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ENVIRONMENTAL HAZARDS - INSPECT, TEST, REMEDY

AIR CLEANER PURIFIER TYPES
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AIR POLLUTANTS, COMMON INDOOR
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AIR TEST FOR MOLD: ACCURACY
AIR TEST SAMPLING CASSETTE STUDY
AIRBORNE MOLD SPORE COUNT ACCURACY

ALLERGEN TESTS for BUILDINGS
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ALLERGY TEST ACCURACY

ANIMAL ALLERGENS / PET DANDER
ANIMAL ENTRY POINTS in buildings
ANIMAL ODORS IN buildings
ASBESTOS IDENTIFICATION IN buildings
ATTORNEYS and EXPERT WITNESSES

Backdrafting Appliances
BIBLIOGAPHY for ENVIRONMENTAL HEALTH, MOLD, IAQ
BIOGAS PRODUCTION & USE
BIOLOGICAL POLLUTANTS
BLOWER DOORS & AIR INFILTRATION
BLUE vs YELLOW COMBUSTION FLAMES
BLUERAY Recall
BIOLOGICAL POLLUTANTS
Bisphenol-A, BPA
BOOKSTORE - ENVIRONMENTAL
BUILDING SAFETY HAZARDS GUIDE
BUY PRODUCTS for MOLD & ALLERGY CONTROL

CARBON DIOXIDE - CO2
  CO2 POISONING SYMPTOMS
  CO2 HEALTH EFFECTS
  CO2 EXPOSURE LIMITS
  TYPICAL CO2 LEVELS
CARBON MONOXIDE - CO
  ALARM CAUSES - CO
  EXPOSURE LIMITS for CO
  INSPECTION for CARBON MONOXIDE
  TESTS for CARBON MONOXIDE
  MEDICAL EFFECTS of CO
  POISONING SYMPTOMS - CO
CARBON MONOXIDE WARNING
Carbon Nanotube Hazards

CARPET DUST IDENTIFICATION
CARPET MOLD CONTAMINATION
CARPET TEST GUIDE
CARPETING & INDOOR AIR QUALITY
CARPETING, SELECTION & INSTALLATION
Cell phone Radiation Hazards
CHIMNEY INSPECTION DIAGNOSIS REPAIR
COALSTOVE SAFETY
COMBUSTION PRODUCTS & IAQ
CHINESE DRYWALL HAZARDS
CHEMICAL CONTAMINANTS in WATER
CHLORINE IN DRINKING WATER
CHLORINE in WATER, HOW TO TEST FOR
CHLORINE IN SEPTIC WASTEWATER
COMBUSTION GASES & PARTICLE HAZARDS
CPSC Indoor Air Pollution Book Online Copy

Disinfectants
Disinfecting Buildings with Bleach

DRAFT HOODS - gas fired
DRAFT MEASUREMENT, CHIMNEYS & FLUES
DRAFT REGULATORS, DAMPERS, BOOSTERS
DRINKING WATER
Diethylstilbestrol - DES
DUCT SYSTEM & DUCT DEFECTS
DUST ANALYSIS for FIBERGLASS
DUST CONTAMINATION FROM HVAC?
DUST SAMPLING PROCEDURE

EMF
EMF Cancer Scare
EMF RF FIELD & FREQUENCY DEFINITIONS
EMF ELECTROMAGNETIC FIELDS & HUMAN EXPOSURE
EMF Levels of Cancer Risk
EMF MEASUREMENT INSTRUMENTS
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EMF SURVEY PROCEDURE - Details

ENERGY SAVINGS in BUILDINGS
ENVIRO-SCARE - PUBLIC FEAR CYCLES
EXTERIORS of BUILDINGS

Fiberboard Insulation Sheathing Mold
Fiberglass Enviro-Scare
FIBERGLASS HAZARDS
FIBERGLASS PARTICLE CONTAMINATION TEST
FIBERGLASS INSULATION MOLD
FIBERGLASS PARTICLE CONTAMINATION TEST

Fireplace Inserts
Fireplaces & Woodstove Contaminants
FLAME COLOR, BLUE vs YELLOW COMBUSTION

FLOOD DAMAGE ASSESSMENT, SAFETY & CLEANUP
FLOODS IN BUILDINGS-mold

FLOOR DAMAGE DIAGNOSIS
FLOOR TYPES & DEFECTS
FLOOR TILE ASBESTOS IDENTIFICATION
FLOOR TILE HISTORY & INGREDIENTS
Floor Tile, Asbestos, Photo ID Guide
FLOORING MATERIALS, Age, Types

