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Texas Emergency Management ONLINE 2017 Vol. 64 No. 11

The Silent Killer: Carbon Monoxide Poisonings

Carbon monoxide (CO) is a colorless, odorless, poisonous gas that causes flu-like symptoms that are often misinterpreted after an exposure. Initial symptoms of CO poisoning, such as headache, nausea and fatigue, are often mistaken for the flu, because the deadly gas isn't detected by our sense of smell. CO poisoning is caused by inhalation combustion fumes. When too much CO is in the air you're breathing, your body replaces the oxygen in your red blood cells with carbon monoxide. This prevents oxygen from reaching your tissues and organs.

Carbon monoxide poisoning can be especially dangerous for people who are sleeping or intoxicated. People may end up with irreversible brain damage or even be killed before anyone realizes there's a problem. Per the Center of Disease Control (CDC), CO poisoning causes thousands of deaths each year in the United States. It is the leading cause of accidental poisoning deaths in America. Patients who survive the initial poisoning still face the prospect of delayed neurologic dysfunction, which occurs in 14% to 40% of serious cases.

Common symptoms of CO Poisonings:

  • Dull headache
  • Weakness
  • Dizziness
  • Nausea or vomiting
  • Shortness of breath
  • Fast heart rate
  • Chest pain
  • Blurred vision
  • Confusion or drowsiness
  • Seizures
  • Loss of consciousness

Common Risk Factors Associated with CO Poisonings

  • Children: Young children take breaths more frequently than adults, which may make them more susceptible to CO poisoning.
  • Older adults: Older people who experience CO poisoning may be more likely to develop brain damage.
  • Depending on the degree and length of exposure, CO poisoning can cause:
    • Permanent brain damage
    • Damage to your heart, possibly leading to life-threatening cardiac complications
    • Death

Common causes of CO Poisonings

CO can come from any device that burns fuel. Common sources are cars, fireplaces, powerboats, woodstoves, kerosene space heaters, charcoal grills, and gas appliances such as water heaters, ovens, and dryers. Usually they cause no problems. Trouble comes when:

  • Cars, trucks, or other engines are left running in enclosed spaces, such as garages. CO can build up in a garage and leak back into the house. Even sitting in an idling car in an open garage or swimming behind an idling boat can be dangerous.
  • Fuel-burning appliances are not installed used or working properly. Dangerous levels of CO can build up inside houses and other buildings.
  • Fuel-burning heating systems and appliances are used during cold weather, when doors and windows are closed. Chimneys in older buildings become blocked and release fumes into the homes or offices. Newer houses that are well insulated and tightly sealed can trap carbon monoxide inside. If you have a leak in the ventilation system, CO can spread through your home which leads to exposure.

Simple precautions can help prevent CO poisoning

  • Install carbon monoxide detectors. Put one in the hallway near each sleeping area in your home. Check the batteries every time you check your smoke detector batteries (at least twice a year). If the alarm sounds, leave the house and call 911 or the fire department. CO detectors are also available for motor homes and boats. Understand that CO detectors are a backup safety measure. They do not replace the need to check appliances regularly and use them safely.
  • Open the garage door before starting your car. Never leave your car running in your garage. Be particularly cautious if you have an attached garage. Leaving your car running in a space attached to the rest of your house is never safe, even with the garage door open.
  • Use gas appliances as recommended. Never use a gas stove or oven to heat your home. Use portable gas camp stoves outdoors only. Use fuel-burning space heaters only when someone is awake to monitor them and doors or windows are open to provide fresh air. Don't run a generator in an enclosed space, such as the basement or garage.
  • Keep your fuel-burning appliances and engines properly vented. These include:
    • Space heaters
    • Furnaces
    • Charcoal grills
    • Cooking ranges
    • Water heaters
    • Fireplaces
    • Portable generators
    • Wood-burning stoves
    • Car and truck engines
  • If you have a fireplace, keep it in good repair. Have your fireplace chimney and flue cleaned every year.
  • Keep vents and chimneys unblocked during remodeling. Check that they aren't covered by tarps or debris.
  • Complete repairs before returning to the site of an incident. If carbon monoxide poisoning has occurred in your home, it's critical to find and repair the source of the CO leak before you stay there again. Your local fire department or utility company may be able to help. Ask your utility company about yearly checkups for all gas appliances, including your furnace.

If you suspect an environment to have high levels of CO or have symptoms that you think could be caused by CO poisoning, leave the area immediately, call 911 and let the fire department assess and manage the cause and ventilation of CO gases.

Jason Dush
EMS Manager
Texas Division of Emergency Management

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