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Mehrpour O, Sadeghi M. The occurrence of unusually cold weather could contribute to the incidence of carbon monoxide poisoning. Clin Exp Emerg Med 2024; 11:231-232. [PMID: 38286513 PMCID: PMC11237264 DOI: 10.15441/ceem.23.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/16/2023] [Indexed: 01/31/2024] Open
Affiliation(s)
- Omid Mehrpour
- Rocky Mountain Poison and Drug Safety (RMPDS), Denver Health Medical Center, Denver, CO, USA
| | - Mahmood Sadeghi
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
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Fatal Unintentional Non-Fire Related Carbon Monoxide Poisoning: Data from Narrative Verdicts in England and Wales, 1998-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074099. [PMID: 35409782 PMCID: PMC8998445 DOI: 10.3390/ijerph19074099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 12/02/2022]
Abstract
Unintentional non-fire related (UNFR) carbon monoxide (CO) poisoning continues to cause fatalities. The narrative verdicts from coroners concerning fatal UNFR CO poisoning in England and Wales, 1998–2019, were collated by the Office for National Statistics. Search terms related to CO exposure were used to obtain information regarding the circumstances of death. Findings were grouped by the location of death, the source of CO, and the reason or behaviour underlying the exposure. There were 750 deaths (77% male). The annual number of deaths decreased over the period studied. Two thirds (68%) of the deaths occurred in the autumn or winter. From the records with information, 59% of deaths occurred within a dwelling (67% male). Males also predominated deaths within vehicles (91%) and garages or outbuildings (95%). From the deaths with information, domestic piped gas was the most common source of CO (36%) and the most frequent underlying factor was inadequate ventilation of exhaust gases (39%, 91% male). Despite the decrease in the annual number of deaths over the study period, there remains a clear need for measures that raise awareness of the dangers of CO poisoning, especially amongst men working alone in garages or outbuildings. Education campaigns and fitting and maintaining CO alarms in high-risk areas should be encouraged.
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Exploring Health Impacts of Occupational Exposure to Carbon Monoxide in the Labour Community of Hattar Industrial Estate. ATMOSPHERE 2022. [DOI: 10.3390/atmos13030406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was designed to assess the health impacts related to noninvasive carbon monoxide saturation (SPCO %) in the blood of respondents. For this purpose, 150 respondents from the labour community of Hattar Industrial Estate (testing site) and 100 respondents from Sultan Pur (control site) were selected. To achieve this objective, a Rad-57 Pulse CO-Oximeter was used for noninvasive carboxyhemoglobin measurement. Carbon monoxide saturation (SPCO%) in the blood of respondents from Hattar Industrial Estate, Haripur, Pakistan has been compared with the WHO’s standard concentration of SPCO% (5%). High saturation of carbon monoxide (carboxyhemoglobin SPCO) in the blood of respondents and disease association have been interpreted in graphs formed on the basis of statistical analysis in terms of frequencies, using statistical software (SPSS), based on demographic entries as well as exposure time of the employees in the processing, food and steel industries. The highest SPCO% measured was 17% in the steel industry and the lowest measured level was 4.2%. Frequencies and percentages of respiratory inflammation, dermatosis, asthma, breathing issues and eye inflammation among respondents were 29%, 35%, 16.7%, 23.5% and 9%, respectively. Prevalence of disease in three different groups of respondents (from three testing sites) was also analyzed on the basis of exposure time (hrs.) to carbon monoxide emissions. Prevalence of disease among the exposed and non-exposed groups was analyzed and showed comparatively lower disease prevalence in the group of respondents who were not exposed to high carbon monoxide emissions. The data of the current study was also subjected to statistical modelling to find the health risk of air pollutants (carbon monoxide) on population health by calculating attributable risk (AR) or attributable proportion (AP). Results indicated that attributable risk of carbon monoxide exposure for respiratory diseases, dermatosis and eye inflammation were 61.12%, 65.77% and 24.95% respectively. Findings of statistical modelling indicated that dermatosis and respiratory diseases were more prevalent in laborers of industrial units than those at control site.