FORMALDEHYDE HAZARDS
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GAS DETECTION & MEASUREMENT
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  GAUGE, REFRIGERATION PRESSURE TEST
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  Warnings: gas detectors
  Warning: gas detector tubes

GASES, EXPOSURE, TESTING
  Carbon Dioxide - CO2
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GAS EXPOSURE EFFECTS, TOXIC
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GAS EXPOSURE TEST PROCEDURES
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GAS LP & Natural Gas Safety Hazards
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GAS MEASUREMENT TOOLS
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GAS TOXICITY LEVELS
  Gas Exposure Standards (Workplace)
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GLARE, Sunlight/Lighting Control
Goodman HTPV RECALL

HVAC Systems
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LEAD POISONING HAZARDS GUIDE
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OXYGEN - O2
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PAINTS & COATINGS ODORS IN buildings
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Pet Dander
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RADON HAZARD TESTS & MITIGATION
Radon Enviro-Scare

ROT, FUNGUS, TERMITES

SAFETY HAZARDS GUIDE
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SEWER GAS ODORS
SIDING VINYL
SLIDE PREPARATION, MICROSCOPE
SMELL PATCH TEST to Track Down Odors

SOLAR ENERGY SYSTEMS
SOUND CONTROL in BUILDINGS
STAIN & BIODETERIORATION AGENT CATALOG
STAINS on buildings - QUICK GUIDE
STAIN DIAGNOSIS on BUILDING EXTERIORS
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SICK HOUSE IAQ QUESTIONNAIRE
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SEPTIC METHANE GAS
SEPTIC SYSTEM ODORS

SEWAGE BACKUP TEST & CLEANUP
SEWAGE & SEPTIC CONTAMINANTS
SEWAGE CONTAMINATION in BUILDINGS
SEWAGE CONTAMINANTS in FRUIT / VEGETABLES
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SEWAGE PATHOGENS in SEPTIC SLUDGE
SEWAGE PUMPS
SEWAGE PUMP CLOG DAMAGE
SEWER BACKUP PREVENTION
SEWER GAS ODORS
SEWER GAS ODORS in COLD WEATHER
SEWER LINE REPLACEMENT

SICK HOUSE IAQ QUESTIONNAIRE
SIDING VINYL
SMELL PATCH TEST to Track Down Odors
SULPHUR & SEWER GAS SMELL SOURCES

THERMAL TRACKING Indicates Heat Loss

Urea Formaldehyde Foam Insulation UFFI
URETHANE FOAM Deterioration, Outgassing

VAPOR BARRIERS & AIR SEALING at BAND JOISTS
VAPOR BARRIERS & CONDENSATION in buildings
VAPOR BARRIERS & HOUSEWRAP
VAPOR CONDENSATION & BUILDING SHEATHING
VENTILATION in buildings
VINYL CHLORIDE HEALTH INFO
VINYL Siding or PLASTIC Window ODORS in buildings
Volatile Organic Compounds VOCs

WATER ODORS, CAUSE CURE
WATER TESTS, CONTAMINANTS, TREATMENT
WATER TREATMENT EQUIPMENT CHOICES
Well Pollution
WIND TURBINES & LIGHTNING
World Trade Center Collapse Dust Photos

More Information

Photograph of a 120Vold carbon monoxide detector device Toxicity of Carbon Monoxide Gas Exposure, Carbon Monoxide CO Poisoning Symptoms, Carbon Monoxide Exposure Limits, and Links to Toxic Gas Testing Procedures
InspectAPedia®  -    

  • Symptoms of carbon monoxide poisoning
  • What makes a CO alarm or carbon monoxide detector go off?
  • How to inspect buildings where carbon monoxide gas is suspected
  • Testing for Carbon Monoxide presence in buildings
  • Medical effects of carbon monoxide exposure - CO exposure - Toxicity of carbon monoxide gas
  • Carbon monoxide gas exposure limits
  • Recommendations for gas measurement instruments, gas detector tubes, Draeger & Gastec tubes & pumps for detection of gases
  • Questions & answers about carbon monoxide gas exposure, hazards, testing, and regulations

This document discusses the toxicity and exposure limits for exposure to carbon monoxide gas (CO). We describe procedures for inspecting buildings for evidence of carbon monoxide hazards, including visual clues that may suggest a safety problem even if CO testing is not detecting carbon monoxide at the time of the inspection. We describe carbon monoxide testing methods, the medical effects of carbon monoxide exposure, and we cite authorities who set the limits on carbon monoxide exposure in different environments.

