1. What you don’t know could hurt you! By : Valerie York PUBH 6165 Environmental Health A general public presentation

2. GOAL  The goal of this presentation is to raise awareness about the life threatening dangers of carbon monoxide within the general public and to present information that can be utilized to prevent carbon monoxide illnesses and deaths.

3. OBJECTIVES To describe what carbon monoxide [CO] is and how it can harm you Inform the public of the sources or producers of CO Identify the signs and symptoms of CO poisoning Describe how to prevent CO poisoning from happening to you and your family

4. What is Carbon Monoxide? (Benjah-bmm27, 2009) CO is a colorless, odorless, non-irritating gas It is extremely poisonous and can cause death in a matter of minutes [1] CO can not be detected by sensory mechanisms It can cause sudden illness or sudden death before a person is even aware of its presence [2] 1. (U.S. Environmental Protection Agency [EPA], 2010) 2. (Prockop and Chichkova, Nov 2007)

5. Sources of CO Automobiles Barbeque Grills Gas Heaters & Furnaces Some common sources of CO that we may use on a regular basis include automobiles, barbeque grills, gas heaters and furnaces (EPA,2010) & (CDC, 2009).

6. Sources of CO Fireplaces and wood stoves Chimneys Gas stoves and other appliances Fireplaces, wood stoves, leaking chimneys, as well as gas and other fuel powered appliances such as stoves, water heaters and boilers can also produce CO (EPA,2010) & (CDC, 2009).

7. Sources of CO Portable generators Lanterns Boats *A single portable generator can produce as much as 100 times more CO gas than a car’s exhaust (NIST, 2009). Portable generators, lanterns and boats are also sources of CO (EPA,2010) & (CDC, 2009).

8. Carbon Monoxide Poisoning  Results from breathing in CO  All people and animals are at risk Most Vulnerable Infants and unborn babies People with respiratory problems People with chronic heart disease People with anemia (CDC, 2009a)

9.  Carbon monoxide poisoning is the most common cause of accidental poisonings [1]  More than 50,000 Emergency room visits per year in the U.S. are attributed to CO poisonings [1]  CO poisonings result in more than 4,000 hospitalizations and more than 400 deaths per year in the U.S. [2] 1. (Weaver, 2009). 2. (CDC, 2009a). Carbon Monoxide Statistics in the U.S.

10. What happens in CO poisoning?  Red blood cells pick up CO much faster than they can pick up oxygen (O2) (CDC, 2009a).  If the CO concentration is high enough, oxygen may be blocked from entering the red blood cells (CDC, 2009a).  The replacing of O2 cells by CO is the main reason CO poisoning occurs (The Interactive Library, 1999).  Low levels of oxygen reaching the tissues in the body mainly effects the brain and the heart, two organs with high oxygen requirements (Murphy, 2010).  Red blood cells pick up CO much faster than they can pick up oxygen (O2) (CDC, 2009a).  If the CO concentration is high enough, oxygen may be blocked from entering the red blood cells (CDC, 2009a).  The replacing of O2 cells by CO is the main reason CO poisoning occurs (The Interactive Library, 1999).  Low levels of oxygen reaching the tissues in the body mainly effects the brain and the heart, two organs with high oxygen requirements (Murphy, 2010). SYMTPOMS include : Headache, Confusion, Dizziness, Nausea, Vomiting, Chest Pain, Loss of Consciousness, DEATH! (EPA, 2010).

11. Prevention  Install at least one carbon monoxide detector on each floor of your home and near sleeping areas [ 1]  Make sure you periodically check and replace the batteries in your CO detector [1]  Have your heating system, gas appliances and water heaters serviced by a professional technician every year [2]  Look for indicators that appliances are not working properly or emitting toxic gases [1]  Never use a gas oven as a heat source for your home [2] 1. (Professional Safety, 2009). 2. (CDC, 2009b).

12. Prevention Never run an automobile inside a garage even if the door is open [2] Never use a portable generator, charcoal grill or other gasoline or charcoal- burning device inside your home, garage, basement or near a window [2] Place Portable generators at least 25 feet away from your home when in use [3] Have fireplaces, wood stoves, chimneys and flues inspected and cleaned (if necessary) by a professional before every heating season [1] Make sure that stoves, fireplaces and space heaters are properly ventilated [2][1]] 1. (Professional Safety, 2009). 2. (CDC, 2009b). 3. (CDC-TV, 2008).

