Occupational Carbon Monoxide Research Articles

Occupational carbon monoxide exposure: An analysis of diagnostic challenges in a 50-year-old male manifesting neurological symptoms

Occupational carbon monoxide exposure: An analysis of diagnostic challenges in a 50-year-old male manifesting neurological symptoms

Occupational Carbon Monoxide Poisoning in Wisconsin: Results From a Statewide Electronic Disease Surveillance System and From the Wisconsin Poison Center, 2018-2021.

Prevention methods for carbon monoxide (CO) poisoning in Wisconsin address occupational and nonoccupational exposures together, but differences between the settings could inform new approaches to preventing occupational CO poisonings. We described occupational CO poisonings in Wisconsin from July 1, 2018, through July 1, 2021, using surveillance data from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. We identified cases of CO poisoning from the Wisconsin Electronic Disease Surveillance System and Wisconsin Poison Center. Occupational CO poisonings were records where "workplace" was recorded as the location of exposure. We excluded records classified as suspect/not a case, those missing laboratory results or information on exposure source/location, and intentional poisonings. We compared characteristics between occupational and nonoccupational settings using odds ratios (ORs), and we estimated crude incidence rates of occupational exposures by occupation. We identified 614 cases of CO poisoning, of which 168 (27.4%) were occupational exposures. When compared with patients with nonoccupational exposures, patients with occupational exposures were more likely to be male (OR = 3.8; 95% CI, 2.4-6.1), Hispanic (OR = 2.4; 95% CI, 1.4-4.2), and younger (mean difference [SD] = 6.6 [20.9]). Several CO sources were significantly associated with occupational poisonings: forklifts (OR = 58.4; 95% CI, 13.9-246.1; P < .001), pressure sprayers (OR = 2.4; 95% CI, 1.3-4.4; P = .003), and other gasoline-powered tools (OR = 3.8; 95% CI, 2.3-6.3; P < .001). The natural resources, construction, and maintenance occupation group had the highest crude incidence rate-45.0 poisonings per 100 000 full-time equivalent employees. Incorporating data from the Wisconsin Poison Center improved data quality, but surveillance is limited by underreporting. Creating strategies to increase reporting would allow for a more comprehensive understanding of occupational CO poisoning.

Notes from the Field: Occupational Carbon Monoxide Exposure in an Industrial Kitchen Facility - Wisconsin, 2017.

Notes from the Field: Occupational Carbon Monoxide Exposure in an Industrial Kitchen Facility - Wisconsin, 2017.

Surveillance and Analysis of Occupational Carbon Monoxide Poisoning in the Paris Region.

Acute carbon monoxide poisoning is common and often severe. Domestic causes have been extensively documented, while occupational exposures have been reported less frequently. We analyse occupational carbon monoxide poisonings from the available data of the carbon monoxide poisoning surveillance network for Paris and its region, and identify predictive factors of severity for occupational poisoning in order to identify priority prevention actions. We retrospectively reviewed all events of acute accidental carbon monoxide exposures which occurred in the Paris region, at the work place, and notified to the surveillance network from 1 January 2005 to 31 December 2011. Over the 7-year study period, 362 exposed workers were identified, representing 8.15% of all cases of carbon monoxide exposures. The largest number of events occurred in the building sector and most commonly affected occupations were craft and related trades workers. The most common sources of exposure were internal combustion engine equipment that was involved in almost half of cases. Minor severity was observed in 86% of cases, and 13% were moderate or more. We identify that the use of internal combustion engine equipment was significantly associated with increased severity. Occupational carbon monoxide poisoning is reported less frequently than domestic poisoning and has different and more numerous causes. It can be potentially severe, especially when it is caused by internal combustion engine equipment. Information about risks, compliance with instructions and cleaning rules, and establishment of collective and individual protective equipment would significantly reduce the frequency and severity of carbon monoxide poisoning.

