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Carbon MonoxideThe “Invisible Killer”

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Objectives Define carbon monoxide Describe possible sources Identify carbon monoxide poisoning

signs and symptoms Understand who is at risk for poisoning Describe key prevention tips and

available resources Review FD’s role, forms, SOG and CO

detecting equipment.

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Source: Center for Disease ControlSource: Center for Disease Control

What is Carbon Monoxide Poisoning?

CO is a by-product of incomplete CO is a by-product of incomplete combustion of natural gas, propane, combustion of natural gas, propane, gasoline, coal, oil, kerosene, and gasoline, coal, oil, kerosene, and wood.wood.

CO is colorless, tasteless, odorless CO is colorless, tasteless, odorless

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Source: Vermont Department of Source: Vermont Department of HealthHealth

Carbon Monoxide (CO) vs.

Carbon Dioxide (CO2)

Carbon Monoxide

Carbon Dioxide

A byproduct of burning fuels

Gas exhaled with normal breathing

A poison even at low doses

An asphyxiant and poisonous at high doses

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Source: Center for Disease Control Source: Center for Disease Control and www.emedicinehealth.comand www.emedicinehealth.com

Who is at Risk?

EVERYONE, especially:

– People using alternate heat sources during power outages

– Elderly

– Unborn babies, infants,

– Individuals with chronic heart disease, anemia or respiratory problems

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Source: Source: www.emedicinehealth.comwww.emedicinehealth.com

Who is at risk? Cont…..

– Personnel at fire scenes (fire-fighters/rescue workers)

– Individuals working with combustion engines or combustible gases indoors

– Industrial workers at pulp mills, steel foundries and plants producing formaldehyde and coke

– Pets

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Source: Olson: Poisoning and Source: Olson: Poisoning and Drug Overdose Drug Overdose

Is CO Poisoning Common? One of the leading causes of

unintentional/accidental poisoning deaths in the United States

Poisonings occur more often in the fall and winter months

Accounts for approximately 50,000 emergency department visits each year in the U.S.

For information on the CDC study “Unintentional non-fire related CO Exposures in the U.S. in 2001-2003 visit http://www.cdc.gov/od/oc/media/pressrel/fs050120.htm

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Source: NNEPC, Vermont Source: NNEPC, Vermont Department of Health, the Department of Health, the

Environmental Protection Agency Environmental Protection Agency and Olson: Poisoning and Drug and Olson: Poisoning and Drug

OverdoseOverdose

Sources Burning fuels such as: wood, oil, natural gas,

gasoline, kerosene, propane, coal and diesel Electrical appliances do not produce CO

Common sources of human exposure include:

– Smoke inhalation from fires

– Automobile exhaust

– Faulty or poorly vented charcoal, kerosene or gas stoves

– To a lesser extent, cigarette smoke and methylene chloride (industrial uses)

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Source: Environmental Protection Source: Environmental Protection Agency, Center for Disease Control Agency, Center for Disease Control

and the Vermont Department of and the Vermont Department of HealthHealth

Cold Weather Hazards Insufficient ventilation

– Generators used inside during a power outage

– Gas or kerosene heater in room without proper ventilation

– Stoves or fireplaces that are improperly vented or blocked

– Exhaust flues or appliance ducts that are blocked or sealed shut

– Cars or trucks idling in a garage Opening the door is not sufficient

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Cold Weather Hazards cont….

Poor function or worn parts– Appliances and equipment

– Heating systems

Improper use– Using charcoal grills indoors

– Heating homes with gas ovens

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Source: Environmenal Protection Source: Environmenal Protection AgencyAgency

Warm Weather Hazards

Enclosed area (poor ventilation)– Gas, kerosene, charcoal, propane or

hibachi grills

– Gasoline-powered equipment (lawnmower, chainsaw, generator), used in a home, garage or under a tarp

– Gas-fueled lanterns and stoves burned inside a tent, trailer, boat cabin without proper ventilation

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Warm Weather Hazards cont…

Excessive inhalation of exhaust fumes– Teak surfing or pulling a skier from a

boat’s diving platform– Diving from or swimming near a

houseboat platform– Riding in the back of a pickup truck

with a camper shell

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How does Carbon Monoxide Poisoning Work?

Enters the body through the lungs and is delivered to the blood

Red blood cells pick up CO instead of oxygen– Hemoglobin likes CO 250 times more than oxygen

CO prevents the oxygen that is present from being readily released to and used properly by tissues

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Source: Illinois & Vermont Department of Source: Illinois & Vermont Department of HealthHealth

Why Do We Need Oxygen?