InspectAPedia offers impartial, unbiased advice without conflicts of interest. We will block advertisements which we discover or readers inform us are associated with bad business practices, false-advertising, or junk science. Our contact info is at InspectAPedia.com/Contact.htm.

We give references and explanation regarding Toxicity of Carbon Monoxide, based on literature search and including research on Compuserve's Safety Forum. This is background information, obtained from expert sources. This text may assist readers in understanding these topics. However it should by no means be considered complete nor authoritative.

Seek prompt advice from your doctor or health/safety experts if you have any reason to be concerned about exposure to toxic gases. Carbon monoxide poisoning can be fatal but exposure at lower limits can produce flu-like symptoms and headaches that are often mistaken for ordinary illness. Readers of this document should also see Backdrafting Appliances and see HEAT EXCHANGER LEAKS.

IF YOU SUSPECT CARBON MONOXIDE POISONING GO INTO FRESH AIR IMMEDIATELY and get others out of the building, then call your fire department or emergency services for help. Links on this page also direct the reader to carbon dioxide gas information in a separate document.

© Copyright 2012 InspectAPedia.com, All Rights Reserved. Information Accuracy & Bias Pledge is at below-left. Use page top links to major topics or use links at the left of each page to navigate within topics and documents at this website. Green links show where you are in a document series or at this website.

Guide to Inspecting buildings for Visible Evidence of Conditions Likely to Produce Dangerous Carbon Monoxide Gas

The fact that you cannot see nor smell dangerous carbon monoxide gas does not mean that there is nothing to look for when assessing the safety of heating equipment. Not only are there easily spotted installation errors (the first list below), there may be more subtle but easily visible errors if you know what to look for (the second list below).

Safety Suggestions: Install Carbon Monoxide Detectors in addition to Smoke Detectors

Carbon monoxide detectors are inexpensive and readily available, both as a battery-operated unit and as a unit that plugs into an electrical outlet in the home. No home should be without this safety protection, and homes with gas-fired equipment (natural gas or LP propane), space heaters, or other sources of risk should be extra cautious. Smoke detectors do not protect against carbon monoxide poisoning, and the opposite is also true. Carbon monoxide detectors do not warn of smoke or fire.

Examples of visible building conditions risking carbon monoxide hazards

This is by no means the complete list of errors that can cause dangerous carbon monoxide exposure in buildings, but here are some common foul ups outside of the workplace that can cause dangerous levels of indoor carbon monoxide:

  • Space heaters: improper use of gas or kerosene fired heaters can produce high indoor CO levels. Warning: Never go to sleep in an enclosed space with a space heater left operating. In addition to the CO hazards there is a risk of oxygen depletion which can also lead to asphyxiation.
  • Gas fired central heating equipment combined with:
    • Improper venting, blocked, under-sized, over-sized, missing parts, improperly sloped chimney or flue. A variety of errors can cause a failure to vent combustion gases out of the building, allowing dangerous flue gases to build up indoors.
    • inadequate combustion air. If a heating appliance is installed in a small confined space it must be provided with outside combustion air. A service technician may tune and inspect a gas-fired boiler with the boiler room door open, finding that it seems to operate fine. When s/he closes it on leaving, there may be an inadequate or no opening for combustion air into the room.
    • Venting small appliances into large cold chimneys: Installation of small, higher efficiency gas-fired equipment into old homes at which the appliance is vented into a large (cold) masonry chimney. In such instances the heater may never develop sufficient heat and draft to actually vent up the chimney.
    • Also sometimes water heaters are left venting into a too-large, too-cold masonry chimney after a gas-fired boiler is converted to a high-efficiency direct-vent (no chimney) unit. One of my clients developed headaches every October - an event I traced to this condition in Poughkeepsie, NY. [DF re E.B. case 1988].
  • Car exhaust, such as to occupants of rooms adjoining or even above a garage where car engines are left running
  • Un-vented gas fired water heaters, often found venting directly into a basement utility room or even directly into a living area or bedroom.
  • CHIMNEY INSPECTION GUIDE contains detailed suggestions for inspecting building chimneys including the detection of blocked chimney flues or indications that a chimney may be blocked.
  • Exhaust leaks in vehicles - see BOAT & CAR SMELLS & ODORS; car exhaust can leak into the vehicle itself, or if a car, camper, or truck engine is left running in a building garage, the vehicle exhaust can leak into the building at dangerous levels.

