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Accidental Poisening: CO

image of a car crash Yet high levels can kill you in minutes. It is the leading cause of accidental poisoning deaths in the United States. Called the Silent Killer, it is carbon monoxide (CO), and we've all heard of it. But most of us don't know how often and easily we can put ourselves at risk. A surge of cases following Hurricanes Katrina and Rita was caused by people using gasoline-powered generators to cool or light their homes, but surprisingly most of the generators involved were not even inside a house. According to the US Centers for Disease Control and Prevention, most of these generators were actually outdoors but located close to the homes they were powering.

No one knows how far away a generator should be placed from a house to be safe, but the CDC warns that even as far as seven feet is not enough. Remember, if it burns, it creates carbon monoxide, says Caroline Fife, MD, hyperbaric medicine expert at The University of Texas Medical School at Houston.

Anything that burns

"Most common causes are combustion engines, but using a charcoal burner inside in the winter can do it. We're used to smelling the results of combustion, but you can have a leaky furnace and not know it. If a group of people start noticing headache, nausea and sleepiness, open the windows and get out."After the last two big hurricanes, many of the poisoning cases occurred because people were afraid that their generators would be stolen. If that's your concern, put a chain and lock on it. Just don't bring it inside." Anything that moves.

People also have succumbed to carbon monoxide poisoning from"teak" surfing too close to exhaust pipes of boats?body surfing by holding on to the swim platform. The same outcome can occur from riding in the back of pickup trucks under covers and tarps. Prevention is the first step, and following some basic safety precautions can minimize your risk."The most important preventive measure regarding the back of a pickup or camper is the direction of the exhaust pipe," says Fife.

If you can smell exhaust, you're too close

"If it is pointing directly back, it can put anyone riding in the back at risk. Poisoning is less likely if the exhaust comes off the side." In short, Fife warns,"If you can smell exhaust, you're too close. If you smell the heavy odor of exhaust, you're breathing carbon monoxide." Basic safety Basic preventive rules recommended by the CDC and the US Environmental Protection Agency (EPA) are:

1. Check annually all fuel-burning appliances such as gas furnaces, water heaters and ranges.

2. If you find yourself in need of a generator for your home, it should be placed on the opposite side of a house from an air conditioning unit.

3. Vent appliances outside?external from the home. (Check your clothes dryer vent periodically to make sure that built-up clothes lint hasn't sealed off the vent.) * Never let your car idle in the garage, even if the door is open. * Never use a gas oven for heat, even for short periods.

4. Never use a charcoal grill indoors.

5. Never sleep in a room with an unvented gas or kerosene space heater.

They also recommend installing carbon monoxide detectors with audible alarms. You must change the batteries annually, and you must use them when using a generator. Anything that breathes. Often the smallest, such as infants and children, show the first symptoms of exposure.

Older people, persons with heart or respiratory disease and those closest to the source of carbon monoxide also tend to succumb more quickly. Prolonged exposure resulting in unconsciousness requires treatment with hyperbaric oxygen. This involves a special chamber that is pressurized with oxygen at greater than twice the amount in the normal atmosphere. Pregnant women especially need to be treated if exposed because a fetus can get into trouble quickly. Even with treatment however, there may be long-term effects.

"Carbon monoxide is a very sneaky poison," says Fife. CO binds 200 times more tightly than oxygen to hemoglobin in the blood, but this binding is not what kills you. Carbon monoxide especially likes to bind to the brain and heart cells themselves, she explains,"which eventually means those organs stop working. What makes it so dangerous is that carbon monoxide poisoning can cause brain damage. You can appear to recuperate and then go down later. Symptoms such as memory loss and Parkinson's-type symptoms can develop later that can be disabling." Since hurricane season is now upon us, Fife especially warns about using generators.

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