Occupational carbon monoxide fatalities in the US from unintentional non‐fire related exposures, 1992–2008

To analyze characteristics of, and trends in, work-related carbon monoxide (CO) fatalities in the US. Records of unintentional, non-fire related fatalities from CO exposure were extracted from the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and the Occupational Safety and Health Administration's Integrated Management Information System for years 1992-2008 and analyzed separately. The average number of annual CO fatalities was 22 (standard deviation=8). Fatality rates were highest among workers aged≥65, males, Hispanics, winter months, the Midwest, and the Fishing, Hunting, and Trapping industry subsector. Self-employed workers accounted for 28% of all fatalities. Motor vehicles were the most frequent source of fatal CO exposure, followed by heating systems and generators. CO has been the most frequent cause of occupational fatality due to acute inhalation, and has shown no significant decreasing trend since 1992. The high number of fatalities from motor vehicles warrants further investigation.

Fatal carbon monoxide poisoning: an outdoor occupational accident case

Fatal carbon monoxide (CO) poisoning by suicide or accident is well known. Most cases are due to smoke from burning buildings, town gas and car exhaust gas all in closed...

Occupational Carbon Monoxide Poisoning in Washington State, 2000–2005

Washington State workers’ compensation data can be used to guide prevention efforts focused on occupational carbon monoxide (CO) poisoning. Between 2000 and 2005, a total of 345 individual claims comprising 221 different exposure incidents were identified for the 6-year time period. The construction industry had 43 (20%) CO incidents, followed by wholesale trade with 32 (15%), and agriculture with 27 (12%) incidents. Fuel-powered forklifts caused 29% of all incidents, while autos/trucks/buses were responsible for 26%. The number of forklift incidents in fruit packing and cold storage companies declined significantly from 1994 through 2007 (Spearman's rho = 0.6659, p < 0.01). While this study used multiple medical records from workers’ compensation claims to identify CO poisoning, a surveillance system that lacks extensive medical records may rely principally on carboxyhemoglobin (COHb) tests. This study demonstrated that 71% of the identified workers’ compensation claims had associated COHb tests. The recurrence and timing of CO poisoning as well as control of the CO-generating source were determined. Approximately 8% of all work sites had recurring CO poisoning incidents. Two percent experienced a recurrent incident within 16 days of the initial incident, and 6% experienced a recurrent incident between 16 days and 3 years after the initial incident. Sixty-seven percent of claimants exposed to CO were not in direct control of the CO-generating source; this has implications for CO prevention and underscores the need for all employees to be trained on CO hazards.

Occupational carbon monoxide poisoning among West Virginia workers' compensation claims: diagnosis, treatment duration, and utilization.

Incidence rates and characterizations of occupational carbon monoxide (CO) poisoning in terms of sources of exposures, diagnosis, treatment, and health care utilization are critical for public health planning. We identified 182 CO poisoning cases occurring over a 6-year period (IR = 4.3/100000 worker-years) in the West Virginia workers' compensation data. Frequent sources of poisoning were gas-powered engines (28%) and furnaces (20%). Minimum treatment duration ranged from 1 day to 8 years with significant differences in mental health comorbidities between cases treated within 1 year compared with cases treated for more than 1 year (OR = 20.75; 95% CI = 3.5-128.4). The average cost (medical and wage loss replacement) for CO claims was dollars 2130 and median lost time was 45 days. CO poisoning could lead to prolonged disability and treatment in patients with mental health comorbidities, suggesting a possible role for early intervention.

Occupational carbon monoxide violations in the State of Washington, 1994-1999.

Occupational exposure to carbon monoxide continues to cause a number of injuries and deaths. This study reviewed the State of Washington OSHA inspection records for occupational safety or health violations related to carbon monoxide for the time period 1994-1999 to assess the agency's efforts and further identify and characterize causative factors. Inspection data were also compared with carbon monoxide claims data from a companion study to determine if the agency was visiting the most at risk work operations. Inspections were identified by searching computerized violation texts for "carbon monoxide" or "CO." The study found 142 inspections with one or more carbon monoxide violations. Inspections were spread over 84 different 4-digit Standard Industrial Classification codes. Most inspections were initiated as a result of a complaint or other informant. Inspections were predominantly in construction and manufacturing, whereas carbon monoxide claims were mores evenly distributed between the major industries. Inspections also may have failed to find violations for some types of equipment responsible for carbon monoxide claims. Forklifts were the source of carbon monoxide most often associated with a violation, followed by compressors for respirators, auto/truck/bus, and temporary heating devices. Inspections in response to poisonings found common factors associated with lack of recognition and failure to use or maintain equipment and ventilation. Some work sites with one or more poisonings were not being inspected. Only 10 of the 51 incidents with industrial insurance claim reports of carboxyhemoglobin at or above 20 percent were inspected. Further, it was found more preventive efforts should be targeted at cold storage operations and certain warehouse and construction activities. It is proposed that more specific standards, both consensus and regulatory, would provide additional risk reduction. Reliance upon safe work practices as a primary method of control in the use of fuel-powered equipment in cold storage or other enclosed and unventilated environments needs to be prohibited. The study further demonstrates how inspection and industrial insurance records can assist with preventive efforts and better focus an agency's efforts.

