Resources about winter weather and carbon monoxide address preparedness needs of new immigrants

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In Brief

Heavy snowfall, wind and ice storms, and power outages can make winter particularly difficult for recent immigrants with little experience living in a cold climate. In 2006, severe winter wind storms in central Washington caused lengthy power outages and flooded emergency departments and hospitals with people sickened by carbon monoxide exposure. Many patients were recent immigrants and/or people with limited English proficiency who were not aware of the dangers associated with unventilated indoor heating and cooking methods used as alternatives during a power outage. In response, Public Health-Seattle & King County developed a communications campaign in multiple languages aimed at increasing winter weather preparedness among immigrant populations. These resources have remained a significant part of the agency's winter preparedness efforts to ensure the safety of new immigrants.


While severe winter weather may be an expected challenge for people living in cold climates, new immigrants and recent arrivals can often experience significant difficulty in adapting to conditions brought about by heavy snow, ice and wind storms, exposure to freezing temperatures, and power outages.

In December 2006, severe winter windstorms with some winds gusting greater than 135 miles per hour occurred in central Washington state. Over approximately 1 week, 1.5 million households lost power and had to use alternative methods for heat and cooking. Due to unsafe uses of generators and grills indoors, eight people were killed and more than 300 people were sickened by carbon monoxide poisoning. The majority of people seen in hospitals and emergency departments for carbon monoxide poisoning during this time were immigrants and/or people who spoke limited or no English.

Specific issues
  • During a severe weather event, immigrants and people who spoke little to no English appeared at greater risk of carbon monoxide poisoning. Many of the immigrants came from warm climates and were accustomed to open ventilation in the homes; they were unaware of the danger of using grills and BBQ units in the home. Virginia Mason Medical Center in Seattle reported that of the 70 people treated for severe carbon monoxide poisoning in its hyperbaric chamber, only five people spoke English as a first language
  • Cases of carbon monoxide poisoning during the central Washington windstorms occurred due to improper and unsafe use of alternative heating and cooking equipment. Hospitals and emergency departments reported that many patients had been using generators in areas without ventilation. More than 30 Somali immigrants who were treated had been using charcoal grills as sources of indoor heat.
The practice

Several organizations in Seattle and King County collaborated to develop a communications campaign aimed at winter weather preparedness and carbon monoxide safety in multiple languages.

After planners realized that carbon monoxide cases were affecting large numbers of recent immigrants, they hastily made calls to immigrant community groups, developed informative flyers in several languages, and held a news conference to explain the dangers of alternative home heating methods. Partners such as churches, grocery stores, restaurants, and community centers spread the message to people who came to them for services.

Building community partnerships and translating risk messages led to several coordinated winter safety communications campaigns for limited-English populations:

  • The Take Winter by Storm campaign shared messages about prevention of carbon monoxide poisoning in various formats:
    • Posters and warning sheets posted in offices, clinics, and community agencies
    • Radio messages in six different languages
    • Clear recommendations for alternate heating during power outages, such as never using charcoal or gasoline-powered equipment indoors, never using a gas oven to heat a home, never idling a car in the garage, never sleeping in rooms where unvented gasoline or kerosene heaters are present, ensuring safety of fireplaces and chimneys, and installing carbon monoxide monitors
    • A variety of interactive preparedness materials for individual or family use, such as a home inventory checklist; emergency preparedness checklists for creating an evacuation kit, storing items at various locations and in a vehicle, and making a family communication plan); and emergency contact cards
    • Up-to-date details about the situation, including breaking news and information about home and utility maintenance, road conditions and transit, updates on flooding and landslides, weather reports, public health advisories, and human services resources for people who might need shelter
    • Language translation of many materials into Simplified Chinese, Traditional Chinese, Korean, Russian, Somali, Spanish, Tagalog, and Vietnamese
  • In-language resources from Public Health-Seattle & King County describe carbon monoxide risks alongside winter weather preparedness tips. Resources include the following:
    • Carbon monoxide fact sheets and flyers in 24 languages
    • Information on addressing conditions that can affect health, such as cleaning a house after a flood, cleaning indoor sewage spills and basements, constructing an emergency toilet, disinfecting private wells, finding hidden water supplies, preparing safe water, preventing hypothermia, keeping septic systems safe, protecting food and medicine during a power failure or flooding, and responding to a boil water order.
What made this practice possible?
  • Inter-governmental and business collaborations led to the multiple perspectives and wide variety of information included in the Take Winter by Storm campaign. Partners included the City of Seattle, King County, Puget Sound Energy, the Washington Department of Transportation, and State Farm Insurance.
  • Public Health-Seattle King County's Vulnerable Populations Action Team had been developing plans around the needs of at-risk populations during an emergency. The 2006 winter storm and subsequent carbon monoxide-related illnesses and deaths were the first time the team was able to put their plans into practice.
  • Strong engagement and involvement of organizations, business, and places of worship that served the immigrant and limited-English communities allowed agencies to disseminate information quickly.
  • In-language resources grew to reach more immigrant communities. In 2006, materials in seven languages were distributed to agencies and businesses serving immigrant communities. By 2011, preparedness resources were available in 24 languages.
  • Resources ready to use each winter. As new immigrants move into the Seattle metropolitan area year-round, information on winter weather safety is important to keep visible and accessible. The resources created in response to the 2006 storm are able to be used and disseminated rapidly whenever required by environmental or community needs.

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