What are the causes of carbon monoxide (CO) toxicity?

Updated: Sep 18, 2018
  • Author: Guy N Shochat, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Most unintentional fatalities occur in stationary vehicles from preventable causes such as malfunctioning exhaust systems, inadequately ventilated passenger compartments, operation in an enclosed space, and utilization of auxiliary fuel-burning heaters inside a car or camper.

Most unintentional automobile-related CO deaths in garages have occurred despite open garage doors or windows, demonstrating the inadequacy of passive ventilation in such situations.

Colorado state datafrom 1986-1991 revealed that leading sources of 1149 unintentional nonfatal CO poisonings were residential furnaces (40%), automobile exhaust (24%), and fires (12%); however, furnaces were responsible for onlly 10% of fatal poisonings [21]

In the setting of structure fires, CO presents greater risk than thermal injury or oxygen deprivation, both for firefighters and victims [22]

In most developing countries, cooking or heating is often done with unvented cookstoves, wood, charcoal, animal dung, or agricultural waste,  which has been linked with elevated HbCO levels

Boats and houseboats represent a significant and underappreciated source of exposure, with multiple case reports and studies [5]

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