Below are Questions (Q) and Comments (C) from people around the world regarding carbon monoxide. Some have Responses (R) attached. Contact me if you would like to correspond with them.
May 5, 1997
David, in Toronto
Chronic CO Poisoning?
Dear Dr. Penney,
Q1. I have been reviewing some of the information at COHQ. My initial concern was generated from the fact that I live in a small apartment above a small restaurant in Toronto Canada. Some months ago I purchased a home CO detector to make sure I had no problem with fumes. It was completely dormant for some months until recently, (a couple of months ago.) when I would get periodic low level warnings (allegedly 60 ppm at 90 min.). The hazard setting (100 ppm) has never gone off except when tested. Ventilating the apartment (back door, windows open) always quickily silenced the unit. These low level warnings seem only to occur A) during the restaurants business hours, and B) when the weather was noticably milder, as spring sets in.
My question is, how much of health risk have I potentially incurred from possible longterm chronic exposure to low level CO, potentailly less than the detectors low warning threshold? I have been in the apartment a little longer than 2 years and never experienced any notable physical symptoms associated with CO exposure. This has been a nagging concern to me and I would appreciate any time you might have to help me be better informed.
R1.CO exposure is insideous, as is described on other pages in this site. The damage that results depends on length of exposure, intensity of exposure, and sensitivity of the exposed person. Every effort should be made to keep CO levels in living quarters as low as possible.
November 12, 1997
Peter Hill, United Kingdom
Training Materials on CO and CN
Dear Dr Penney:
Q1. I have a project to write on carbon monoxide and cyanide poisoning. I would like to use some of the info on your web pages including the case studies you mention and maybe some of the graphics as well. Would it be ok to use this information? It will be given out to First Aid instructors within the Royal Mail (U.K. post office) of which I am one. The idea is to build up a collection of articles for our reference. although I cannot be sure that they will not go further afield. I look forward to hearing from you.
R1. Please make use of any and all materials you find in COHQ. Also, please let me know how your training program worked out. Thanks.
Jan. 8, 1998
Yuval & Revital, Israel
Dear Dr. Penney:
We would like to begin by thanking you for the brilliant and HIGHLY Informative web site have established. We learned so much about CO poisoning and therefore about our own case. I (Yuval- male 32 years old) have been suffering from strange symptoms for the last 5 years and these days the symptoms reached their peak. This means that I am unable to work for the past 2 months due to: loss of memory, dizziness, chest pains, strange smiles, tiredness, headaches especially around the eyes and in the back and top of the head, nausea, chronic loss of concentration, diarrhea, loss of hearing and after treatment tinnitus, breathing problems, depression, and confusion..................................
Sept. 18, 1997
Q1. I hope that you have the time to help me out of a credibility problem. After a safety meeting concerning the subject of CO, I added that CO does not just leave the body after seeking fresh air- that the gas will build up and over time a person could die from the build up of low levels of this gas. I used the example of, say, driving one's car for a hour every day with a low level CO leak, or a low level leak in one's home, if the timing was right for the number of hours of exposure compared to number of hours of fresh air it could build up. My next point is if this is true, why doesn't a person who spends all their time in a small apartment and smokes 5 packs of cigarettes a day suffer sooner rather than later. I am sorry to take your time but I guess it is just the world we live in. I live in Fond du Lac, WI.
R1. Carbon monoxide leaves the body the way it enters. As more oxygen enters the lungs the CO is "washed out" CO does build up in the body when CO is constantly present, but leaves when CO is no longer present. See my pages on CO uptake and loss.
May 1, 1997
Peter Hackett, MD, Colorado
CO at altitude
I am a physician and a researcher studying the effects of high altitude hypoxia in humans. I've authored over 70 papers, including one on CO from my lab on Mt. McKinley in Alaska.(We have had problems with CO poisoning in climbers cooking in tents and snow caves.) I am currently in Grand Junction, Colorado.
The current question and search for new data was triggered by a request from the staff at Yellowstone National Park. They are concerned about the dangers of CO exposure from all the snowmobiles entering the park on weekend days, sometimes more than 1,000 per day. They have measured high levels in the air, and wonder about the interaction of CO and their altitude of 7,000 ft. I found an excellent monograph from the EPA (Altitude as a factor in air pollution), but it is from 1978, and I am looking for more current data.
May 4, 1997
Andrew Dawson, Australia
Q1. I was wondering whether all patients should receive allopurinol. It is my understanding that lipid peroxidation begins to occur more rapidly as CO levels drop. Clinically it is not uncommon to see patients with substantial CO levels at arrival. It seemed to me that regardless of whether patients are to receive hyperbaric treatment that this would be worthwhile.
R1. Probably you should. But what to use? I know of no one who has yet attempted to specifically reduce free radicals and/or dicarboxylic acid release in CO poisoning. It isn't even clear that these are the culprits. What might you suggest? We showed that ketamine, an NMDA blocker, is effective in acute CO pioisoning in rats (J. Appl. Toxicol., 16 (4), 297-304, 1996. I don't know whether it has yet been tried in humans.
Q2. I have read the abstract of your ketamine work and am awaiting the full article. I am assuming that the rats were anaethetised? The clinical problem would be what dose to use. The ideal drug would be one that wouold not further complicate the patients clinical state by depressing conciousness or causing cardiovascular instability.
Jan. 3, 1998
Daniel Carlson, Ft. Collins, CO
CO, SIDS, etc.
I have a theory as to a possible cause for SIDS, but, being a layman, it is extremely difficult to get anyone to listen! As ridiculous as it may seem, this theory does fit and explain much of the material that I have been able to research on sids. My 20-year career history in the same industry, of controlling the home and work place environment, has given me the expertise and the experience to have discovered the basis for this theory. I do so hope that you will hear me out.
My theory is simply this, I believe that high, intermittent levels of CO2, (not CO), may be responsible for sids! It is from fuel burning appliances in the home that these high levels mostly come from with a few other sources not being excluded. Putting high levels of CO2 in a home is the one thing I can prove out for it is a far greater problem than most people realize! I have seen and experienced this situation many, many times. In fact, it is my learning about this problem that has given me the necessary insight to make the connection. Consider this if you will, with your knowledge of SIDS and CO, simply replace CO in the equation with CO2.
As you know, CO is born out of CO2, so if CO is found to be present, (presently found by home detectors) CO2 must also be present (no home detectors yet available)! Yet, CO can only be present if there is an unclean burn of fuel and somehow this unclean burn releases its products inside the home where the burn is taking place. Now, if the burn of fuel were clean, there would be no CO, yet, there would always be CO2 present. One very good example would be a gas range and/or oven in a home. This is a non-vented appliance commonly found in many homes and as long as the burn of fuel is clean, there would be no CO present yet there would have to be CO2 present. This example is but a tip of the iceburg of examples that I can provide. The one fact that I know is that CO2 levels in the home are much higher and happen more often than anyone seems to realize! There is so much more that I can and would explain given the opportunity. I have been working on this theory for over four years now trying to find something that would not fit, but, so far, I can relate this theory with all the information that I can find and understand about SIDS.
If you would wish to contact me, I would be more than happy to explain everything I can! Thank you for your time and consideration!
Sincerely, Daniel Carlson
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