Other clues which can suggest a risk of carbon monoxide hazards in buildings

  • CO detector alarms Do not ignore this first line of defense. Install CO detectors near the heating equipment as well as in sleeping areas of the home. People have died after not believing their CO detector and taking out the batter to silence the annoying device which they believed was malfunctioning.
  • Missing parts: Gas fired water heaters, furnaces, boilers which are missing flue vent connector components such as draft hoods and flue gas spill detection switches - it can be difficult to spot that something is missing unless you know what's supposed to be there. Review this topic with a trained heating service technician or plumber.
  • Clogged heater draft hood from hair or other debris
  • Signs of flue gas spillage Blocked flues will result in combustion gas spillage back into the building. Often this will cause:
    • Rust on heating equipment at the point of flue gas spillage - you can detect this even when the equipment is not operating
    • Rusty debris on the top of gas fired heating equipment below the draft hood
    • Water condensation on building surfaces may occur if gas-vented appliances are venting back into the building, especially on cool basement surfaces - you can only observe this when the equipment is operating
    • Odors of combustion products: while CO and CO2 are themselves odorless, if they are spilling from heating equipment, odors of other combustion products may be notices.

Procedures for Testing for Carbon Monoxide Gas Leaks, Exposure, Hazards

In addition to the installation of CO monitoring alarms in buildings, a variety of electronic and gas sampling equipment is available to make spot checks for hazardous gases. I have and have used a variety of these devices under a wide range of conditions.

While a "positive" indication of a gas is an important indicator of a hazard, a "negative" or "not found" result is nothing to rely on.

The fact that dangerous levels of CO are not present in a building at a particular instant is absolutely no guarantee that dangerous levels of CO (for example) may not occur even moments later. For example, opening a window, turning on a fan or clothes dryer, closing a door, and similar innocent acts can significantly change air flow, combustion air, and other building conditions.

Therefore spot tests for dangerous gases should not be relied upon to guarantee building safety. This is why the list of visual inspection items and proper heating equipment maintenance are so important.

Suggestions and content additions are invited. Contact me with items to add to these lists.

More Reading:
Heating System Check Recommended for Carbon Monoxide - CPSC Release 88-92

CHIMNEY INSPECTION GUIDE contains detailed suggestions for inspecting building chimneys including the detection of blocked chimney flues or indications that a chimney may be blocked.

MEDICAL EFFECTS of CO - Medical effects of Carbon Monoxide (CO) Poisoning

Many sources I (DF) reviewed indicated that if carbon monoxide exposure was sub acute, that is if the person did not lose consciousness and was removed from the CO exposure before losing consciousness, then any medical effects were temporary. Indeed detection of CO exposure at a hospital is problematic since CO leaves the bloodstream quickly once a person is exposed to normal air. However there is evidence that lasting physical damage may occur from carbon monoxide exposure, though the popular press has not (2006) discussed the exposure level and duration necessary for these effects.

Heart muscle damage occurs from Carbon Monoxide (CO) exposure, screening recommended

31 January 2006 - The New York Times Science Section reports on a new study, released in JAMA's January 25 2006 Magazine Issue, and which indicated that people exposed to carbon monoxide suffer damage to their heart muscles and are at much greater risk for heart attacks in later years.

The Times article asserted that CO Poisoning results in 40,000 emergency visits a year in the United States - the most common accidental poisoning event in the U.S. with an annual average accidental death rate of about 1000 people and average suicidal death rate of about 2400 people. [U.S. CDC] Five percent of such patients die in the hospital. Research was not cited regarding sub acute exposures and exposures which do not result in a visit to a hospital. -- New York Times Science Section, January 31, 2006 p. F6, "After Crisis, Carbon Monoxide Still Takes a Toll."

The carbon monoxide exposure and heart muscle damage study was led by Christopher R. Henry, Minneapolis Heart Institute Foundation, in the current [Jan 2006] Journal of the American Medical Association The study examined the medical history of 230 people exposed to carbon monoxide and treated at hospital between 1994 and 2002, following their health to 2005.

After 7 1/2 years, in this otherwise low risk (of heart failure) population, 25% of the originally-surviving patients had died - a rate about three times the average heart failure death rate statistic. For people who had suffered heart muscle damage the mortality rate was 38% with half of the mortalities being (apparently) traced to cardiovascular problems.

The study concludes that people who are exposed to carbon monoxide should be screened for heart muscle damage. Heart muscle damage from CO poisoning (in the study) was characterized by elevated levels of cardiac troponin I (a type of protein) or creatine kinase-MB (a type of enzyme), and/or changes in diagnostic electrocardiogram (ECG). -- DJ Friedman paraphrasing the NY Times article and JAMA's news release regarding this study.

