Thursday, February 26, 2015

Elderly at higher risk for CO poisoning

As winter continues its cold, firm grip on the country, the risk for many types of injuries and ailments linger into the final weeks of the season, including one very dangerous risk inside the home - accidental carbon monoxide (CO) poisoning. The gas has no color, no odor, no taste and it kills.

93. And who can be more unjust than he who invents a lie against Allah, or says: "I have received inspiration," whereas he is not inspired in anything; and who says, "I will reveal the like of what Allah has revealed." And if you could but see when the Zalimun (polytheists and wrong-doers, etc.) are in the agonies of death, while the angels are stretching forth their hands (saying): "Deliver your souls! This day you shall be recompensed with the torment of degradation because of what you used to utter against Allah other than the truth. And you used to reject His Ayat (proofs, evidences, verses, lessons, signs, revelations, etc.) with disrespect! "

94. And truly you have come unto Us alone (without wealth, companions or anything else) as We created you the first time. You have left behind you all that which We had bestowed on you. We see not with you your intercessors whom you claimed to be partners with Allah. Now all relations between you and them have been cut off, and all that you used to claim has vanished from you. 6. Surah Al-An'am (The Cattle)

According to the Centers for Disease Control and Prevention (CDC) every year CO poisoning sends at least 15,000 Americans to the emergency room and kills 439 people yearly.

CDC statistics indicates that men and adults aged 65 years and older were more likely to die from CO poisoning than other persons. The higher rate in men has been attributed to high-risk behaviors among men, such as working with fuel-burning tools or appliances. The higher rate among older persons has been attributed to the likelihood of older adults mistaking symptoms of CO poisoning for other conditions common among persons in this age group - influenza-like illnesses or fatigue.

CO deaths are highest during colder months, likely because of an increased use of gas-powered furnaces and use of alternative heating and power sources used during power outages, such as portable generators, charcoal briquettes, and propane stoves or grills.

Delphos Fire Department’s Platoon Chief Roy Hoehn said he has been on several calls where carbon monoxide backed up into a house from a chimney or an older furnace’s heat exchange cracked sending fumes throughout the house.

“Residents realized the issue and got out of the house before anyone suffered poisoning,” Hoehn said. “We perform CO checks free of charge for residents who believe they may have a CO leak.”

CDC statistics from 1999-2004 indicate a total of 139 Ohio residents died from unintentional, non-fire-related carbon monoxide poisonings.

On a national level, during that same time frame, 2,631 people died from unintentional, non-fire-related carbon monoxide poisonings and of that number, 628 were age 65 or older.

“Prolonged headaches and red splotchy skin are the two most common symptoms of CO poisoning,” Hoehn explained. “There was a resident that would be at home and have a headache, leave the house and the headache would disappear and then he’s go back home and have a headache again.”

According to the United States Consumer Product Safety Commission (CPSC) the health effects of CO depend on the concentration and length of exposure, as well as each individual’s health condition. Most people will not experience any symptoms from prolonged exposure to CO levels of approximately 1 to 70 ppm (parts per million) but some heart patients might experience an increase in chest pain.

As CO levels increase and remain above 70 ppm, symptoms become more noticeable and can include headache, fatigue and nausea. At sustained CO concentrations above 150 to 200 ppm, disorientation, unconsciousness and death are possible.

Stop chugging sugary soda and munching sweet treat...

To prevent carbon monoxide poisoning, the CDC recommends:

• Every year, have a qualified technician check heating systems, water heaters, and other gas-, oil-, or coal-burning appliances;

• Install battery-operated carbon monoxide detectors in homes and change the batteries when you change the clocks for daylight-saving time;

• Seek medical attention if you suspect carbon monoxide poisoning is the cause of your dizziness or nausea;

• Never use generators, camp stoves, charcoal grills, or any other gas- or oil-burning device inside the home or outside the home near a window;

• Never run a motor vehicle inside the garage, even if the garage door is open;

• Never burn anything in a fireplace or stove that is not vented to the outside; and

• Never heat a house with a gas oven.

The CPSC reports about 170 people in the United States die every year from CO produced by non-automotive consumer products. These products include malfunctioning fuel-burning appliances such as furnaces, ranges, water heaters and room heaters; engine-powered equipment such as portable generators; fireplaces; and charcoal that is burned in homes and other enclosed areas.

