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Abstract
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The current energy crisis may be accompanied by an increase in carbon monoxide poisoning. Fuel shortages will spawn the use of various devices for providing additional heat in homes. Fireplaces and other heating facilities which have not been used recently may be placed into operation. Catalytic heaters, charcoal- burning units, and similar devices may be used indoors or in confined spaces. Many individuals will undoubtedly resort to "makeshift" measures to prevent the loss of heat from their homes, including installing additional insulation, sealing cracks and crevices, covering windows with plastic, and using other measures which tend to make the home "airtight". Any measure that reduces the amount of air movement into a home, coupled with a defective heating device or the improper use of a combustible fuel indoors enhances the potential for poisoning by carbon monoxide. Health officials are urged to work with private organizations, industry, and the news media in publicizing the carbon monoxide hazards associated with improper heating devices, as illustrated by the following report from Mississippi.
On the evening of September 7, 1973, a family of 7 from Hinds County, Mississippi, began to experience lassitude, headaches, and malaise. Their symptoms abated during the next day but returned that night: several of the children had nausea and vomiting. The following day the symptoms again disappeared, but they recurred that evening. On September 10, 2 of the family consulted a private physician. He noted that they had fever (101-102 deg F) and prescribed symptomatic treatment for their malaise, nausea, and vomiting.
The next evening the entire family again had headaches, malaise, and intermittent nausea and vomiting followed by dizziness and syncope, and the next morning they all stayed home. Later that day they were found unconscious by a relative and were taken by ambulance to a nearby hospital. In the emergency room all family members were found to be stuporous and febrile, and several of the children had flushed skin color. Two family members were given oxygen nasally. All had normal chest X-rays. The diagnosis of carbon monoxide poisoning was made, and all 7 were admitted to the hospital for observation; the following morning they had completely recovered and were discharged. Blood specimens obtained in the emergency room from the 7 family members and tested for carboxyhemoglobin levels by the Toxicology Department, University of Mississippi Medical Center, all showed elevated levels.
Representatives from the Hinds County Health Depart- ment and a local utility company visited the home of the affected family and found a leaking hot water faucet and an improperly vented gas hot water heater. The leaking faucet was thought to have caused the hot water heater to operate continually. Carbon monoxide levels in the house were measured and were markedly elevated (0.1 volume percent or 1,000 ppm).
(Reported by Dan J. Mitchell. M.D., private physician, Jackson: Robert B. Ireland. M.D., private physician, Clinton: Arthur Hume, M.D.. Assistant Professor of Pharmacology and Toxicology, University of Mississippi Medical Center: Eric McVey. M.D., Director, Hinds County Health Department: Durward L. Blakey, M.D., State Epidemiologist, Mississippi State Board of Health: and an EIS Officer.)
Editorial Note The fact that carbon monoxide poisoning can produce fever, leukocytosis, and an abnormal urinary sediment is not generally appreciated. In this instance, the diagnosis of carbon monoxide poisoning was not considered initially when several family members presented with gastrointestinal complaints and fever but was made only after mental changes had occurred several days later and several of the children were noted to have a slightly flushed appearance. The source of carbon monoxide in the household was thought to be fumes produced from combustion of natural gas in an improperly vented water heater, not fumes from leaking unburned natural gas. In the United States, natural gas does not contain carbon monoxide |