More references for this study:
see: Heart Injury Due to Carbon Monoxide Poisoning Increases Long-Term Risk of Death, JAMA January 25 2006. AMA news release 2006. This study was supported by an unrestricted educational grant from the Minneapolis Heart Institute Foundation. Study copies may be available from the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) - mediarelations@jama-archives.org.

Carbon Monoxide Poisoning Information From U.S. Army Field Manual 8-285:

Pathology of CO poisoning: Asphyxiation is caused by the inactivation of blood hemoglobin through a combination with CO. The resultant anoxia may produce nervous system changes. Postmortem examinations reveal little beyond the characteristic cherry red color of the blood and hemorrhages in the brain

Symptoms of CO poisoning: Carbon monoxide is very insidious in its action and poisoning may occur without appreciable initial signs. The symptoms progress from throbbing headaches, vertigo, yawning, and poor visual acuity, to the development of cherry red mucous membranes, weakness and coma, subnormal temperature, feeble pulse, and death.

Diagnosis of CO poisoning: The diagnosis is made from the circumstances of exposure and the appearance of
cherry red skin and mucous membranes color.

Protection against CO poisoning: In general, exposure to CO should be avoided whenever possible. Adequate ventilation should be provided for all enclosed spaces where CO may be produced. The safety of air in the space for people to breathe may be tested by standard CO indicator or detector devices. Individuals required to
enter closed areas where high concentrations of CO are (known or suspected to be) present must be provided with respiratory protective devices. For the approved devices, refer to TB MED 502.

Treatment for Carbon Monoxide Poisoning: Remove the victim to pure air. If respirations are weak or absent, begin assisted ventilation at once. Oxygen, if available, should be given by a face mask, preferably under pressure (up to 3 atmospheres). The patient should be kept warm and at rest (sedated, if necessary). After resuscitation, initial supportive measures (such as the need for parenteral fluids and pressor drugs) can best be decided by the medical officer. Ordinarily, methylene blue solution, morphine, and atropine should NOT be used (TB MED 269).

Prognosis for people exposed to carbon monoxide poisoning: The longer the period of the coma,
the less the chance for recovery. Most mildly exposed individuals recover with early treatment. Tachycardia and dyspnea may continue for months. There may be CNS disturbances ranging from simple neuritis to mental deterioration.

CO EXPOSURE LIMITS - Carbon monoxide exposure limits PEL and TLV set by OSHA and NIOSH

Carbon monoxide is a colorless, odorless, tasteless gas that, in its effects on humans, is a chemical asphyxiant - that is, it causes asphyxiation, or death by preventing a person from receiving adequate oxygen. When inhaled, carbon monoxide combines with hemoglobin in the blood more readily than oxygen does. Thus CO "displaces" or moves oxygen out from hemoglobin in the bloodstream. This interferes with oxygen transport by the blood.

A person suffering from carbon monoxide (CO) intoxication may first experience euphoria (similar to the effect of a martini or two), then carbon monoxide poisoning effects lead to a headache, followed by nausea and possibly vomiting as the concentration of carboxyhemoglobin in the blood increases. To prevent these effects, OSHA has established a PEL of 50 ppm for an 8-hr exposure, identical to the TLV. NIOSH, on the other hand, has decided to be more conservative and recommends a standard of 35 ppm. All of these concentrations refer to exposures with durations of 8 hr/day, 40 hr/week for a working lifetime and all are attempts to establish a "no effect" level.

To prevent these effects, OSHA has established a PEL of 50 ppm for an 8-hr exposure, identical to the TLV. NIOSH, on the other hand, has decided to be more conservative and recommends a standard of 35 ppm.

All of these carbon monoxide or other gas exposure limit concentrations refer to exposures with durations of 8 hr/day, 40 hr/week for a working lifetime and all are attempts to establish a "no effect" level. Here are some other exposure levels and effects of carbon monoxide exposure from various sources:

