Carbon Monoxide Poisoning

Carbon Monoxide Poisoning

Carbon monoxide poisoning occurs after too much inhalation of carbon monoxide (CO). Carbon monoxide is a toxic (poisonous) gas, but, being colorless, odorless, tasteless, and initially non-irritating, it is very difficult for people to detect. Carbon monoxide is a product of incomplete combustion of organic matter due to insufficient oxygen supply to enable complete oxidation to carbon dioxide (CO2).

Symptoms of mild acute poisoning include lightheadedness, confusion, headache, vertigo, and flu-like effects; larger exposures can lead to significant toxicity of the central nervous system and heart, and death. After acute poisoning, long-term sequelae often occur. Carbon monoxide can also have severe effects on the fetus of a pregnant woman. Chronic exposure to low levels of carbon monoxide can lead to depression, confusion, and memory loss. Carbon monoxide mainly causes adverse effects in humans by combining with hemoglobin to form carboxyhemoglobin (HbCO) in the blood. This prevents hemoglobin from carrying oxygen to the tissues, effectively reducing the oxygen-carrying capacity of the blood, leading to hypoxia.

It is easily absorbed through the lungs. Inhaling the gas can lead to hypoxic injury, nervous system damage, and even death. Different people and populations may have different carbon monoxide tolerance levels. On average, exposures at 100 ppm or greater is dangerous to human health.

Acute poisoning

The main manifestations of carbon monoxide poisoning develop in the organ systems most dependent on oxygen use, the central nervous system and the heart. The initial symptoms of acute carbon monoxide poisoning include headache, nausea, malaise, and fatigue. These symptoms are often mistaken for a virus such as influenza or other illnesses such as food poisoning or gastroenteritis. Headache is the most common symptom of acute carbon monoxide poisoning; it is often described as dull, frontal, and continuous. Increasing exposure produces cardiac abnormalities including fast heart rate, low blood pressure, and cardiac arrhythmia; central nervous system symptoms include delirium, hallucinations, dizziness, unsteady gait, confusion, seizures, central nervous system depression, unconsciousness, respiratory arrest, and death. Less common symptoms of acute carbon monoxide poisoning include myocardial ischemia, atrial fibrillation, pneumonia, pulmonary edema, high blood sugar, lactic acidosis, muscle necrosis, acute kidney failure, skin lesions, and visual and auditory problems.

One of the major concerns following acute carbon monoxide poisoning is the severe delayed neurological manifestations that may occur. Problems may include difficulty with higher intellectual functions, short-term memory loss, dementia, amnesia, psychosis, irritability, a strange gait, speech disturbances, Parkinson's disease-like syndromes, cortical blindness, and a depressed mood. Depression may occur in those who did not have pre-existing depression. These delayed neurological sequelae may occur in up to 50% of poisoned people after 2 to 40 days. It is difficult to predict who will develop delayed sequelae; however, advanced age, loss of consciousness while poisoned, and initial neurological abnormalities may increase the chance of developing delayed symptoms.

One classic sign of carbon monoxide poisoning is more often seen in the dead rather than the living – people have been described as looking red-cheeked and healthy (see below). However, since this "cherry-red" appearance is common only in the deceased, and is unusual in living people, it is not considered a useful diagnostic sign in clinical medicine. In pathological (autopsy) examination the ruddy appearance of carbon monoxide poisoning is notable because unembalmed dead persons are normally bluish and pale, whereas dead carbon monoxide poisoned persons may simply appear unusually lifelike in coloration. The colorant effect of carbon monoxide in such postmortem circumstances is thus analogous to its use as a red colorant in the commercial meat-packing industry.

Causes
Sources of carbon monoxide include cigarette smoke, house fires, faulty furnaces, heaters, wood-burning stoves, internal combustion vehicle exhaust, electrical generators, propane-fueled equipment such as portable stoves, and gasoline-powered tools such as leaf blowers, lawn mowers, high-pressure washers, concrete cutting saws, power trowels, and welders. Idling automobiles with the exhaust pipe blocked by snow has led to the poisoning of car occupants. Generators and propulsion engines on boats, especially houseboats, has resulted in fatal carbon monoxide exposures. Poisoning may also occur following the use of a self-contained underwater breathing apparatus (SCUBA) due to faulty diving air compressors. In caves carbon monoxide can build up in enclosed chambers due to the presence of decomposing organic matter. In coal mines incomplete combustion may occur during explosions resulting in the production of afterdamp. Another source of poisoning is exposure to the organic solvent dichloromethane, found in some paint strippers.

Notable People who died from Carbon Monoxide Poisoning:

1. Wikipedia -- Deaths from Carbon Monoxide Poisoning 37 people listed including:

• Ike Altgens – (1919 – 1995) Photojournalist, Journalist, Actor
• Balvano train disaster – Mar 2-3, 1944 (https://en.wikipedia.org/wiki/Balvano_train_disaster )
• Anita Bitri – (1968 – 2004) Singer, Violinist
• James T. Blair, Jr. (1902 – 1962) Politician, Lawyer, 44th Govenor of Missouri
• Micky Cave (1949 – 1984) Football player
• George Daney (1946 – 1990) Football player
• Carwyn Davies (1964 – 1997) Rugby player
• Deaths of Christianne and Robert Shepherd (https://en.wikipedia.org/wiki/Deaths_of_Christianne_and_Robert_Shep... )
• Michael Malloy
• Mitsui Miike Coal Mine disaster
• Myojo 56 building fire
• Hugo Sánchez Portugal
• Senghenydd colliery disaster
• Matthias Sindelar
• Jiří Šlitr
• Betty Steiner
• Alfred Robert Wilkinson
• Don Wilson (baseball)

2, Ranker – Famous People Who Died of Carbon Monoxide Poisoning 60 people listed including:

• Sylvia Plath – (1932- 1963) Poet, Novelist, Author, Writer
• Dan James White – (1946 – 1985) Firefighter, Politician, Police officer
• John Kennedy Toole – (1937 -1969) Journalist, Soldier, Professor, Novelist, Author
• Thelma Todd – (1906 – 1935) Actress 3. Geni
• Colonel Henry Joseph Woodside

For Further Reading:

• 1. Wikipedia -- Carbon monoxide poisoning
• 2. Carbon Monoxide Information Center
• 3. Consumer Product Safety Commission – Carbon Monoxide Questions and Answers
• 4. MedlinePlus -- Carbon monoxide poisoning

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