How to Avoid Carbon Monoxide Poisoning
As People Head Indoors, the Risk for CO Intoxication Increases
Nov 20, 2008
Carbon monoxide (CO) is the product of incomplete combustion of carbon-based substances, such as fossil fuels. Carbon monoxide is an odorless, colorless, tasteless, non-irritating, toxic gas.
CO is the leading cause of poisoning deaths in the United States and other industrial countries. (Kao LW. Toxicity associated with carbon monoxide. Clin Lab Med. 2006; 26(1): 99-125 and Omaye S. Metabolic modulation of carbon monoxide toxicity. Toxicology 2002;180(2):139-50)
Since CO is undetectable to humans, unwitting exposures can lead to significant intoxication and death. Lethal poisoning can occur within ten minutes in a closed garage where a car is running.
Where is Carbon Monoxide Found?
CO is produced in any situation where organic material is burned in a limited-oxygen environment. A partial list includes:
- Appliances (including water heaters) that burn coal, gasoline, natural gas, oil, propane, or wood
- Automobile engines
- Industrial settings
- Indoor or portable heaters
- Camp stoves or lanterns
- Charcoal grills
- Wood stoves
- Methylene chloride fumes (from paint strippers) are metabolized in the body to CO and can cause severe intoxication
What are the Signs and Symptoms of Carbon Monoxide Poisoning?
The signs and symptoms of CO poisoning stem from its displacement of oxygen from hemoglobin in the red blood cells. CO binds to hemoglobin much more tightly than oxygen does; tissues and organs are thus deprived of critically-needed oxygen.
Non-specific flu-like symptoms are typical of CO intoxication:
- Headache
- Nausea and vomiting
- Weakness
- Drowsiness
- Dizziness
- Abdominal pain
- Sore throat
- Dry cough
More severe intoxication can result in:
- Rapid or irregular heartbeat
- Hyperventilation and difficulty breathing
- Confusion
- Seizures
- Collapse
- Coma
- Death
Unlike flu, CO poisoning does not cause high fever. The classic cherry-red coloration of the skin that is associated with CO poisoning is RARE and is not a reliable diagnostic sign. Sometimes, chronic exposure to low levels of CO can lead to confusion, memory loss, and loss of coordination.
Diagnosis of CO poisoning is often missed unless exposure is suspected. Occasionally, symptoms like confusion, memory loss, or loss of coordination may not appear for days or even months following initial exposure.
What is the Treatment for Carbon Monoxide Poisoning?
First, individuals who have been exposed to CO must be moved to fresh air. Basic life support (if needed) and oxygen must be administered. Since CO is difficult to clear from tissues, and since tissue damage may continue for many hours after poisoning occurs, it is essential that anyone with known or suspected exposure be transported to a hospital for further evaluation.
The initial medical treatment for CO poisoning includes 100% oxygen and medications to correct metabolic abnormalities. Patients may be transported to facilities where hyperbaric oxygen can be administered.
Victims of mild CO poisoning typically recover, but up to 50% of those who survive moderate to severe intoxication experience long-term complications (e.g., brain or heart damage).
How can Carbon Monoxide Poisoning be Prevented?
- Watch for symptoms among family members or co-workers (symptoms may resolve with a change in location, only to recur upon returning to the area where exposure occurs)
- Never run automobiles, motorcycles, lawn mowers, or snow blowers in a closed space
- Never burn charcoal indoors
- Have gas-burning appliances and heating systems inspected annually
- Inspect flues and chimneys at least annually
- Never go to sleep in an area where a portable gas- or propane-burning heater or lantern is in use
- Use paint strippers only in well-ventilated areas
- Install CO alarms (available in stores) in areas of potential risk
Winter brings people indoors, where they burn fuels to stay warm. A few simple precautions can avert tragedy as the season unfolds.
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