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Carbon Monoxide

October 28, 2011

It’s the time of year when wood stoves and fire places are being used for more heat and we need to be careful about carbon monoxide.  Carbon monoxide (or CO) is a byproduct of the burning process.  Any fuel that is burned creates carbon monoxide:  wood, gas, oil, coal, kerosene, pellets, charcoal briquettes, etc.  The problem with carbon monoxide is what it does to our blood when we inhale it.

Blood keeps us alive by circulating oxygen to our bodies.  Hemoglobin is the component in our blood that carries and transfers oxygen.  Some tissues (like the heart and brain) need more oxygenation then others.  Carbon monoxide will adhere to hemoglobin more readily than oxygen (creating a compound called carboxyhemoglobin), and it will stay with the hemoglobin much longer.  The more of your hemoglobin that is bound up with carbon monoxide, the less oxygen your body is getting.  A little carboxyhemoglobin can be survived, but at some point there is no longer enough free hemoglobin to carry oxygen and the brain and heart start to die.

Symptoms of CO poisoning are similar to the flu or food poisoning and include headaches, dizziness and nausea.  You can also experience confusion, respiratory difficulty and feeling faint.  Because CO poisoning symptoms are so similar to common flu symptoms, victims sometimes go undiagnosed.  That makes CO poisoning insidious.  It is the number one accidental fatal poisoning agent in the U.S. (Medscape, 2011).

Those most at risk of CO poisoning tend to be the elderly (over 65) and the very young whose respiratory systems are less robust.  People of any age with respiratory ailments share that risk.  Smokers already have higher than normal carboxyhemoglobin so they don’t need much CO exposure to experience CO problems.  Statistically men tend to suffer from CO poisoning more than women (Medscape, 2011).  It seems that men spend more time fiddling around with internal combustion engines in less than adequate ventilation.  CO poisoning occurs more in colder climates due to the use of alternate heat sources.  Most non-fatal CO poisonings occur in the home, however current studies warn of the CO effects on kids riding in the back of enclosed pickups.  Vehicles and home heating are our top two culprits for CO poisoning in the United States (Cobb & Etzel, 2005).

PREVENTION

There are two ways to protect against carbon monoxide:  prevention and detection.

One preventative aspect is ensuring that fuel-burning appliances (furnaces, wood stoves, gas hot-water heaters, gas stoves, gas clothes dryers, cars, etc.) are maintained to manufacturer’s specifications.  Furnaces should be inspected annually.  Flues used to provide for exhaust of smoke and carbon monoxide must be kept clear at all times.

Another preventative aspect is to ensure all fuel burning appliances are used where there is adequate ventilation.  Running a car in the garage accumulates carbon monoxide.  Studies show that even opening the garage door does not provide completely adequate ventilation.  Internal combustion engines (vehicles and generators) must be used outside.  The same goes for barbecues.  We’ve had several CO fatalities here in Spokane County during winter cold snaps when someone tries using barbecue briquettes inside to heat the home.

Next week we’ll look at detection and what to do when your CO detector goes off!

 

REFERENCES

Cobb N, & Etzel R. A. Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988.  Journal of the American Medical Association.  August 7, 1991; 266(5), 659-63. [Medline].

Consumer Search.  (April, 2010).  Carbon monoxide detectors:  What to look for.  Retrieved September 20, 2011, from http://www.consumersearch.com/carbon-monoxide-detectors/important-features.

Medscape. (May 19, 2011).  Carbon monoxide toxicity in emergency medicine.  Retrieved September 20, 2011, from http://emedicine.medscape.com/article/819987-overview#a0199.

Unintentional non-fire-related carbon monoxide exposures–United States, 2001-2003.  Morbidity and Mortality Weekly Report.  January 21, 2005; 54(2), 36-9. [Medline]. [Full Text].

United States Environmental Protection Agency.  (Sept, 2010).  Protect your family and yourself from carbon monoxide poisoning.  Retrieved October 26, 2011 from http://www.epa.gov/iaq/ pubs/coftsht.html.

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