Brain damageBrain damage– Can only live a few minutes without Can only live a few minutes without

oxygen.oxygen. Organ damageOrgan damage

– Vital organs such as brain and heart Vital organs such as brain and heart need oxygenneed oxygen

Possibly deathPossibly death

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Source: Vermont Department of Source: Vermont Department of Health, Consumer Product Safety Health, Consumer Product Safety

Commission, Environmental Commission, Environmental Protection AgencyProtection Agency

Toxic effects = Concentration X Exposure

May =

Long-term exposure to low levels of CO

Short-term exposure to high levels of CO

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What do the numbers mean?

Concentration of CO in air (Parts per millions)Concentration of CO in air (Parts per millions)

50ppm - 50ppm - Threshold limit value for no adverse effects even Threshold limit value for no adverse effects even with 6-8 hours exposurewith 6-8 hours exposure

200ppm – 200ppm – Possible mild headache after 2-3 hoursPossible mild headache after 2-3 hours

400ppm – 400ppm – Headache and nausea after 1-2 hoursHeadache and nausea after 1-2 hours

800ppm – 800ppm – Headache, nausea, and dizziness after 45 Headache, nausea, and dizziness after 45 minutes; collapse and possible unconsciousness after 2 minutes; collapse and possible unconsciousness after 2 hourshours

Source – NFPA Carbon Monoxide – Risks At Home Fact Sheet

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Numbers Cont…. 1000ppm – 1000ppm – Loss of consciousness after 1 hoursLoss of consciousness after 1 hours

1600ppm – 1600ppm – Headache, nausea and dizziness after 20 Headache, nausea and dizziness after 20 minutesminutes

3200ppm – 3200ppm – Headache and dizziness after 5-10 minutes; Headache and dizziness after 5-10 minutes; unconsciousness after 30 minutesunconsciousness after 30 minutes

6400ppm – 6400ppm – Headache and dizziness after 1-2 minutes; Headache and dizziness after 1-2 minutes; unconsciousness and danger of death after 10-15 minutesunconsciousness and danger of death after 10-15 minutes

12,800ppm – 12,800ppm – Immediate physiological effects; Immediate physiological effects; unconsciousness and danger of death after 1-3 minutesunconsciousness and danger of death after 1-3 minutes

Source – NFPA Carbon Monoxide – Risks At Home Fact Sheet

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Source: Illinois & Vermont Source: Illinois & Vermont Department of Health, Environmental Department of Health, Environmental

Protection AgencyProtection Agency

Signs and Symptoms Flu-like symptoms (without fever or runny

nose) including:– Headache– Fatigue/sleepiness– Shortness of breath– Nausea– Dizziness– Confusion or disorientation

Young children, elderly and household pets are usually effected first

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Source: Center for Disease Control Source: Center for Disease Control , Environmental Protection Agency, , Environmental Protection Agency,

MedlineplusMedlineplus

Failure to Detect Danger

Often mistaken for the flu, food poisoning or other illnesses

Those sleeping or intoxicated can die before experiencing any symptoms

Prolonged exposure can lead to brain damage and death

Victims may become disoriented and unable to save themselves

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Source: EMedicineHealth and Source: EMedicineHealth and Olson: Poisoning and Drug Olson: Poisoning and Drug

OverdoseOverdose

Prognosis

Difficult to predict the long-term effects of CO poisoning/exposure. – Even with proper medical treatment a few

people can develop long-term brain damage. – Some individuals appear to have no long-term

affects. If pregnant, fetal complications or death

may result.

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Carbon Monoxide AlarmYour best protection!

Install a carbon monoxide alarm close to sleeping areas. For more protection:

– Install one with 15’ of each bedroom

– Install one on every level of your home Never ignore a carbon monoxide alarm, IT

COULD SAVE YOUR LIFE!

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Source: Illinois Department of Source: Illinois Department of Public Safety/Division of Fire Public Safety/Division of Fire

Safety, OSFMSafety, OSFM

Illinois LawCO Alarm Requirement

Effective January 1, 2007, every Illinois home is Effective January 1, 2007, every Illinois home is required to have at least one carbon monoxide required to have at least one carbon monoxide alarm in an operating condition within 15 feet of alarm in an operating condition within 15 feet of every room used for sleeping purposes. Homes every room used for sleeping purposes. Homes that do not rely on the burning of fuel for heat, that do not rely on the burning of fuel for heat, ventilation or hot water; are not connected to a ventilation or hot water; are not connected to a garage; and are not near a source of carbon garage; and are not near a source of carbon monoxide (as determined by the local building monoxide (as determined by the local building commissioner) are not required to install carbon commissioner) are not required to install carbon monoxide detectors. (monoxide detectors. (Public Act 94-741) )

  OFSM version of the law - OFSM version of the law - http://www.state.il.us/osfm/documents/OSFM_Interpretation_CO_Act_10_23_06.pdf

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Source: Center for Disease Control Source: Center for Disease Control and the Environmental Protection and the Environmental Protection

AgencyAgency

Prevention Tips: Don’t…

Never run a portable generator, gasoline-powered engines (such as mowers, snow-blowers, chainsaws) or burn charcoal in:

Never leave a car, mower or other vehicle running in a garage, even with the door open

Do not heat home with gas oven.