The CPSC recommends that one CO alarm be installed into a plug-in receptacle or high on the wall in the hallway outside the bedrooms in each separate sleeping area of the home. Hard wired or plug-in CO alarms should have battery backup. People should avoid locations that are near heating vents or that can be covered by furniture or draperies. Installing CO alarms in a kitchen or above fuel-burning appliances is not recommended.

If a CO alarm signal sounds do not try to find the source, immediately move outside to fresh air and call emergency services, the fire department or 911. Perform a head count to check that all persons are accounted for. Do not reenter the premises until the emergency services responders permit re-entry. If the source of the CO is determined to be a malfunctioning appliance, do not operate that appliance until it has been properly serviced by trained personnel.

“Most of our calls are from residents who’s carbon monoxide detectors have sounded an alarm,” Hoehn said. “Ninety-nine percent of them have data stacked in them - the detector collects readings over an extended time frame and when it peaks at the point where it would go off, it does - and sends a warning alarm.”

Hoehn said many people don’t know they should reset/clear their CO detectors once a year by pulling out the battery pack and setting the alarm outside for 72 hours.

“If a CO detector — or smoke detector — is 10 years old, it’s time to throw it away and buy a replacement,” Hoehn added. “We still have free smoke detectors here at the station for Delphos residents if they need one.”

Carbon monoxide (sometimes referred to as CO) is a colorless, odorless gas produced by burning material containing carbon. Carbon monoxide poisoning can cause brain damage and death. You can't see it, smell it, or taste it; but carbon monoxide can kill you.

Carbon monoxide is odorless, tasteless, and colorless gas is known as the "silent killer."
Carbon monoxide is produced by common household appliances. When not properly ventilated, carbon monoxide emitted by these appliances can build up. See the list of appliances that can emit carbon monoxide in this article under Carbon Monoxide Poisoning Causes.
Early symptoms of carbon monoxide poisoning such as headaches, nausea, and fatigue, are often mistaken for the flu because the deadly gas goes undetected in a home. Prolonged exposure can lead to brain damage and even death.

Carbon Monoxide Poisoning Causes

Carbon monoxide is formed when organic compounds burn. The most common sources are motor vehicle exhaust, smoke from fires, engine fumes, and nonelectric heaters. Carbon monoxide poisoning is often associated with malfunctioning or obstructed exhaust systems and with suicide attempts.

Sources of carbon monoxide:

Gas water heaters
Kerosene space heaters
Charcoal grills
Propane heaters and stoves
Gasoline and diesel powered generators
Cigarette smoke
Propane-fueled forklifts
Gasoline powered concrete saws
Indoor tractor pulls
Boats engines
Spray paint, solvents, degreasers, and paint removers

Risks for exposure to carbon monoxide include

Children riding in the back of enclosed pickup trucks (particularly high risk)
Industrial workers at pulp mills, steel foundries, and plants producing formaldehyde or coke (a hard grey fuel)
Personnel at fire scenes
Using heating sources or electric generators during power outages
Those working indoors with combustion engines or combustible gases
Swimming near or under the stern or swim-step of a boat with the boat enginerunning
Back drafting when a boat is operated at a high bow angle
Mooring next to a boat that is running a generator or engine
Improper boat ventilation

Exposure to carbon monoxide is most commonly accompanied by the following symptoms:

Headache
Dizziness
Nausea
Flu-like symptoms, fatigue
Shortness of breath on exertion
Impaired judgment
Chest pain
Confusion
Depression
Hallucinations
Agitation
Vomiting
Abdominal pain
Drowsiness
Visual changes
Fainting
Seizure
Memory problems
Walking problems

Carbon Monoxide Poisoning Diagnosis

Because signs and symptoms of carbon monoxide poisoning are not specific, a blood test to look for it is the most effective way to make the diagnosis.

Carbon Monoxide Poisoning Treatment

Carbon Monoxide Poisoning Self-Care at Home

Move all family members and pets to fresh air away from the source of carbon monoxide (CO).
No home therapy is available for carbon monoxide poisoning.
Seek medical care in a hospital emergency department.

Carbon Monoxide Poisoning Prevention

The best protection from carbon monoxide poisoning is to install a carbon monoxide alarm on each level of your home or boat as your first line of defense. A carbon monoxide monitor with an audible alarm works much like a home smoke alarm and beeps loudly when the sensors detect carbon monoxide.

