Carbon Monoxide

Data indicates that, each year, approximately 15,000 U.S. residents visit emergency rooms for unintentional, non--fire-related CO exposure and approximately 500 die from unintentional, non--fire-related CO poisoning. Primary CO sources were home appliances, and the majority of exposures occurred during the fall and winter months, when persons are more likely to use gas furnaces and heaters. During warmer months, boating activities might also be a source of exposure. This analysis also determined that males are more likely to die from CO poisoning than females, which is consistent with previous findings. Males might be exposed to higher CO levels during high-risk activities, such as working indoors or in enclosed garages with combustion-engine--driven tools (e.g., generators or power washers) . The CO poisoning death rate was highest among persons aged 65 years, likely attributable to their being at higher risk for undetected CO exposure because symptoms often resemble those associated with other health conditions common among older persons . [source: CDC]

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Common sources of Carbon Monoxide that may lead to poisoning include house fires, furnaces or heaters, wood-burning stoves, motor vehicle exhaust, propane-fueled equipment such as portable camping stoves, ice resurfacers, forklifts, and gasoline-powered tools such as high-pressure washers, concrete cutting saws, power trowels, floor buffers, and welders used in buildings or semi-enclosed spaces. CO poisoning can also occur in scuba diving due to faulty or badly sited diving air compressors. Generators and propulsion engines on boats, especially houseboats, have resulted in fatal carbon monoxide exposures. Another source is exposure to the organic solvent methylene chloride, which is metabolized to CO by the body.

[picture source: CDC]

Early symptoms of carbon monoxide poisoning such as headaches, nausea, and fatigue, are often mistaken for the flu because the deadly gas goes undetected in a home. Prolonged exposure can lead to brain damage and even death.

Acute
The main manifestations of poisoning develop in the organ systems most dependent on oxygen use: the central nervous system and the heart. The clinical manifestations include tachycardia and hypertension, and central nervous system symptoms such as headache, dizziness, confusion, convulsions, and unconsciousness. Poisoning may also produce myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, hyperglycemia, muscle necrosis, acute renal failure, skin lesions, visual and auditory problems, and respiratory arrest.

One of the major concerns following CO poisoning is the severe neurological manifestations that may occur days or even weeks after an acute poisoning. Common problems encountered are difficulty with higher intellectual functions and short-term memory, dementia, irritability, gait disturbance, speech disturbances, parkinson-like syndromes, cortical blindness, and depression, which can even occur in those accidentally exposed who do not have pre-existing depression. These delayed sequelae occur in approximately 15 percent of severely poisoned patients after an interval of 2 to 28 days. It is difficult to predict who may develop delayed sequelae; however, advancing age, loss of consciousness while poisoned, and initial neurological abnormalities may indicate a greater chance of developing delayed symptoms. According to the Philadelphia poison control hotline, sequelae are generally not anticipated when exposure is not severe enough to result in loss of consciousness.

Chronic
Long term, repeated exposures present a greater risk to persons with coronary heart disease and in pregnant patients. Chronic exposure may increase the incidence of cardiovascular symptoms in some workers, such as motor vehicle examiners, firefighters, and welders. Patients often complain of persistent headaches, lightheadedness, depression, confusion, and nausea/vomiting. Upon removal from exposure, the symptoms usually resolve themselves.

Toxicity
Carbon monoxide is a significantly toxic gas, although patients may demonstrate varied clinical manifestations with different outcomes, even under similar exposure conditions. Toxicity is also increased by several factors, including: increased activity and rate of ventilation, pre-existing cerebral or cardiovascular disease, reduced cardiac output, anemia or other hematological disorders, decreased barometric pressure, and high metabolic rate.

Carbon monoxide is life-threatening to humans and other aerobic forms of life, as inhaling even relatively small amounts of it can lead to hypoxic injury, neurological damage, and possibly death. A concentration of as little as 0.04% (400 parts per million) carbon monoxide in the air can be fatal. The gas is especially dangerous because it is not easily detected by human senses. One report concluded that carbon monoxide exposure can lead to significant loss of lifespan after exposure due to damage to the heart muscle.

Concentration Symptoms:
35 ppm (0.0035%) Headache and dizziness within six to eight hours of constant exposure
100 ppm (0.01%) Slight headache in two to three hours
200 ppm (0.02%) Slight headache within two to three hours
400 ppm (0.04%) Frontal headache within one to two hours
1,600 ppm (0.16%) Dizziness, nausea, and convulsions within 45 minutes. Insensible within two hours.
3,200 ppm (0.32%) Headache, dizziness and nausea in five to ten minutes. Death within 30 minutes.
6,400 ppm (0.64%) Headache and dizziness in one to two minutes. Death in less than 20 minutes.
12,800 ppm (1.28%) Unconsciousness after 2-3 breaths. Death in less than three minutes.

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Much of the information used here has been researched from Wikipedia, the free encyclopedia.

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