It's the day after Thanksgiving, and the members of one family have suddenly fallen ill. In fact, the entire clan is nauseated and vomiting, with fatigue and headaches so severe they're unable to get out of bed. At first, they suspect a nasty flu. But no one has a fever, so an undercooked turkey is the suspected culprit. Still, something just doesn't add up. Other dinner guests who ate the same dishes didn't become ill, so food poisoning is unlikely.

In recent years, a growing number of Americans have learned that symptoms commonly associated with a virus or food poisoning may be the result of something more insidious: carbon monoxide (CO) fumes.

According to the Centers for Disease Control and Prevention, carbon monoxide leaks are the leading cause of fatal accidental poisonings in the United States today. Every year, more than 15,000 people suffer nausea, vomiting, fatigue, severe headaches, and confusion from CO poisoning. But that's not all: Each year as many as 2,500 deaths are due to carbon monoxide poisoning, according to the Centers for Disease Control.

Pregnant women, infants, seniors, smokers, or people with circulatory problems can be especially susceptible to carbon monoxide poisoning, so take extra precautions if any of those groups include you or your family members.

Any device that burns fuel can produce carbon monoxide fumes. For example, a central heating system that uses gas, the family car, a portable camping heater, a boat, even a grill can emit the potentially deadly fumes. In February 2004, kids participating in an ice hockey tournament in Lyndon, Kentucky were sent to the hospital after suffering CO poisoning from a seemingly improbable source -- a propane-fueled Zamboni machine used to smooth the surface of the ice.

How carbon monoxide finds its way into your home is no mystery: When fuels such as gasoline, kerosene, propane, firewood, or charcoal aren't burned completely, they produce carbon monoxide. The odorless, tasteless, colorless, and nonirritating gas is undetectable to the human senses, contributing to its reputation as a "silent killer." Malfunctioning heaters are the most common source of these fumes, but generators running in poorly ventilated spaces can be just as hazardous.

"Generators should never be placed in an enclosed or semi-enclosed space, like a basement, cellar bulkhead, or attached garage. That's where carbon monoxide can build up to dangerous levels," cautions Andrew Smith, SM, ScD, a state toxicologist in Maine, where three-quarters of all CO accidents occur from leaky gas-powered electrical generators located in basements and garages. "If you have high levels of CO in an attached garage, the dangerous gas will find its way into your home."

Although the gas is colorless and odorless, it leaves a few telltale signs you can watch out for: vents or chimneys with rust or water streaks; loose or missing furnace panels; moisture inside of windows; loose vent or chimney connections, and debris or soot falling from a fireplace, chimney, or appliance. You may also experience symptoms of CO poisoning, which include shortness of breath, nausea, dizziness, headache, and fatigue.

You can protect yourself and your family from carbon monoxide poisoning with a CO detector, a small, easy-to-install gadget that is available at most hardware stores. CO detectors usually cost less than $100, and some even combine the safety features of a smoke alarm with carbon monoxide detection. Unfortunately, most people don't know that such a simple device can alert them to dangerous levels of carbon monoxide and prevent poisonings. Although the Consumer Products Safety Commission recommends that every household have a carbon monoxide detector, researchers estimate only 29 percent of U.S. households have the monitors. However, in some states and cities they are already mandatory.

There are two basic types of CO monitors -- battery-operated and electric. Battery-operated detectors can run up to three years on a single battery, but it's a good idea to change the batteries every year, just to be safe. Electric varieties usually need to be replaced every five to 10 years because they can become more sensitive to carbon monoxide as they get older and go off when there's no danger.

Properly working CO detectors can prove invaluable. In 2002, a CO alarm may have saved the lives of the Ketofsky family of Kendall Park, New Jersey. Hal and Kathleen Ketofsky were sleeping soundly when their 11-year-old son Aaron ran into their bedroom to warn them that the CO alarm had gone off. Still groggy and confused, Hal Ketofsky suspected the shrill sound he heard was from a smoke detector that had been giving off false alarms. But when he looked at the CO detector in the children's room, it showed a reading far into the danger zone.

According to the Consumer Product Safety Commission, 150 parts per million (ppm) can be enough to cause disorientation, unconsciousness, and even death. In this particular situation, CO levels reached as high as 400 ppm, according to the fire marshal who responded. If the alarm had not sounded, the family might have died during the night. By the time EMT workers arrived on the scene, both Aaron and his sister required oxygen treatment.

When inspectors checked the Ketofsky house a few days later, they pinpointed the source of the leakage to a broken air-conditioning unit. The system was pulling combustion fumes into the house instead venting them outdoors.

When shopping for a CO detector, don't go by price alone. Make sure the monitor has a long-term warranty and meets the standards of Underwriters Laboratories Inc., an organization that tests various products for safety and drafts guidelines for proper use. (Look for the agency's seal of approval -- a "UL" in a circle -- on the outside packaging for assurance that a product is in compliance with the safety guidelines.) The guidelines also require an alarm to sound when exposure to CO reaches potentially dangerous levels over a period of time.

Depending on the size of your house or apartment, one monitor may not be enough. The Consumer Product Safety Commission recommends installing a CO detector in the hallway near every separate sleeping area of the home. Detectors should also be standard equipment for recreational vehicles and enclosed motorboats.

Never ignore a CO detector when it sounds, even if you think it's a false alarm: You could lose consciousness and die if you do nothing. Open the nearest windows and check your family immediately, rousing them from sleep if necessary. (If someone can't wake up, it's a likely sign of CO poisoning: call 911.) Look for other symptoms, such as headache, nausea, or confusion. If these symptoms are present, have everyone leave the house, call the fire department, and seek immediate medical attention.

If your family reports no symptoms, you may have just had a minor leak that wasn't serious enough to make you ill. Open the windows and doors and turn off all heaters or appliances that can leak carbon monoxide. Then hit the reset button to check to see if the detector is working properly.

Remember to make sure your heaters and other appliances are working properly, and have your heating system, chimney, or flue inspected and cleaned once a year. Also, don't use an oven or range to heat your house, and don't burn charcoal in a garage or inside your home. Here are some other tips to prevent CO poisoning:

•Make sure CO detectors aren't covered up by furniture or curtains.

•Don't go to sleep with a gas-burning heater on.

•Never leave a car running in an attached garage, even with the garage door open.

•Don't use gas-powered tools and engines indoors. If this is unavoidable, open all the windows and doors, and make sure the room is well-ventilated.

•Install CO detectors in boats and recreational vehicles.

•Never burn charcoal inside a vehicle, tent, or inside your house. (In some cases, entire families have been poisoned while using a grill indoors on a rainy day.)

•Don't use portable heaters or lanterns in a camper, tent, or other enclosure.

•Never operate unvented fuel-burning appliances in a room with closed doors or windows.

Don't let children or adults swim near the exhaust from a boat engine, and don't stand directly over the boat's exhaust pipe while on deck.

Today's detectors are very reliable, especially if you follow the manufacturer's instructions. Still, even the best monitor is no substitute for a little common-sense prevention.

-- Diana Reiss-Koncar is a freelance journalist in Oakland, California, who has written for Hippocrates, Salon, and many other publications.

References

First published June 22, 2004
Last updated June 26, 2008
Copyright © 2004 Consumer Health Interactive

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