• Michael W Schmitt, Timothy L Williams, Kristinza R Woodard, and Richard C Harruff.
• King County Medical Examiner's Office, 325 Ninth Avenue, HMC Box 359792, Seattle, WA 98104-2499, USA.
• J. Forensic Sci. 2011 May 1;56(3):652-5.

AbstractCarbon monoxide (CO) inhalation is one of the leading methods of suicide in the United States. A sharp increase in suicide by inhaling the CO produced from burning charcoal has been reported in parts of Asia; however, the incidence of this method has not been determined in a U.S. population. Thus, we determined trends of CO suicide in the ethnically diverse population of King County, Washington, U.S.A. During the period 1996-2009, we identified 158 cases of suicide by CO poisoning, with 125 because of automotive exhaust, 26 because of charcoal burning, and seven from other CO sources. While historical U.S. data indicate >99% of CO suicides in the United States occurring by automobile exhaust inhalation, in the most recent years analyzed, c. 40% of CO-related suicides in King County, Washington, were because of charcoal burning, indicating a possible shift in suicide trends that warrants further scrutiny in additional populations.© 2011 American Academy of Forensic Sciences.

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