What is Carbon Monoxide Poisoning?
Carbon monoxide or CO is a colorless, odorless and tasteless toxic gas existing in a very small concentration in the atmosphere (normally < 0.001%), and is a product of partial combustion of carbon-based materials. Carbon monoxide poisoning is associated with a high incidence of morbidity and mortality.
Sources of Carbon Monoxide in Work Place
One may be exposed to unsafe levels of Carbon Monoxide in work places by:
- poor industry maintenance or unvented heating equipment;
- poorly vented natural gas burning equipment;
- vehicles in garages (car engine exhaust fumes) or other enclosed spaces;
- during a plant fire (smoke from fires); etc.
Other sources may include the use of charcoal fire grills in confined spaces (e.g. tents). Poorly installed domestic gas heating appliances and incomplete combustion of butane and propane (e.g. in caravans) may lead to sub-acute, chronic or occult poisoning.
For example, assume that one man is working in a small enclosed non-ventilated room with a fired heater in, and complaining from dizziness, severe headache, nausea, weakness, angina is chest pain. He is a patient of CO poisoning.
Who are at Risk from CO poisoning?
All people are at risk for CO poisoning. The elderly and people with chronic heart disease or respiratory problems are generally more at risk than others. In the condition of CO poisoning, the patient must be moved away from the CO source to fresh air immediately. In an emergency room, oxygen therapy is the main treatment of CO poisoning.
Symptoms and Health Effects for CO poisoning
Occupational CO poisoning is not well recognized. Hence, regulatory measures should be implemented to prevent CO poisoning in the workplace.
Breathing CO can cause headaches, dizziness, vomiting, and nausea. If CO levels are high enough, one may become unconscious and even die. Exposure to moderate and high levels of CO over long periods of time has also been linked with an increased risk of heart disease. People who survive severe CO poisoning may suffer long-term health problems. Sleeping or drunk people can even die from CO poisoning before showing any symptoms.
Delayed features of Carbon Monoxide
Uncommon complications of CO poisoning include well-defined neurological conditions such as:
- Parkinsonism, chorea, and choreoathetosis (which correlate with lesions of the putamen and globus pallidus seen on computed tomography and magnetic resonance imaging)
- cortical blindness
- peripheral neuropathy.
Mechanisms of CO toxicity
CO reduces oxygen delivery to tissues in several ways:
- It combines with hemoglobin to form carboxyhemoglobin (COHb), reducing the amount of hemoglobin available to carry oxygen (CO has 240 times the affinity of O2).
- Formation of COHb shifts the oxyhemoglobin dissociation curve to the left, impairing liberation of oxygen to the cells.
- CO binds to myoglobin and cytochrome oxidases (particularly cytochrome a and cytochrome a3) and may impair their ability to utilize the oxygen they receive.
- Tissue oxygenation, particularly in vulnerable organs such as the brain, maybe further impaired if poisoning is complicated by peripheral circulatory failure. Lipid peroxidation results.
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About the Author: The author of this article is Mr. Amir Razmi, an International, a dynamic and multi-functional chemical engineer with more than 14 years’ experience in engineering and EPC of oil and energy projects from pre-contract activities to execution, and closeout.