display images of generators and grills used outside the home with a green check mark, and images of these items used inside the home marked with a big red "X."

As the materials were developed, planners recruited people with low literacy levels, urban residents, and people who only speak/read Spanish to serve on eight focus groups held in urban areas. Participants offered feedback on the educational materials' readability and use of clear messages and also provided information on how people prefer to receive information during emergencies.

What made this practice possible?
  • Epidemiologic data. Investigation into the poisoning cases revealed that people needed information on placement of alternate cooking and heating sources during power outages and also provided data on target groups that would benefit most from the educational materials.
  • Focus group participation. Input from target groups ensured that messages and their delivery were appropriate and helpful.
  • Funding. Project activities were funded with assistance from a CDC Public Health Emergency Preparedness (PHEP) grant.
  • Availability and reach of materials. The final educational materials (in 10 diffferent languages) are available online, and each of Connecticut's five health regions stores printed copies at their locations for easy access and distribution during a future storm and power outage.
  • Applicability of materials to other preparedness efforts. CDPH posted materials online, made printed copies available, and shared information with local health departments before Hurricane Sandy made landfall in October 2012. Materials were also posted on CDPH's Facebook and Twitter sites before, during, and after the storm.

Find Practices

Newsletter Sign-up

Get CIDRAP news and other free newsletters.

Sign up now»


Unrestricted financial support provided by

Bentson Foundation 3MAccelerate DiagnosticsGilead Become an underwriter»