.
Table I. Effects of Carbon Monoxide Exposure and CO Exposure Limits
PPM CO ExposureEffects of Exposure
to Carbon Monoxide
at this level
Source/comment
0 ppmNo effects, this is the normal level in a properly-operating heating applianceNo carbon monoxide should be detected in residential properties. Possible brief technical exceptions occur.
9 ppmMaximum allowable short term exposureASHRAE
10 - 24 ppmInvestigation needed to find source; Health effects on humans uncertain.
25 ppmMaximum allowable TWA exposure limitOSHA. Used in personal CO alarms.
35 ppmMaximum allowable workplace exposure limit for an 8-hour work shiftNIOSH (40 hour work week)
50 ppmMaximum allowable workplace exposure limit for an 8-hour work shiftOSHA (40 hour work week)
125 ppmWorkplace alarm must soundOSHA
200 ppmEvacuate the area immediately.Exposure at 200 ppm of CO causes dizziness, nausea, fatigue.
400 ppmEvacuate the area.3 hour exposure may be fatal.
800 ppmEvacuate the area.2-3 hour exposure causes convulsions, loss of consciousness, death.
1600 ppmEvacuate the area.
6400 ppmEvacuate the area.30 minutes of exposure causes convulsions, loss of consciousness, death
12,800 ppmEvacuate the area.1-3 minutes of exposure causes convulsions, loss of consciousness, death

NOTES to the Carbon Monoxide Effects Table: sources include OSHA, EPA, www.transducertech.com

ABBREVIATIONS: used with gas exposure limits:
PEL = permissible exposure limit. PEL's are a regulatory limitation to exposure used to specify the allowable exposure to a substance in the workplace and assume that the exposure takes place over an 8-hour shift in a 40-hour work week. Note that there are more stringent exposure limits for higher levels of exposure that may occur over a shorter time interval
PPM = parts per million of concentration of the gas of interest in air. 1 ppm means one part of gas to 1 million parts of air
MAX = maximum exposure in ppm for any individual in the work area over an 8-hour period
MSDS = Material Safety Data Sheet, published for every chemical or substance that may be hazardous; if an exposure limit has been published for a substance being discussed in an MSDS, that limit, such as TWA or PEL, is required to be included in the MSDS publication. Ref: 29 CFR 1910.1200 (g)(2)(i)(C)(2) and (g)(2)(vi). TWA's and PEL's are not available for most chemicals. There are simply too many chemicals, many of which have not gone through the rigorous scientific study and peer review required. The absence of an exposure limit for a substance should not be used to assume that a substance is not hazardous.
TIME = point in time when the maximum exposure will occur from the beginning of any 8-hour period
TE = total exposure in ppm per hour
TLV = threshold limit value: the level of exposure that a worker can experience in the workplace without an unreasonable risk of disease or injury. These are not estimates of "level of risk" for different exposure levels nor do they address the different means by which a person may be exposed to a substance. TLV's are specified by ACGIH, the American Conference of Government Industrial Hygienists. TLV's are guidelines prepared by ACGIH and are solely concerned with health risk. They do not address economic considerations. TLV's are not regulatory but rather are advisory. (See PEL and TWA which are specified by OSHA).
TWA = time weighted average exposure level. TWA's are a regulatory exposure limit. The TWA calculation takes into account that exposure level may vary over a time period.

Original document source

This carbon monoxide discussion file originated from a technical expert message board discussion on Carbon Monoxide and later Carbon Dioxide alarms, featuring comments by one of the leading authorities on CO, Jack Peterson, P.E., CIH, Ph.D., in May, 1987. NOTE: Daniel Friedman extracted CO and CO2 sections from that document, edited and added practical and field inspection-based information. Since its original publication this document has been expanded by reference materials from a variety of other sources.

Carbon Monoxide Hazards - Carboxyhemoglobin levels and related health effects on people

Quoting from CPSC Indoor Air Pollution Book Online Copy

Carbon monoxide is an asphyxiant. An accumulation of this odorless, colorless gas may result in a varied constellation of symptoms deriving from the compound's affinity for and combination with hemoglobin, forming carboxyhemoglobin (COHb) and disrupting oxygen transport. The elderly, the fetus, and persons with cardiovascular and pulmonary diseases are particularly sensitive to elevated CO levels. Methylene chloride, found in some common household products, such as paint strippers, can be metabolized to form carbon monoxide which combines with hemoglobin to form COHb. The following chart shows the relationship between CO concentrations and COHb levels in blood.

Tissues with the highest oxygen needs -- myocardium, brain, and exercising muscle -- are the first affected. Symptoms may mimic influenza and include fatigue, headache, dizziness, nausea and vomiting, cognitive impairment, and tachycardia. Retinal hemorrhage on funduscopic examination is an important diagnostic sign19, but COHb must be present before this finding can be made, and the diagnosis is not exclusive. Studies involving controlled exposure have also shown that CO exposure shortens time to the onset of angina in exercising individuals with ischemic heart disease and decreases exercise tolerance in those with chronic obstructive pulmonary disease (COPD)20.

