What is carbon monoxide poisoning?

Use a boiler, water heater, generator, stove or any other fuel-burning appliance poses a risk of carbon monoxide (CO) poisoning. Since September 2022, according to data from Poison centers, more than 70 people were poisoned after having wanted to heat their home with appliances not intended for this use, reports theHANDLES in November.

What is carbon monoxide?

Carbon monoxide is an asphyxiating, odorless, colorless and very toxic gas. : in an enclosed space, it can kill in less than an hour. Carbon monoxide (CO) released when a gas, wood or coal-burning appliance, for example, malfunctions. Combustion is not done properly and releases this highly toxic CO. Most of the time, it is a boiler that is involved, which explains an upsurge in poisonings in the winter period.. But what makes carbon monoxide dangerous for the body is the fact that it binds to hemoglobin and blocks the transport of oxygen in the blood. It also prevents oxygen to attach to the organs that need it. In fact, these different organs are no longer sufficiently supplied with oxygen, which leads to death.

How quickly can you die from carbon monoxide poisoning?

Carbon monoxide is an asphyxiating gas which can kill in less than an hour in a confined space.

What are the figures for carbon monoxide poisoning in France?

Each year in France, carbon monoxide poisoning is responsible for nearly 100 deaths and more than 3 000 hospital admissions. Carbon monoxide is today the leading cause of poisoning in industrialized countries.

Headaches, fatigue, dizziness, nausea or vomiting should alert.

What causes carbon monoxide poisoning?

Carbon monoxide is produced by incomplete combustion of a carbon compound due to an insufficient amount of oxygen. This phenomenon is due to:

• an insufficient quantity of oxygen in the air (caulked room, insufficient ventilation, blocked air inlet, etc.)
• the presence of impurities in the carbonaceous materials, objects of combustion
• insufficient evacuation of combustion gases (poorly connected flue, clogged or poorly cleaned chimney, etc.)
• prolonged or inappropriate use of a device
• a malfunction of the device used for combustion.

What are the sources of carbon monoxide?

In homes, the main sources of carbon monoxide are:

• heating systems (wood, coal, gas, butane, gasoline, fuel oil, ethanol, etc.) or hot water production (boilers),
• cooking appliances (stove, barbecue, brazier),
• chimneys,
• vehicle engines in a garage without ventilation,
• generators placed in a garage or cellar.

► In a collective establishment

These sources are also found in performance halls, restaurants, ice rinks, municipal halls or places of worship, for example. Other sources are specific to this type of place, such as certain combustion heating devices (heating by gas radiant heaters, resurfacer in skating rinks).

► In the workplace, the main sources of carbon monoxide are thermal engine tools, gas-powered machines (forklifts), ovens but also heating or hot water production systems, generatorsetc.

What are the symptoms of carbon monoxide poisoning?

The symptoms of carbon monoxide poisoning come on quickly and can obviously affect everyone in the same place. Please note that the symptoms associated with CO poisoning are not not typical. These are most often:

• headache,
• nausea and/or vomiting,
• muscle fatigue,
• chest or abdominal pain,
• of balance disorders,
• ofa confusion even of brief blackouts.

At a later stage, of the heart trouble (arrhythmias and coronary ischemia), disorders pulmonary (acute pulmonary edema), muscle and visceral disorders (pancreatitis) may occur. Finally some neurological manifestations such as convulsions, apraxia (movement disorders), amnesia, agnosia (object recognition disorder), parkinsonism, cortical blindness, incontinence can also be part of the initial symptoms of intoxication. The coma of course testifies to a vital emergency and requires immediate care.

► In pregnant womencarbon monoxide poisoning carries a high risk of death or damage to the fetus

► A regular exhibition even at low doses of carbon monoxide can be manifested by a decline in intellectual performance, learning difficulties, chronic headaches, impaired visual and auditory acuity “even even parkinsonian symptoms“adds our interlocutor.

Faced with the symptoms and following an interrogation carried out by the doctor in order to highlight the possible causes of intoxication, “the diagnosis is refined by a determination of the carboxyhemoglobin, that is to say the hemoglobin which has fixed the carbon monoxide” explains Dr. Perez. When the carboxyhemoglobin (HbCO) is above the thresholds below, it asserts intoxication, below, no conclusion is possible.

