Carbon monoxide poisoning
Carbon monoxide (CO) poisoning occurs when individuals are exposed to toxic levels of this colorless, odorless, and tasteless gas, which is produced from the incomplete combustion of carbon-containing materials like gasoline, natural gas, and wood. It is the most prevalent form of accidental poisoning in the United States, often resulting in severe health impacts or fatalities if not detected and treated promptly. Common sources include motor vehicle exhaust, household appliances, and recreational devices like charcoal grills. The symptoms of CO poisoning can be vague and mimic those of viral illnesses, including headache, dizziness, and nausea, which can lead to misdiagnosis. Vulnerable populations, such as infants, pregnant women, and individuals with certain health conditions, are at higher risk. Diagnosis is confirmed through measuring CO levels in hemoglobin, and treatment typically involves administering supplemental oxygen. Preventive measures, such as regular servicing of appliances and installing CO detectors, are crucial in reducing the risk of poisoning. Awareness and quick medical response are essential when CO exposure is suspected, as data indicate significant annual fatalities and hospitalizations related to this silent but potentially deadly gas.
On this Page
Subject Terms
Carbon monoxide poisoning
Definition: Poisoning caused by exposure to toxic levels of carbon monoxide, a colorless, odorless, and tasteless gas derived from incomplete burning of carbon-containing organic materials, such as gasoline, natural gas, oil, propane, coal, and wood.
Significance: Carbon monoxide (CO) poisoning is the most common type of accidental poisoning that occurs in the United States. Undetected, unsuspected, or undiagnosed, carbon monoxide poisoning can result in death. Hospital emergency departments treat thousands of patients with confirmed and probable CO poisoning yearly, and hundreds of fatalities occur as the result of unintentional, non-fire-related CO exposure. It is estimated that the incidence of intentional CO poisoning, such as suicide and homicide, is even higher.
Carbon monoxide is known as the “silent cold-weather killer” and as “the Great Imitator” because the manifestations of its toxicity are nonspecific. If CO is not considered as a cause when CO poisoning occurs, health care personnel can easily misdiagnose the victim. CO is a ubiquitous gas that is present in workplaces, recreational areas, and homes. The most common sources of carbon monoxide include motor vehicle exhaust, smoke from fires, portable kerosene heaters, charcoal grills, propane stoves, and tobacco smoke. Chemical sources include spray paints, solvents, degreasers, and paint removers containing methylene chloride, which is processed in the liver and changed into CO.
The annual incidence of fatal and nonfatal toxic exposure to carbon monoxide is highest during the winter months, when many homes are closed up against cold weather; cases of CO poisoning are fewest during the summer months. More than two hundred CO poisoning fatalities are caused annually in the United States by fuel-burning appliances such as furnaces, gas ranges, water heaters, and kerosene space heaters. CO poisoning occurs at low levels in susceptible individuals, such as young infants, pregnant women, the elderly, and those with anemia or heart and lung diseases.
The symptoms of CO poisoning are vague; in many ways they are similar to those of viral illnesses, and victims may be misdiagnosed. The most common symptoms are headache, dizziness, nausea, and fatigue. More severe symptoms include loss of consciousness, shortness of breath, confusion, and loss of muscle control. Some patients develop delayed symptoms of the nervous system, such as memory loss, personality changes, and movement disorders. All of these symptoms arise because CO binds tightly to hemoglobin, a protein found in red blood cells, and this binding causes a decrease in oxygen supply, especially in the heart and brain. Medical personnel should be suspicious if anyone displaying such symptoms reports circumstances of the illness that could relate to possible CO exposure.
The diagnosis of CO poisoning is made through the measurement of the CO bound to hemoglobin. Treatment consists of providing supplemental oxygen to dissociate the CO-hemoglobin binding. Oxygen may be delivered through a face mask, through hyperbaric oxygen therapy, or through mechanical ventilation.
Preventive measures to avoid CO poisoning include having heating and ventilation systems, water heaters, and other similar devices serviced yearly by qualified technicians. Generators, charcoal grills, camp stoves, and other similar appliances should not be used indoors or near buildings, and gas ovens should not be used to heat homes. In addition to these precautions, many experts recommend the installation of home CO detectors, which should be checked regularly. Finally, medical attention should be obtained immediately if CO poisoning is suspected.
Bibliography
Occupational Safety and Health Administration. Carbon Monoxide Poisoning Fact Sheet. Washington, D.C.: Government Printing Office, 2002.
Penny, David G., ed. Carbon Monoxide Poisoning. Boca Raton, Fla.: CRC Press, 2007.
Piantadosi, Claude A. “Perspective: Carbon Monoxide Poisoning.” New England Journal of Medicine 347, no. 14 (2002): 1054-1055.