Feeling a little dizzy lately? Suffering bouts of headache and nausea? Dogged by persistent flu-like symptoms that seem to clear up on the way to work? These are the symptoms of carbon monoxide poisoning in the home.
Georgia Prime Minister Zurab Zhvania died Thursday morning of apparent gas poisoning, overcome along with his host and friend while playing a game of backgammon. The source of the carbon monoxide fumes was a gas-powered heating stove.
Although such tragedies are much more common in foreign countries, hundreds die each year in the U.S. from carbon monoxide poisoning.
Carbon monoxide is found in combustion fumes, such as those produced by cars and trucks, small gasoline engines, stoves, lanterns, burning charcoal and wood, as well as gas ranges and heating systems.
It is called "the silent, cold weather killer" because odorless, colorless accumulations from leaking gas or other fuel-burning appliances can rise to deadly levels when doors and windows are kept shut in winter.
Fatigue in healthy people and chest pain in people with heart disease are common symptoms of low concentrations of carbon monoxide in the home or workplace, according to the U.S. Environmental Protection Agency. Higher concentrations may result in impaired vision and coordination, headaches, dizziness, confusion and nausea. Carbon monoxide poisoning is fatal at very high concentrations.
Levels in the Home
Carbon monoxide is a byproduct of fuel-burning appliances and equipment, but properly installed and vented apparatus add only minuscule amounts to a home's atmosphere. Average levels in homes without gas stoves vary from 0.5 to 5 parts per million; levels near properly adjusted gas stoves may range between 5 to 15 ppm, according to an EPA report. Carbon monoxide levels in the air surrounding a poorly adjusted stove can jump to double that high average or even higher.
Installation and annual maintenance of all fuel-burning appliances should be left to the professionals. Hire a professional each year to inspect, clean and tune-up central heating systems, including boilers, furnaces, flues and chimneys, as well as ranges, ovens and gas stoves.
Misuse of even properly adjusted appliances can result in carbon monoxide poisoning. Never use a gas oven or range to heat a room.
Now that all the appliances are properly tuned up, it's time to look at other sources of carbon monoxide.
Other Sources
Generators are a handy piece of equipment when the power goes out during a fierce winter storm, but strictly follow instructions regarding its placement. Gas or fuel-burning generators are not designed to run inside a garage—even with that door to the backyard open. Not only can a person stepping into the garage be overcome, fumes leaking stealthily through the door to the house may sicken family members in the adjoining room. Proper, professional installation and venting—usually including an exhaust fan to the outdoors—is well worth the money if generators are essential to keeping electricity available at all times.
Even when placing a generator outside the home, do not set it up near windows, doors or air intake vent that could draw fumes into the living space.
Wood stoves are another potential source of carbon monoxide. Ensure the stove is EPA certified for emissions, properly installed and vented to the outdoors. Be sure the flue is in good working order and the chimney is cleaned and inspected annually.
How Does It Kill?
Carbon monoxide is a colorless, tasteless, odorless and non-irritating gas formed when carbon in fuel is not burned completely.
The gas enters the blood stream through the lungs, attaching to hemoglobin, the body's oxygen carrier, forming carboxyhemoglobin and thereby reducing oxygen to the body's organs and tissues, according to EPA's office of Research and Development. High concentrations are poisonous, affecting the central nervous system. Depending on the severity of exposure, symptoms in individuals suffering acute poisoning include those listed above, as well as vomiting, collapse, coma and death.
Complications occur frequently. Immediate death is most likely cardiac in origin because heart tissues are most sensitive to the hypoxic effects of carbon monoxide. Severe poisoning often results in hypotension, lethal arrhythmia and electrocardiograph changes. Pulmonary edema may occur.
Many of the symptoms of carbon monoxide poisoning correlate with symptoms of heart disease and common flu viruses. An emergency physician unaware that carbon monoxide poisoning is a potential source of the symptoms may never consider it, and as time elapses during the ambulance ride and emergency treatment evidence of the gas may be eliminated from the bloodstream by the body.
While symptoms may ease when the victim of a severe poisoning is removed to fresh air, resolution of the consequences may be slow to improve. Other neurological impairments may develop from two to 28 days after poisoning, which the victim or family may never attribute to the initial event and never mention to the attending physician.
While all people and animals are at risk for carbon monoxide poisoning, unborn babies, infants and people with chronic heart disease, anemia or respiratory problems are more susceptible to its effects.
Each year, more than 500 Americans die from unintentional carbon monoxide poisoning and more than 2,000 are estimated to commit suicide by intentionally poisoning themselves, according to numbers collected by the EPA. Many more unknowingly suffer the effects of occasional or continual low-level poisoning. In fact, carbon monoxide may be the cause of more than half the fatal poisonings reported in many countries. Fatal cases are also grossly under-reported or misdiagnosed by medical professionals, according to the EPA studies.
Tips on Prevention
· Carbon monoxide poisoning is preventable. Simple precautions can help ensure the safety of every family. The CDC provides this list, so make sure that:
· All fuel-burning appliances are properly installed, maintained and operated;
· furnaces, water heaters and gas dryers are inspected annually by a qualified service technician;
· fireplace chimneys and flues are checked and cleaned every year;
· unvented fuel burning space heaters are used only while someone is awake to monitor them and doors or windows in the room are open to provide fresh air;
· automobile exhaust systems are routinely inspected for defects; and
· automobile tailpipes are routinely inspected for blockage by snow during the winter months.
And, remember:
· Never use a gas range or oven to heat a home.
· Never use a charcoal grill, hibachi, lantern or portable camping stove inside a home, tent or camper.
· Never run a generator, pressure washer or any gasoline-powered engine inside a basement, garage or other enclosed structure, even if the doors or windows are open, unless the equipment is professionally installed and vented.
· Never run a motor vehicle, generator, pressure washer or any gasoline-powered engine outside of an open window or door where exhaust can vent into an enclosed area.
· Never leave the motor running in a vehicle parked in an enclosed or semi-enclosed space, such as a closed garage.
In most cases, victims are not aware of the presence of carbon monoxide, but if exposure could be the source of the patient's symptoms, be sure to mention it to the attending physician.
Knowledge is the key to preventing carbon monoxide poisoning. Carbon monoxide alarms are available and should be placed on each level of the house and in bedrooms.
