Investigation of the first carbon monoxide poisoning cluster associated with a hotpot restaurant in Thailand, 2023

Authors

  • Siriyakorn Thanasitthichai Field Epidemiology Training Program, Ministry of Public Health, Nonthaburi, Thailand https://orcid.org/0000-0002-6925-2551
  • Oranut Srihadom Division of Occupational and Environmental Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
  • Tanaporn Thongsim Division of Occupational and Environmental Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
  • Pasika Nonluecha Division of Occupational and Environmental Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
  • Kriangkrai Kampaiboon Pathum Thani Hospital, Pathum Thani, Thailand
  • Chuthamat Bodnok Pathum Thani Provincial Public Health Office, Ministry of Public Health, Pathum Thani, Thailand
  • Pawinee Doungngern Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand

DOI:

https://doi.org/10.5365/wpsar.2026.17.1.1110

Keywords:

carbon monoxide poisoning, charcoal, restaurants, hotpots

Abstract

Objective: On 27 June 2023, the Thailand Department of Disease Control was notified of an incident of carbon monoxide poisoning related to a Thai-style hotpot restaurant. An outbreak investigation was performed to describe the incident, confirm its cause and sources of exposure, and provide preventive measures.

Methods: The restaurant owner, restaurant guests and waiting staff were interviewed, and the medical records of hospitalized cases were reviewed. In an environmental survey, air quality parameters were measured, including temperature, relative humidity, carbon dioxide and carbon monoxide. Additionally, a simulation of the incident was conducted, and data were reviewed from previous poisoning incidents in Thailand.

Results: There were 11 cases, all of whom were guests who dined in the same private dining room. The median age of cases was 28 years (range 2–62 years). Three cases were hospitalized and received hyperbaric oxygen therapy. The air changes in the dining rooms were below the recommended level. The incomplete combustion of charcoal in a poorly ventilated room led to carbon monoxide build-up, which caused the incident. The simulation experiment showed a high concentration of carbon monoxide (mean 183.16 ± 55.15 parts per million), above the standard level. Ten similar poisoning incidents occurred between 2019 and June 2023, totalling 23 cases and 2 deaths; none occurred in a restaurant.

Discussion: Charcoal use in poorly ventilated areas poses a health risk, especially for children. The use of charcoal stoves for hotpot cooking indoors is prohibited. Public health policy should mandate regular restaurant inspections to ensure compliance with occupational and environmental health standards.

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Published

25-03-2026

How to Cite

1.
Thanasitthichai S, Srihadom O, Thongsim T, Nonluecha P, Kampaiboon K, Bodnok C, Doungngern P. Investigation of the first carbon monoxide poisoning cluster associated with a hotpot restaurant in Thailand, 2023. Western Pac Surveill Response J [Internet]. 2026 Mar. 25 [cited 2026 Mar. 28];17(1). Available from: https://ojs.wpro.who.int/ojs/index.php/wpsar/article/view/1110

Issue

Vol. 17 No. 1 (2026): January - March

Section

Original Research

License

Copyright (c) 2026 Siriyakorn Thanasitthichai, Oranut Srihadom, Tanaporn Thongsim, Pasika Nonluecha, Kriangkrai Kampaiboon, Chuthamat Bodnok, Pawinee Doungngern

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