Carbon monoxide is odorless, tasteless and invisible, yet highly toxic. A product of fossil fuel combustion, it commonly leaks from domestic heating appliances and is also present in vehicle exhaust. Children, fetuses and the elderly are most susceptible. Children under 5 years are commonly seen in emergency rooms with carbon monoxide poisoning.
Toxic Activity
Oxygen is transported around the body by attachment to the hemoglobin within red blood cells. Carbon monoxide combines with hemoglobin up to 300 times more readily than does oxygen. In this way it blocks oxygen uptake, reducing blood's oxygen carrying capacity. Additionally, carbon monoxide inhibits the release of oxygen to the tissues. Starving tissues of oxygen, CO inhibits cell metabolism, creates inflammation and causes immunological responses. This can cause neurological damage and kill cells in vital organs, including the heart.
Children's Heightened Risk
The fetus is at highest risk for carbon monoxide poisoning. Fetal hemoglobin combines with CO even more readily than adult hemoglobin. When a pregnant woman inhales carbon monoxide, the CO saturation of her fetus's blood will be higher than her own CO level. Additionally, developing organs are at more risk of permanent damage than mature organs. Possible results of fetal CO exposure include fetal death, low birth weight, heart problems and brain damage. Newborns are similarly susceptible. Infants breathe more rapidly than adults and have a higher metabolic rate, increasing their vulnerability. According to the Alliance for Healthy Homes, per pound of body weight, a sleeping infant inhales twice as much air as a sleeping adult.
Prognosis
Given oxygen, child victims usually revive. If inhalation is suspected, get victims into the fresh air and seek medical help. Although children under five are the most common victims of accidental CO poisoning, they have the lowest fatality rate. The Centers for Disease Control and Prevention statistics show fatality risk rises with age, with CO poisoning fatal in only 0.6 percent of cases of children under 4. Accidental inhalation is not usually fatal at any age. Most fatalities result from deliberate acts, for example adult suicides.
Children at Risk
Fumes from poorly maintained heating systems and inhalation during house fires are the main causes of accidental inhalation, with most cases occurring during winter. Children and babies sleeping in the home are particularly vulnerable in either case. Because of economic disadvantage, children from ethnic minorities are more likely to live in housing with substandard appliances or poor fire safety, placing them at greatest risk. Twenty percent more African American children experience accidental carbon monoxide poisoning than Caucasian children.
Prevention
Service furnaces, water heaters and gas appliances regularly. Ensure they vent outdoors and keep rooms ventilated and chimneys clear. Do not use portable heaters in enclosed spaces. If family members complain of headaches, dizziness, breathlessness or lethargy during winter, get appliances checked. This is particularly important if several family members experience this concurrently, or if pets exhibit symptoms. Fit carbon monoxide detection alarms outside all bedrooms. Never leave vehicles running in an attached garage. Do not allow children to travel in the back of enclosed pick-up trucks.
References
- Medscape Reference; Pediatric Carbon Monoxide Toxicity; Dr Samara Soghoian; May 2011
- Children's Hospital Boston: Carbon Monoxide Poisoning
- Alliance For Healthy Homes: Why Children Are at Higher Risk
- Quebec Department of Social Services: Who is Most Vulnerable to Carbon Monoxide Poisoning?
- E-medicine Health; Carbon Monoxide Poisoning; John P. Cunha and Dr. Melissa Conrad Stoppler
- Minnesota Department of Health: Carbon Monoxide (CO) poisoning in Your Home
- Kid Source: Carbon Monoxide Awareness Week: Children Are at Greater Risk For CO Poisoning; Know How to Protect Your Family
- South Coast Air Quality Management District; The Health Effects of Air Pollution on Children; Michael T. Kleinman; Fall 2000
- American Association of Poison Control Centers: Prevent CO Poisoning
- Vermont Department of Health: Carbon Monoxide
