Healthy Living

With the recent snowstorm and power outages, carbon monoxide poisoning has made lots of news. And as the cold weather continues to make its way into the region, this public health threat will remain.

It is important to make the community aware of this condition because it is very treatable, and more importantly, preventable.

Carbon monoxide is a toxic gas, but, being colorless, odorless, tasteless, and initially non-irritating, it is very difficult for people to detect.

Carbon monoxide poisoning is the most common cause of injury and death by poisoning -- both accidental and intentional (suicide). Inhaling even small amounts can be fatal. Serious neurological effects may be delayed days or weeks after acute poisoning. Chronic exposure may cause persistent headaches, dizziness, and nausea, if not permanent neurological damage.

Sources of carbon monoxide include fuel-burning vehicles, heaters, and cooking equipment. It is important to always operate this equipment in a well-ventilated area to avoid the accumulation of carbon monoxide in a closed space.

Since the gas is odorless and non-irritating, people can be fooled into thinking no harm is being done until symptoms come about. Symptoms of mild poisoning include lightheadedness, confusion, and headaches and larger exposures can lead to significant toxicity of the nervous system and heart, and even death. The most important rescue measure is to remove individuals from the source of the carbon monoxide build up.

Red blood cells that provide oxygen to the human body have more affinity for the carbon monoxide molecule and displace the oxygen molecule. This results in much lower levels of oxygen reaching the organs of the body. Since the brain is very sensitive to changes in oxygen levels, it is usually the first organ affected. Hence, the early symptoms of carbon monoxide poisoning tend to be neurologic in nature.

Treatment of poisoning largely consists of administering 100% oxygen or providing hyperbaric oxygen therapy. High concentrations of oxygen work as an antidote as it increases the removal of carbon monoxide from hemoglobin, in turn providing the body with normal levels of oxygen. As I mentioned earlier, the hemoglobin has a higher affinity for carbon monoxide than oxygen, so the only way to combat poisoning is to provide very high oxygen concentrations to compete for these binding sites. Hyperbaric oxygen works by utilizing high concentrations and pressure of oxygen to achieve an even higher competitive advantage than can be achieved with even 100% oxygen not delivered this way.

Carbon monoxide poisoning is a significant public health issue. Domestic carbon monoxide poisoning can be prevented by early detection with the use of household carbon monoxide detectors. Avoiding usage of carbon monoxide-producing equipment in a closed space and recognizing the early symptoms are key to avoiding long term health issues with carbon monoxide poisoning.

Mark Tramontozzi, MD, is the Medical Director of the Backus Wound Care and Hyperbaric Oxygen Therapy Center, which is located in the Backus Outpatient Care Center on Salem Turnpike in Norwich. This column should not replace the advice of your healthcare provider. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Tramontozzi or any of the Healthy Living columnists at healthyliving@wwbh.org