If the alarm sounds, evacuate the building. People who have symptoms of carbon monoxide poisoning should seek emergency medical care. Call the fire department or public service company to investigate.
Inspect your home for hazards.
- Your home heating system, chimney, and flue must be inspected and cleaned by a qualified technician every year. Keep chimneys clear of bird and squirrel nests, leaves, and residue to ensure proper ventilation.
- Be sure your furnace and other appliances, such as gas ovens, ranges, and cook tops, are inspected for adequate ventilation.
- Do not burn charcoal inside your house (even in the fireplace). Have gas fireplaces inspected each fall to ensure the pilot light burns safely.
- Do not operate gasoline-powered engines in confined areas such as garages or basements. Do not leave a car, mower, generator, or other vehicle running in an attached garage, even with the door open.
- Do not block or seal shut exhaust flues or ducts for appliances such as water heaters, ranges, and clothes dryers.
- Become familiar with the hazards of carbon monoxide poisoning and boating (please see Web Links section).
Some states in the US require carbon monoxide poison detectors in homes, boats, day care centers, businesses, etc. For a list of states that require carbon monoxide detectors, please read the Carbon Monoxide Detectors State Statues to see if you are in compliance.

Prevent Carbon Monoxide (CO) Poisoning

When you set your clocks back one hour beginning Sunday, November 2, 2014, remember to check or change the batteries in your carbon monoxide (CO) detector.

Daylight Saving Time ends Sunday, November 2, 2014. As you prepare to set your clocks back one hour, remember to check or change the batteries in your carbon monoxide (CO) detector. If you don't have a battery-powered or battery back-up CO alarm, now is a great time to buy one. At least 430 people die each year in the US from unintentional, non-fire related CO poisoning.

CO is found in fumes produced by furnaces, vehicles, portable generators, stoves, lanterns, gas ranges, or burning charcoal or wood. CO from these sources can build up in enclosed or partially enclosed spaces. People and animals in these spaces can be poisoned and can die from breathing CO.

When power outages occur during emergencies such as hurricanes or winter storms, the use of alternative sources of power for heating, cooling, or cooking can cause carbon monoxide (CO) to build up in a home, garage, or camper and to poison the people and animals inside.

You Can Prevent Carbon Monoxide Exposure

Do have your heating system, water heater and any other gas, oil, or coal burning appliances serviced by a qualified technician every year.
Do install a battery-operated CO detector in your home and check or replace the battery when you change the time on your clocks each spring and fall. If the detector sounds, leave your home immediately and call 911.
Do seek prompt medical attention if you suspect CO poisoning and are feeling dizzy, light-headed, or nauseous.
Don't use a generator, charcoal grill, camp stove, or other gasoline or charcoal-burning device inside your home, basement, or garage or outside less than 20 feet from a window, door, or vent.
Don't run a car or truck inside a garage attached to your house, even if you leave the door open.
Don't burn anything in a stove or fireplace that isn't vented.
Don't heat your house with a gas oven.

CO poisoning is entirely preventable. You can protect yourself and your family by acting wisely in case of a power outage and learning the symptoms of CO poisoning.

Carbon monoxide (CO), an odorless, colorless gas, which can cause sudden illness and death, is produced any time a fossil fuel is burned. CDC works with national, state, local, and other partners to raise awareness about CO poisoning and to monitor CO-related illness and death in the U.S.

Accidental carbon monoxide poisoning kills more than 400 Americans annually and lands another 20,000 in hospital emergency rooms, according to the federal Centers for Disease Control and Prevention.

Here are five important things to know about carbon monoxide poisoning and how to prevent it:

1. It can build up in your home. Carbon monoxide is a colorless, odorless gas found in fumes produced by home heating systems, gas ranges, burning charcoal and wood, stoves, small gas engines, cars and trucks. Carbon monoxide builds up in enclosed spaces. Never use a gas range or oven to heat your house or use a portable gas camp stove indoors.

2. It's hard to diagnose. Common symptoms are headache, dizziness, weakness, nausea, vomiting, chest pain and confusion. It can be difficult to diagnose because symptoms mimic other illnesses. People asleep or intoxicated can die from carbon monoxide poisoning before experiencing symptoms.

3. Some people are at higher risk. All people and animals are at risk of carbon monoxide poisoning. Unborn babies, infants and people with chronic heart disease, anemia or respiratory problems are more susceptible.

4. Check home appliances regularly. Have your heating system, water heater and any other gas, oil or coal burning appliances serviced by a qualified technician annually. Have your chimney checked or cleaned every year. Make sure all gas appliances are vented properly so carbon monoxide will not build up in your home.

5. Get a detector: Install a battery-operated carbon monoxide detector in your home and check or replace the battery when you change the time on your clocks each spring and fall.

