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This document discusses the short term & long term medical & health effects of exposure to carbon monoxide gas (CO). We give references and explanation regarding Toxicity of Carbon Monoxide, based on literature search and search 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 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.

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

Many sources I (DF) reviewed indicated that if carbon monoxide exposure was subacute, 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 subacute 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.

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.

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.

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• 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.
• A Toxic Gas Testing Plan: A Gas Sampling Plan for Residential and Commercial buildings lists some of the toxic indoor gases for which we test, depending on the building complaint and building conditions
• Gas Exposure Hazard Levels: for Toxic Gas Exposure to Ammonia, Arsine, Arsenic, Bromine, Carbon Dioxide, Carbon Monoxide, Hydride, Ozone - allowable exposure levels and hazard levels
• Carbon Dioxide Gas Toxicity hazard level, poisoning symptoms, & testing
• Carbon Monoxide Gas Toxicity hazard levels, poisoning symptoms, & testing
• Formaldehyde: US EPA. UFFI (Urea Formaldehyde Foam Insulation) was previously considered a hazard (formaldehyde outgassing). Subsequent research virtually closed concern regarding this material; however formaldehyde appears to remain a health concern for sensitive individuals.
• Ozone Warnings - Use of Ozone as a "mold" remedy is ineffective and may be dangerous.
• Sampling for gases in air such as VOC's, MVOC's, toxic chemicals, and combustion products.
  Unfortunately no single test or tool can detect all possible building contaminants. We use methods and equipment which can test for common contaminants. If the identity of a specific contaminant is known in advance we can also test for a very large number of specific contaminant gases in buildings.
  We use gas sampling equipment provided by the two most reliable companies in the world, Draeger-Safety's detector-tubes and Drager accuro� bellows pump, the Gastec� cylinder pump and detector-tube system produced by Gastec or Sensidyne, and we also use Sensidyne's Gilian air pump. For broad screening for combustibles and a number of other toxic gases and for leak tracing we also use Amprobe's Tif8850. All of these instruments, their applications, and sensitivities (minimum detectable limits) for specific gases are described in our Gas Sampling Plan online document.
• Radon Gas U.S. EPA Radon level maps
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• Best Practices Guide to Residential Construction, by Steven Bliss. John Wiley & Sons, 2006. ISBN-10: 0471648361, ISBN-13: 978-0471648369, Hardcover: 320 pages, available from Amazon.com and also Wiley.com. See our book review of this publication.
• Decks and Porches, the JLC Guide to, Best Practices for Outdoor Spaces, Steve Bliss (Editor), The Journal of Light Construction, Williston VT, 2010 ISBN 10: 1-928580-42-4, ISBN 13: 978-1-928580-42-3, available from Amazon.com
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