CARBON MONOXIDE POISONING FROM PORTABLE ELECTRIC GENERATORS Hampson NB

I am Very Happy to see that Bacharach is "Zooming In" on the Portable Generator / Small Gasoline Engine C O Problems, and that COSA has joined the CALL. ..... I have been "Preaching" the lack of recognition and public awareness of this problem to CPSC and anyone else that would listen for over 20 years, and it took a "Record Setting Ice Storm", many extended power outages and far too many DEATHS to finally get the ATTENTION of CPSC and the Media.

As you may remember, the "LINK" to the "C O / Small Gasoline Engine INFO" was one of the first "Links" that I put on my website.

Once again, the "Appliance Manufactures" and their Associations have not cooperated very well, despite the ever growing number of fatalities.

Once again, I THANK Bacharach and COSA for joining this effort to make our Citizens, HVAC Contractors, Weatherization Groups, Fire Departments and other "First Responders" AWARE of this DEADLY HAZARD.

George E. Kerr, President

C O - Experts

NOTICE TO ALL READERS OF BACHARACH'S CARBON MONOXIDE NEWS

Tell everyone you know that using gasoline generators inside buildings can be dangerous, deadly and is not a good idea. Though this practice is obviously a hazard to most people, some just don't seem to get it. This includes garages that have doors open, basements, and under porch roofs of attached buildings. Review the archives of the CO News and see how often this type of poisoning accident occurs. Thanks from COSA, Carbon Monoxide Safety Association.

See: http://www.bacharach-inc.com/co_news.htm

CARBON MONOXIDE POISONING FROM PORTABLE ELECTRIC GENERATORS
Hampson NB, Zmaeff JL. Virginia Mason Center for Hyperbaric Medicine, Seattle, Washington 98101 USA.

INTRODUCTION: While the overall death rate from accidental carbon monoxide (CO) poisoning has declined in the US due to improved automobile emissions controls, exposures remain common from some other sources of CO. One of these is the operation of portable electric generators in poorly ventilated spaces. Development of effective prevention efforts will require identification of the population poisoned from CO in this manner and determination of the reasons that generators are operated in a hazardous fashion.
METHODS: Following IRB approval, a retrospective review of cases of patients with CO poisoning treated with hyperbaric oxygen at Virginia Mason Medical Center in Seattle from November 1978 to January 2004. Those cases that resulted from portable generator use were selected for analysis.
RESULTS: Sixty-two patients ranging in age from 2 to 85 years were poisoned in 36 separate incidents. They included 34 males and 28 females, 33 of whom lost consciousness with the exposure. Of the 62 total patients, 60 spoke English. Blood COHb levels ranged from 6.6 to 49.7% (23.1 + 10.2%). Generators were typically used when normal electrical service was disrupted by a storm or in remote locations where electrical service was not available. In 28 of 36 incidents, the generator was operated in the home environment, most commonly in the garage. Lack of awareness of the dangers of CO poisoning or lack of knowledge of ventilation requirements were the most commonly identified reasons for indoor use.
CONCLUSIONS: CO poisoning from portable electric generators occurs in a characteristic population, in a few typical locations and for a limited number of reasons. This information will allow effective targeting of prevention efforts for this form of poisoning.

USE OF EXPIRED CARBON MONOXIDE (ECO) TO DIAGNOSE ACUTE CO POISONING
Smart D, *Oxer H, *Mark P, *Banham N. Diving and Hyperbaric Medicine, Royal Hobart Hospital, Hobart, Australia; *Fremantle Hospital, Perth, Australia

INTRODUCTION: The aim of this study was to investigate the use of ECO to diagnose acute CO poisoning in the Emergency Department, and to determine if poisoned individuals could be differentiated from non-poisoned smokers and non-smokers.
METHODS: A system to measure ECO was developed using a Dräger Datalogger® with accuracy to 1 ppm [CO]. Measurement of ECO was preformed in real-time using controls (smokers and non-smokers) and poisoned individuals breathing air. ECO values were then evaluated to determine if poisoned and control groups could be differentiated. RESULTS: Twelve acutely (<6H) CO poisoned patients mean age 34.7 (95% CI = 28.8 to 40.5), 80 non-smoker controls mean age 26.6 (23.8 to 29.3) and 119 smoker controls mean age 32.8 (29.9 to 36.6) were enrolled in the study. Mean ECO values were: poisoned patients 66.17ppm (30.5 to 101.9), smokers 15.9ppm (14.1 to 17.8) and non-smokers 1.8ppm (1.5 to 2.1). ECO values were significantly different in each group (p<0.0001). In the diagnosis of acute CO poisoning, ECO>40ppm had a sensitivity of 0.67, specificity of 1.0, positive predictive value (PPV) of 1.0, and negative predictive value (NPV) of 0.98. For an ECO > 10ppm, sensitivity improved to 1.0, NPV = 1.0, at the expense of specificity = 0.63, and PPV = 0.14. The receiver operating characteristic curve for the ECO test had an area under the curve of 0.92.
CONCLUSIONS: ECO shows promise as a non-invasive method to diagnose acute CO poisoning, provided the ECO is > 40ppm. For values between 10 and 40ppm, clinical data is needed to interpret ECO results, to differentiate poisoned patients from smokers.