Note: Since CO poisoning can mimic influenza, the health care provider should be suspicious when an entire family exhibits such symptoms at the start of the heating season and symptoms persist with medical treatment and time.

relationship between CO and COHb levels in blood

Relationship between carbon monoxide (CO) concentrations and carboxyhemoglobin (COHb) levels in blood

Predicted COHb levels resulting from 1- and 8-hour exposures to carbon monoxide at rest (10 l/min) and with light exercise (20 l/min) are based on the Coburn-Foster-Kane equation using the following assumed parameters for nonsmoking adults: altitude = 0 ft; initial COHb level = 0.5%; Haldane constant = 218; blood volume = 5.5 l; hemoglobin level = 15 g/100ml; lung diffusivity = 30 ml/torr/min; endogenous rate = 0.007 ml/min.

Source: Raub, J.A. and Grant, L.D. 1989. "Critical health issues associated with review of the scientific criteria for carbon monoxide." Presented at the 82nd Annual Meeting of the Air Waste Management Association. June 25-30. Anaheim, CA. Paper No. 89.54.1, Used with permission.

Carboxyhemoglobin levels and related health effects on people

% COHb in blood

Effects Associated with this COHb Level

80

Deatha

60

Loss of consciousness; death if exposure continuesa

40

Confusion; collapse on exercisea

30

Headache; fatigue; impaired judgmenta

7-20

Statistically significant decreased maximal oxygen consumption during strenuous exercise in healthy young menb

5-17

Statistically significant diminution of visual perception, manual dexterity, ability to learn, or performance in complex sensorimotor tasks (such as driving)b

5-5.5

Statistically significant decreased maximal oxygen consumption and exercise time during strenuous exercise in young healthy menb

Below 5

No statistically significant vigilance decrements after exposure to COb

2.9-4.5

Statistically significant decreased exercise capacity (i.e., shortened duration of exercise before onset of pain) in patients with angina pectoris and increased duration of angina attacksb

2.3-4.3

Statistically significant decreased (about 3-7%) work time to exhaustion in exercising healthy menb

SOURCE: a U.S. EPA (1979); b U.S. EPA (1985)

Nitrogen dioxide (NO) and sulfur dioxide (SO2) act mainly as irritants, affecting the mucosa of the eyes, nose, throat, and respiratory tract. Acute S02-related bronchial constriction may also occur in people with asthma or as a hypersensitivity reaction. Extremely high-dose exposure (as in a building fire) to N02 may result in pulmonary edema and diffuse lung injury. Continued exposure to high N02 levels can contribute to the development of acute or chronic bronchitis.

The relatively low water solubility of N02 results in minimal mucous membrane irritation of the upper airway. The principal site of toxicity is the lower respiratory tract. Recent studies indicate that low-level N02 exposure may cause increased bronchial reactivity in some asthmatics, decreased lung function in patients with chronic obstructive pulmonary disease, and an increased risk of respiratory infections, especially in young children.

The high water solubility of S02 causes it to be extremely irritating to the eyes and upper respiratory tract. Concentrations above six parts per million produce mucous membrane irritation. Epidemiologic studies indicate that chronic exposure to S02 is associated with increased respiratory symptoms and decrements in pulmonary function21. Clinical studies have found that some asthmatics respond with bronchoconstriction to even brief exposure to S02 levels as low as 0.4 parts per million22.

Frequently Asked Questions about carbon monoxide gas exposure, hazards, testing, and regulations in homes and other buildings

Question: My furnace service tech shut down my gas fired unit and says I need a new one. He said he could smell the CO and he wouldn't let me see his CO detector meter. Am I getting scammed?

I recently had a serviceman come to work on our natural gas furnace. When he was done he said that it was unsafe and needed to be replaced. He indicated that there was a high level of carbon monoxide (10,000 ppm) and shut the furnace off. I was made a little suspicious when he directed me to the exhaust pipe for the furnace and told me that the leak was so bad he could smell the CO. Since I always thought that CO is odourless that hit me a little strange. Plus the fact that he shoved the meter he was using under my nose for 3 seconds, not enough time for me to even read what was on the display.

His sales pitch was that the heat exchanged was clogged and needed to be replaced. Would there really be a CO level that high with a blocked exchanger or would it need to have a leak? Is it possible he is just trying to get some work out of me and hoping that I won't know any better? - Matthew

Reply: CO itself is odorless, but mixed in with combustion flue gases there would be a "flue gas" smell that someone might observe;

Watch out: Because of very serious life safety issues, do not turn the equipment back on.