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Mahonski S, Su MK. Comment on Treatment of carbon monoxide poisoning: high-flow nasal cannula versus non-rebreather face mask. Clin Toxicol (Phila) 2021; 59:768. [PMID: 33448901 DOI: 10.1080/15563650.2020.1862144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sarah Mahonski
- Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Mark K Su
- Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA.,Department of Health and Mental Hygiene, New York City Poison Control Center, New York, NY, USA
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Zazzeron L, Fischbach A, Franco W, Farinelli WA, Ichinose F, Bloch DB, Anderson RR, Zapol WM. Phototherapy and extracorporeal membrane oxygenation facilitate removal of carbon monoxide in rats. Sci Transl Med 2020; 11:11/513/eaau4217. [PMID: 31597752 DOI: 10.1126/scitranslmed.aau4217] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 04/02/2019] [Accepted: 09/18/2019] [Indexed: 11/02/2022]
Abstract
Inhaled carbon monoxide (CO) displaces oxygen from hemoglobin, reducing the capacity of blood to carry oxygen. Current treatments for CO-poisoned patients involve administration of 100% oxygen; however, when CO poisoning is associated with acute lung injury secondary to smoke inhalation, burns, or trauma, breathing 100% oxygen may be ineffective. Visible light dissociates CO from hemoglobin. We hypothesized that the exposure of blood to visible light while passing through a membrane oxygenator would increase the rate of CO elimination in vivo. We developed a membrane oxygenator with optimal characteristics to facilitate exposure of blood to visible light and tested the device in a rat model of CO poisoning, with or without concomitant lung injury. Compared to ventilation with 100% oxygen, the addition of extracorporeal removal of CO with phototherapy (ECCOR-P) doubled the rate of CO elimination in CO-poisoned rats with normal lungs. In CO-poisoned rats with acute lung injury, treatment with ECCOR-P increased the rate of CO removal by threefold compared to ventilation with 100% oxygen alone and was associated with improved survival. Further development and adaptation of this extracorporeal CO photo-removal device for clinical use may provide additional benefits for CO-poisoned patients, especially for those with concurrent acute lung injury.
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Affiliation(s)
- Luca Zazzeron
- Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Anna Fischbach
- Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Walfre Franco
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - William A Farinelli
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Fumito Ichinose
- Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Donald B Bloch
- Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.,Division of Rheumatology, Allergy and Immunology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - R Rox Anderson
- Wellman Center for Photomedicine, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Warren M Zapol
- Anesthesia Center for Critical Care Research of the Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
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KAVAK N, DOĞAN B, SULTANOĞLU H, KAVAK RP, ÖZDEMİR M. Clinical and Magnetic Resonance Imaging Findings of Patients with Acute Carbon Monoxide Poisoning. KONURALP TIP DERGISI 2020. [DOI: 10.18521/ktd.735274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Moon JM, Chun BJ, Cho YS, Mun JG. Does alcohol play the role of confounder or neuroprotective agent in acute carbon monoxide poisoning? Clin Toxicol (Phila) 2019; 58:161-170. [PMID: 31198068 DOI: 10.1080/15563650.2019.1625915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objectives: This study investigated whether alcohol influences the predictive value of initial blood lactate concentration and Glasgow Coma Scale (GCS) score at presentation for the severity of acute carbon monoxide (CO) poisoning and neurologic outcome in patients with acute CO poisoning. Additionally, whether alcohol has a neuroprotective effect after acute CO poisoning was evaluated.Methods: This retrospective study included 158 patients who presented with acute CO poisoning between January 2017 and July 2018 and had an available blood alcohol content (BAC) at presentation. The baseline characteristics, clinical course during hospitalization and neurologic status at 30 days after acute CO poisoning were collected and compared according to BAC. To account for possible confounding or neuroprotective effects of alcohol, BAC was introduced as a continuous variable and a stratified categorical variable in the analysis.Results: The mean and maximum BAC at presentation were 56.8 mg/dl and 408 mg/dl, respectively, in 158 patients presented at a mean of 1.0 hour after acute CO poisoning. Lactate, adjusted for previously suggested predictors, was not associated with acute CO poisoning severity; however, after additional adjustment with BAC variables, lactate was associated with CO poisoning severity. Initial GCS score was associated with CO poisoning severity during hospitalization and neurologic outcome at 30 days after acute CO poisoning, regardless of BAC adjustment. BAC variables were negatively associated with CO poisoning severity but not neurologic outcome at 30 days.Discussion and conclusion: The severity of CO poisoning should never be predicted based on serum lactate alone without adjusting for BAC. However, the initial GCS score can be used as a predictor of CO poisoning severity and the neurologic outcome at 30 days after acute CO poisoning, regardless of alcohol consumption history. Alcohol does not have a neuroprotective effect on acute CO poisoning. Further study is needed to validate these results.
