Abstract
Other than vehicle collisions, causes of death in vehicle passengers include carbon monoxide （CO） poisoning, heatstroke and drowning. However, there are no statistics available on these issues, so no effective preventive measures have been put in place. We collected reports of autopsies on cases of accidental CO poisoning from April 2014 to March 2019 and reviewed the literature on this issue to 2018 in Japan. Three autopsies from two accidents were examined. One accident was caused by obstruction of the exhaust tail pipe by snow, and the other by damage to the exhaust tail pipe after a collision. The literature review found 39 cases of accidental CO poisoning in automobiles reported in Japan, of which 14 were fatal. In total, 42.9％ of the fatal cases, and 8.0％ of the non-fatal cases were caused by poor vehicle maintenance, and 21.4％ of the fatal cases and 92.0％ of the non-fatal cases by obstruction of the exhaust tail pipe by snow.
To prevent CO poisoning, it is therefore necessary to raise awareness of the danger of this issue, and the importance of regular vehicle inspections and maintenance to identify any damage to the exhaust pipe. People should also be reminded of the importance of removing snow from around the exhaust tail pipe before starting the engine. The cases we reviewed might be limited, so we suggest that it may be helpful to register all CO poisoning relating to motor vehicles. This would allow nationwide analyses to be carried out. In future, it may be necessary to develop a CO warning system for vehicles.