- Crawlspaces- Indoors- Garages- Basements

- Closed in porch- Vehicle- Tent- Under windows

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Source: Consumer Product Safety Source: Consumer Product Safety Commission, Underwriters Commission, Underwriters

Laboratories Inc.Laboratories Inc.

Visual Warning Signs

Streaks of carbon or soot around door of your fuel-burning appliance.

No draft in the chimney. A large amount of rusting on flue pipes

or appliance jackets or vent pipes. Moisture on windows/walls of furnace

doors.

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Source: Underwriters Laboratories Source: Underwriters Laboratories Inc.Inc.

Visual Warning Signs Cont….

Discolored or damage bricks at top of chimney.

Soot falling from fire place. Flu-like symptoms that go away when

you leave home and come back when you re-enter.

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Fire Department’s Role

Use special detectors that monitor parts per million (PPM) of the atmosphere at any given location. – Find source of CO– Can detect small amounts of CO

If CO is detected:– The source will be investigated and identified– Next steps will be recommend– The area will be ventilated until CO levels are

safe

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Fire Department’s Role Cont…

Remove Occupants Clearing the buildingClearing the building

– Positive pressure Positive pressure ventilation will clear the ventilation will clear the building quickly, however, building quickly, however, the gas fired engine on the gas fired engine on the fan will be introducing the fan will be introducing CO into the building.CO into the building.

– Use electric fans, or Use electric fans, or household exhaust fans household exhaust fans whenever possible.whenever possible.

– Open windows & use Open windows & use natural ventilation.natural ventilation.

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NWFD Procedures

SOG # 61 – Carbon Monoxide ResponseSOG # 61 – Carbon Monoxide Response Non-urgent unless reports of medical problemsNon-urgent unless reports of medical problems If dispatcher does not relay information, ASKIf dispatcher does not relay information, ASK Activate detector and wear appropriate PPE (including SCBA)Activate detector and wear appropriate PPE (including SCBA) Investigate all areas of the building in a systematic order. Use Investigate all areas of the building in a systematic order. Use

the Checklistthe Checklist Check vented appliances for an updraftCheck vented appliances for an updraft Any levels of CO shall result in FD shutting gas off to the Any levels of CO shall result in FD shutting gas off to the

residence, or applianceresidence, or appliance Go thru questions with each occupant of the building.Go thru questions with each occupant of the building. ANY YES ANSWER GETS PARAMEDIC RESPONSE.ANY YES ANSWER GETS PARAMEDIC RESPONSE. Leave final form indicating highest level of CO found in the Leave final form indicating highest level of CO found in the

building.building.

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Department Forms

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Testing Equipment

MSA ALTAIR 4MSA ALTAIR 4Capable of detecting multiple gasesCapable of detecting multiple gases

Oxygen Level, LEL, COOxygen Level, LEL, COMust be calibrated periodicallyMust be calibrated periodically

Fresh air set must be done away from running vehiclesFresh air set must be done away from running vehicles

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Questions ?

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Resources Environmental Protection Agency

Information Clearinghouse (EPA)– Information on indoor air quality– 1-800-438-4318 – www.epa.gov/iaq/iaqinfo.html

Consumer Product Safety Commission (CPSC)– Information on CO poisoning prevention,

purchasing a CO alarm & report products or product-related injuries

– 1-800-638-2772 (TTY 1-800-638-8270)– info@cpcs.gov

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Resources Cont… Centers for Disease Control (CDC)

– How to prevent poisoning from home appliances

– www.cdc.gov/co/faqs.htm

National Institute for Occupational Safety Health (NIOSH)– Information about small engine hazards

– www.cdc.gov/niosh/homepage.html

National Institute of Health and Library or Medicine (NLM)– General Information– nlm.nih.gov/medlineplus/print/carbonmonoxidepoisoning.html

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Resources Cont…

Coast Guard (USCG) Office of Boating Safety – Information on safe boating

– www.uscgboating.org/command/co.htm

Underwriters Laboratories (UL)– Information on CO alarms

– www.ul.com/consumers/co.html