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Affiliation(s)
- Jeong Mi Moon
- Department of Emergency Department, Chonnam National University Medical School, Gwangju, South Korea
| | - Byeong Jo Chun
- Department of Emergency Department, Chonnam National University Medical School, Gwangju, South Korea
| | - Yong Soo Cho
- Department of Emergency Department, Chonnam National University Medical School, Gwangju, South Korea
| | - Jong Goo Mun
- Department of Emergency Department, Chonnam National University Medical School, Gwangju, South Korea
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Jones VC, Kennedy RD, Welding K, Gielen AC, Frattaroli S. The prevalence of fire and CO safety amenities in Airbnb venues that permit smoking - Findings from 17 countries. Prev Med 2019; 123:8-11. [PMID: 30802470 DOI: 10.1016/j.ypmed.2019.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 02/05/2019] [Accepted: 02/15/2019] [Indexed: 01/07/2023]
Abstract
Airbnb hosts rent their homes to guests as an alternative to traditional hospitality settings. Airbnb venues are not uniformly regulated for allowing smoking or requiring fire-safety amenities. This study quantified the reported prevalence of fire-safety amenities in 413,339 Airbnb venues that allow smoking in 43 cities in 17 countries. Proportions of host-reported smoke detectors and carbon monoxide (CO) alarms, and those that allow smoking were calculated. Across the entire sample 9.3% (n = 38,525) allowed smoking. An overall evaluation of those venues shows that 46% (n = 17,569) had smoke detectors compared to 64% of the 374,814 venues that do not allow smoking, a statistically significant difference (X2 = 5277 p < 0.01). A similar difference is found between venues that allow smoking and had CO alarms (19%, n = 7176) and the 33% of venues that prohibit smoking (X2 = 3442, p < 0.01). Among this sample, most Airbnb venues that allow smoking are less likely to have safety amenities.
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Affiliation(s)
- Vanya C Jones
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Center for Injury Research and Policy, United States.
| | - Ryan D Kennedy
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Institute for Global Tobacco Control, United States
| | - Kevin Welding
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Institute for Global Tobacco Control, United States
| | - Andrea C Gielen
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, United States; Johns Hopkins Center for Injury Research and Policy, United States
| | - Shannon Frattaroli
- Johns Hopkins Center for Injury Research and Policy, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management, United States
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Masters T, Willenbring B, Westgard B, Cole J, Hendriksen S, Walter J, Logue C, Olives T. Availability of Bedside and Laboratory Testing for Carbon Monoxide Poisoning in the Upper Midwestern United States. West J Emerg Med 2019; 20:506-511. [PMID: 31123553 PMCID: PMC6526886 DOI: 10.5811/westjem.2019.2.41428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 02/06/2019] [Accepted: 02/16/2019] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The objective of this study was to assess the ability to test patients for carbon monoxide (CO) exposure in all hospitals in three United States (U.S.) Midwestern states. METHODS We surveyed hospitals in three states. Telephone queries assessed processes for measuring carboxyhemoglobin, including capacity for real-time vs send-out testing. Facilities were separated based on their location's population size for further analysis. Descriptive statistics are reported. RESULTS Of the 250 hospitals queried, we ultimately excluded 25. Nearly all (220, 97.8%) reported a process in place to test for CO exposure. Over 40% (n=92) lacked real-time testing. Testing ability was positively associated with increasing population size quartile (range 32.6% - 100%). Hospitals in the lowest-quartile population centers were more likely to report that they were unable to test in real time than those in the largest-quartile population centers (67.4% vs 0%). CONCLUSION In a large geographic region encompassing three states, hospital-based and real-time capacity to test for CO exposure is not universal. Hospitals in smaller population areas are more likely to lack real-time testing or any testing at all. This may have significant public health, triage, and referral implications for patients.
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Affiliation(s)
- Thomas Masters
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Brian Willenbring
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Bjorn Westgard
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Jon Cole
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Stephen Hendriksen
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Joseph Walter
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Christopher Logue
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
| | - Travis Olives
- Hennepin Healthcare, Department of Emergency Medicine, Minneapolis, Minnesota
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