While many of the acute risks posed by flooding and other disasters are well characterised, the burden of carbon monoxide (CO) poisoning and the wide range of ways in which this avoidable poisoning can occur around flooding episodes is poorly understood, particularly in Europe. The risk to health from CO may continue over extended periods of time after flooding and different stages of disaster impact and recovery are associated with different hazards.

Methods
A review of the literature was undertaken to describe the changing risk of CO poisoning throughout flooding/disaster situations. The key objectives were to identify published reports of flood-related carbon monoxide incidents that have resulted in a public health impact and to categorise these according to Noji’s Framework of Disaster Phases (Noji 1997); to summarise and review carbon monoxide incidents in Europe associated with flooding in order to understand the burden of CO poisoning associated with flooding and power outages; and to summarise those strategies in Europe which aim to prevent CO poisoning that have been published and/or evaluated.
The review identified 23 papers which met its criteria. The team also reviewed and discussed relevant government and non-government guidance documents. This paper presents a summary of the outcomes and recommendations from this review of the literature.

Results
Papers describing poisonings can be considered in terms of the appliance/source of CO or the circumstances leading to poisoning.The specific circumstances identified which lead to CO poisoning during flooding and other disasters vary according to disaster phase. Three key situations were identified in which flooding can lead to CO poisoning; pre-disaster, emergency/recovery phase and post-recovery/delayed phase. These circumstances are described in detail with case studies.
This classification of situations is important as different public health messages are more appropriate at different phases of a disaster. The burden of disease from poisoning caused by each potential source and at each phase of a disaster is different. CO poisoning is not compulsory and deaths associated with a flood but delayed for a period of months, for example due to a damaged boiler, may never be attributed to the flood as surveillance often ends once the floodwaters recede. The problem of under–reporting is crucial to our understanding of flooding-related poisoning.
The indoor use of portable generators, cooking and heating appliances designed for use outdoors during periods of loss of mains power or gas is a particular problem. In the recovery phase, equipment for pumping, dehumidifying and drying out of properties poses a new risk. In the long term, mortality and morbidity associated with the renewed use of boilers which may have suffered covert damage in flooding is recognised but very difficult to quantify.
Papers evaluating interventions were not found and where literature exists on prevention of CO poisoning in disaster situations, it is from the USA.

Conclusions
This paper for the first time describes the different risks of CO poisoning posed by the different phases of a disaster. There is a specific need to recognise that any room in a building can harbour a CO emitting appliance in flooding; wood burners and rarely used chimney flues may become particularly problematic following a flood.

Recommendations
1) Public health workers and policy makers should consider establishing toolkits using the CDC toolkit approach; the acceptability of any intervention must be evaluated further to guide informed policy.

2) CO poisoning must form part of syndromic and event based surveillance systems for flooding and should be included in measures of the health impact of flooding.

3) CO monitors in the domestic environment should be sited not only in proximity to known CO emitters but also in locations where mobile or short term CO emitting appliances may be placed, including woodburners and infrequently used fireplaces.

If you're not feeling well and suspect it's the flu, think again: There's a possibility your symptoms may be due to carbon monoxide poisoning.

The chronic form of CO poisoning, caused by repeated exposure to lower levels of the odorless gas, can cause headaches, general malaise, nausea, vomiting and dizziness, says WESTMEDpulmonologist Dr. Bruno DiCosmo. What differentiates it from a virus is that you'll feel bad in the morning, but better when you're out of the house — with symptoms coming back when you return home.

According to the Consumer Product Safety Commission, severity of symptoms is related to the duration of exposure and the levels of carbon monoxide in the air.

"The treatment is just to get out of the carbon monoxide exposure," says DiCosmo. "If you're severely overdosed, you'll need oxygen."

Many people are unaware they're being exposed to the poisonous gas, and are sometimes misdiagnosed, says the CPSC. Experts recommend that doctors consider carbon monoxide exposure when patients come in complaining of chronic headache, fatigue, dizziness, nausea or mental confusion, particularly when those symptoms arise during the heating season.

Carbon monoxide exposure is of greater concern in the winter, due to the use of furnaces, space heaters and generators, all of which may produce dangerous levels of the gas.

Make sure you have a functioning carbon monoxide detector in your home, and change the batteries when you change your clocks, says DiCosmo.

Acute carbon monoxide poisoning can kill rapidly, with victims sometimes falling into a coma while they're asleep. Chronic exposure to lower levels of the gas can also lead to increasingly severe symptoms.

Health