But before replacing the gas furnace due to a carbon monoxide hazard I'd want an accurate diagnosis of just what the problem really is. Some problems might indeed justify a whole new heater, for example if the heat exchanger is perforated and if the cost to remove and replace the damaged heat exchanger is close to the cost of a whole new furnace, I'd consider going with the latter.

Other problems can cause flue gas spillage, equally dangerous, but with different solutions such as

  • A blocked chimney
  • Inadequate combustion air
  • Improperly adjusted gas burners and air shutters

I wouldn't insult the service tech when s/he may have been saving your life. But it's quite reasonable to ask that a carbon monoxide hazard be properly diagnosed and the evidence shown to you before you approve equipment replacement. After all, if you replace the gas furnace but leave an unsafe chimney in place a fatal carbon monoxide hazard could still be present.

Question: what does a utility company gas furnace safety check red-tag placed on our heating equipment mean?

When your Utility Company Technician performs a safety check of your gas furnace and determines it to be "unsafe/hazardous" plus "Shut off and capped due to recirculation," what exactly does this mean? - Chris

Reply: significance of red-tagging heating equipment - serious safety hazards are present and the equipment cannot be safely used until repaired

Chris: details may vary by state or municipality, but in general you are describing what the industry calls "red tagging" - a utility company or a heating contractor or even a licensed plumber or other trades expert who inspects heating equipment and finds that it is in a condition that is unsafe to operate should leave the system turned off and red-tagged with - usually - an attached red safety tag that indicates the date, the identity of the inspector, and the unsafe condition.

Red-tagged equipment should not be turned back on before it has been repaired and confirmed safe to operate.

There are some wrinkles in this scheme however. I've found some oil service companies who put a red border on ALL of their service tags - some lawyer must have decided that that would somehow protect the oil company from a lawsuit should a future unsafe condition be discovered, since the lawyer could argue that the system had already been "red tagged".

That's a boy-who-cried-wolf argument and a sloppy defense that interferes with true unsafe equipment notifications - a bad practice.

So presuming that your equipment was actually found unsafe, and red-tagged, it should indeed be left off until it's repaired. The problem that needs to be fixed is not necessarily expensive - it depends on just what's wrong. But leave your gas furnace off until you know the specifics and they have been addressed.

Question: asphyxiation hazards from gas fired water heaters?

what asphyxiation statistics are available for water heaters and water heater venting? - Dan Lewis

Reply:

Dan that's an interesting way to put a carbon monoxide hazard question. Asphyxiation from CO depends on the concentration and exposure time, as we've published. One could calculate some theoretical carbon monoxide production rates from water heaters of various BTUH input ratings, but frankly in my opinion such data would be wild speculation. That's because the accumulation of a toxic gas in a building or any enclosed space depends on so many variables, such as:

- the actual equipment firing rate and combustion air supply; variations in combustion air supply would vary the CO production rate

- variations in chimney and flue gas venting, depending on indoor temperature, outdoor temperature, heating appliance temperature, appliance run time, lack of combustion air, and chimney design details such as routing, height, horizontal flue vent connector length, impedence of draft regulators or draft hoods, etc.

In sum, I am doubtful that a simple CO output number for a water heater would be credible, and a maximum potential CO output number would fail to consider the many peculiar variables of the building itself.

If you have a more specific case in mind we could try to work out more details.

Question: how to conduct a carbon monoxide CO survey of CO from street traffic?

I live on a residential street in the community of Glendale Ca. My street happens to be the only access to a regional park that was developed by the city. There are not only the hundreds of cars that access the park but also continual city large truck traffic and school busses that are creating high levels of CO. How can I get someone to take readings and correct this situation - Ken Steele

Reply:

Ken,

Because of the high cost of hiring an expert to make CO measurements, and because any individual measurement made at one location at one time is absolutely unreliable as an overall characterization of the CO exposure in or around your home, you'd want measurements that include, as a study the CO levels at

different times of day and in different seasons

  • at different locations outside and inside the building at specifically documented distances and locations relative to the suspected source (say the center of the street or park entry)
  • along with documentation of the level and type of traffic nearby at the time
  • Along with baseline measurements of CO levels at other locations that offer points of comparison with your own street or home

All of that data, collected and prepared with sufficient professionalism to be credible would be very expensive, surely thousands of dollars.

A plausible alternative would be to purchase a CO level monitoring instrument, become educated in its proper use, and then to conduct your own less formal study.

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CARBON MONOXIDE - CO

CARBON MONOXIDE WARNING

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