► In the presence of clinical signs:

• HbCO > 6% in a smoker
• HbCO > 3% in a non-smoker

► In the absence of clinical signs:

• HbCO > 10% in a smoker
• HbCO > 6% in a non-smoker

Measurement of carbon monoxide in exhaled air is rapid and correlates well with COHb. It is useful when it comes to confirming the diagnosis before admission to hospital or in situations involving multiple victims.

Other tests can be carried out to assess the consequences of poisoning:

• Blood gas or arterial blood gas which makes it possible to evaluate the respiratory and acid-base function of a patient and which can highlight a respiratory alkalosis.
• Electrocardiography (ECG) may show heart rhythm disturbances
• Cardiac enzyme assay
• Blood tests may reveal hyperglycaemia in the event of severe intoxication.
• Chest x-ray looking for lesional edema.
• Pregnancy test in patients of childbearing age.
• brain imaging if another cause of altered state of consciousness must be excluded.

We must act very quickly!

What are the treatments for carbon monoxide poisoning?

Significant poisoning can lead to coma and death, sometimes within minutes. We must therefore act very quickly. Especially when they occur in several people occupying the same room equipped with a combustion appliance and they disappear outside of it. In this case, it is essential

• immediately ventilate the room by opening doors and windows,
• ofevacuate the place
• if necessary call the emergency services by dialing 15 (EMS), the 18th (firefighters) or the 112 (European emergency number).
• otherwise call a Poison Control Center. They are reachable 24 hours a day, 7 days a week.

“During poisoning without serious symptoms and if it is neither a child nor a pregnant woman, treatment is based on normobaric oxygen therapy at a very high concentration for at least 12 hours through an oxygen mask. If there are severity criteria (cardiac symptoms, loss of consciousness, etc.) or if it is a pregnant woman or a child, the treatment is based on placement in a hyperbaric chamber“, explains Dr. Perez. Patients are then monitored in the hospital and warned of the risk of sequelae.

What are the sequelae and consequences after carbon monoxide poisoning?

Serious and untreated, carbon monoxide poisoning is deadly. Carbon monoxide poisoning can sometimes cause long-term neurological and cardiac sequelae that leave disabling symptoms. “It also increases thehe risk of developing cardiovascular disease within ten years“, adds our expert. There are also neurological symptoms at a distance, despite a well-administered and followed treatment. These can appear in patients who nevertheless seemed to have completely recovered from acute intoxication. They appear after a latency period. from two days to five weeks. so-called “postinterval syndrome” manifests itself in particular by symptoms resembling those of Parkinson’s disease, such as chronic headaches, visual disturbances, mood changes or personality disorders.

Carbon monoxide poisoning can affect anyone. In order to limit the risks, it is advisable to adopt the right actions:

• Systematically have the heating and hot water production installations checked and maintainedas well as the flues (mechanical sweeping) by a qualified professional, before entering winter.
• Install a carbon monoxide detector. Unlike stand-alone smoke alarm detectors (DAAF), mandatory since March 8, 2015, stand-alone CO alarm detectors (DAACO) are neither mandatory nor subject to construction product regulations. Make sure that the chosen detector is declared by the manufacturer complies with European standard NF EN 50291 (this mention must appear on the packaging of the product). During the annual maintenance of your boiler, the qualified professional who intervenes is required to measure the carbon monoxide to ensure that your installation does not emit carbon monoxide.
• Ventilate your home every day for at least 10 minuteseven if it is cold.
• Check that the ventilation systems are in good working order.
• Never block the air inlets and outlets.
• Scrupulously respect the instructions for use of combustion appliances given by the manufacturer.
• Never run space heaters continuously.
• It is essential to place the generators outside buildings. In other words: never use a generator in an enclosed space (house, basement, garage, etc.).
• Do not heat yourself with appliances not intended for this purpose (camping stoves, ovens, braziers, barbecues, etc.).

Thanks to Dr Noémie Perez, pediatrician.