13. Quiz True or False? 1. CO is a toxic, deadly gas? 2. Some sources of CO include electric heating and stoves. 3. Some symptoms of Co poisoning include fatigue, headache, dizziness, nausea, chest pain and loss of consciousness. 4. It is not okay to allow your car to run in your garage. 5. It is okay to heat your house with a gas oven. 6. Oxygen has a much greater ability can bind to red blood cells than does CO. 7. It is okay to place your barbeque grill near a window on your patio. 8. You can smell CO in your home when concentrations become high. 9. Have your gas or propane appliances service every other year. 10. Seek medical attention right away if you are feeling dizzy, light- headed or nauseous and you suspect CO poisoning. (CDC, 2009)

14. Comments Remember the symptoms of CO poisoning Practice Prevention Guidelines Share Information with Others For more information about CO and CO poisoning: - Contact your local health department or your local fire department - Also visit the CDC’s website @ www.cdc.gov/co

15. References Best Practices Can Prevent Carbon Monoxide PoisoningBest Practices Can Prevent Carbon Monoxide Poisoning (2009). Professional Safety, 54(12), 1-1. Centers for Disease Control and Prevention CDC-TV. (National Center for Environmental Health). (2008). The Quiet Killer. Available from http://www.cdc.gov/CDCTV/QuietKiller/National Center for Environmental Health http://www.cdc.gov/CDCTV/QuietKiller/ Centers for Disease Control and Prevention (CDC).( 2009a). Carbon Monoxide Poisoning: Fact sheet. Retrieved June 26, 2010 from http://www.cdc.gov/co/faqs.htm http://www.cdc.gov/co/faqs.htm

16. References Centers for Disease Control and Prevention (CDC). (2009b). Carbon Monoxide Poisoning: Prevention Guidelines. Retrieved June 26, 2010 from http://www.cdc.gov/co/guidelines.htmhttp://www.cdc.gov/co/guidelines.htm Interactive Library. (1999). Why is carbon monoxide so dangerous? Retrieved on July 1, 2010 from http://www.edinformatics.com/interactive_molecules/ca rbon_monoxide.htm Murphy, S. (2010). Carbon Monoxide Poisoning. Nursing Standards, 24(40), 50-55.

17. References National Institute of Standards Technology (NIST). (usnisgov). (2009). How Close is Too Close for Portable Generators? [Video]. Available from http://www.youtube.com/user/usnistgov#p/f/13/jkO9PK4JvJI How Close is Too Close for Portable Generators?http://www.youtube.com/user/usnistgov#p/f/13/jkO9PK4JvJI Prockop LD, Chichkova RI (Nov 2007). "Carbon monoxide intoxication: an updated review". Journal of the Neurological Sciences 262 (1-2): 122–130. doi:10.1016/j.jns.2007.06.037. doi10.1016/j.jns.2007.06.037 U.S. Environmental Protection Agency (EPA). (2010). An introduction to indoor air quality: Carbon monoxide (CO). Retrieved on July 1, 2010 from http://www.epa.gov/iaq/co.html#Sources%20of%20Carbon%20M onoxide

18. References Wang, D., Agrawal, D., Toruka, W., Chaiwatpongsakorn, C., Mingming, L. and Keener, T. (2010). Monitoring Ambient Air Quality with Carbon Monoxide Sensor-based Wireless Network. Communications of the ACM, 53( 5), 138-141.Monitoring Ambient Air Quality with Carbon Monoxide Sensor-based Wireless Network. Wang, S., Emmerich, S., and Powell, R. (2010) NIST Technical Note 1666: Modeling the Effects of Outdoor Gasoline Powered Generator Use on Indoor Carbon Monoxide Exposures – Phase II.(NIST Technical Note 1666). Retrieved on July 1, 2010 from http://www.cdc.gov/co/pdfs/CDC_PhaseII_TN1666.pdfNIST Technical Note 1666: Modeling the Effects of Outdoor Gasoline Powered Generator Use on Indoor Carbon Monoxide Exposures – Phase II http://www.cdc.gov/co/pdfs/CDC_PhaseII_TN1666.pdf Weaver LK (2009) Carbon monoxide poisoning. New England Journal of Medicine. 360, 12, 1217-1225.

19. Further Reading Centers for Disease Control and Prevention CDC-TV. (National Center for Environmental Health (NCEH). (2008). The Quiet Killer. [video]. Available from www.cdc.gov/CDCTV/QuietKiller/National Center for Environmental Health (NCEH)www.cdc.gov/CDCTV/QuietKiller/ Wang, D., Agrawal, D., Toruksa, W., Chaiwtpongsakorn, C., Mingming, L. and Keener, T. (2010). Monitoring Ambient Air Quality with Carbon Monoxide Sensor-based Wireless Network. Communications of the ACM, 53(5), 138-141.Monitoring Ambient Air Quality with Carbon Monoxide Sensor-based Wireless Network. Muscatiello, N., Badcock, G., Jones, R., Horn, E. and Hwang, S. (2009). Hospital Emergency Department Visits for Carbon Monoxide Poisoning Following an October 2006 Snowstorm in Western New York. Journal of Environmental Health, 72(6), 43-48.