Occupational carbon monoxide poisoning in the State of Washington, 1994-1999.

Carbon monoxide poisonings continue to be significant and preventable for a number of work operations. This study assesses occupational carbon monoxide morbidity and mortality for the state of Washington based on a review of workers' compensation records for the years 1994-1999. The study characterizes sources, industries, and causative factors, and further attempts to identify work operations most at risk. Records were identified by both injury source and diagnostic codes. The study limits itself to non-fire-related carbon monoxide poisonings and primarily those from acute exposure. A decline in the number of claims was not evident, but the number of incidents per year showed a slight decline. Carbon monoxide poisonings were found to occur throughout all types of industries. The greatest number of claims was found in agriculture, followed by construction and wholesale trade, with these three accounting for more than half the claims and nearly half of the incidents. The more severe poisonings did not necessarily occur in industries with the greatest number of incidents. The major source for carbon monoxide poisoning was forklift trucks, followed by auto/truck/bus, portable saws, and more than 20 other sources. Fruit packing and storage had the highest number of incidents mostly due to fuel-powered forklift activity, with nearly half of the incidents occurring in cold rooms. Adverse health effects as measured by carboxyhemoglobin, hyperbaric oxygen treatment, unconsciousness, and number and cost of claims were indexed by source. Though several specific work operations were identified, the episodic nature of carbon monoxide poisonings, as well as the diverse industries and sources, and the opportunity for a severe poisoning in any number of operations, poses challenges for effective intervention.

A new carbon monoxide occupational dosimeter: results from a worker exposure assessment survey

The LBNL/QGI occupational carbon monoxide (CO) dosimeter (LOCD), a new, inexpensive CO passive sampler, was field-validated in an occupational exposure assessment study in the Moscone Convention Center (MCC) in San Francisco, CA in January, 1997. The LOCD measures time-weighed-average (TWA) CO exposures from 10 to 800 parts per million hours (ppm h; accuracy +/- 20%; precision 10 ppm h). This device represents a major improvement over currently available low-cost personal CO monitors. At the MCC, over 1000 workers set up and remove exhibitions. Forty propane-powered forklifts moved materials throughout the 42,000 m2 of exhibit halls. Diesel truck emissions enter the building via three internal underground loading docks. The LOCD was used to measure 154 worker exposures on 3 days. Sampler performance was compared to a standard method at 15 fixed sites. The geometric mean (GM) of all 154 exposures was 7 ppm (geometric standard deviation (GSD) = 1.6); 10% of the exposures was 10 ppm or more. Dock Walkers and Forklift Operators had the highest exposures (maximum = 34 ppm) with GM (GSD) of 9 (1.7) and 9 (1.6) ppm, respectively. Attendants and Installer/Decorators had the lowest exposures with GMs of 6 (1.6) and 7 (1.4), respectively. The Cal/OSHA personal exposure limit for CO is 25 ppm time-weighted average (TWA).

Indoor use of concrete saws and other gas-powered equipment. Analysis of reported carbon monoxide poisoning cases in Colorado.

Poisoning due to "non-automobile" gas-powered engines accounts for the largest proportion of occupational carbon monoxide (CO) poisonings in Colorado workers. The present analysis was undertaken to characterize the problem and develop prevention strategies. Cases of occupational CO poisoning were identified from Colorado's population-based surveillance system for unintentional CO poisonings. For cases poisoned by "non-automobile" gas-powered engines, medical records were obtained. Results showed that almost all of the poisonings from these engines occurred indoors or in an enclosed space. Concrete saws were the most frequent source of poisoning. When compared with operators of other equipment, concrete saw operators had shorter durations of exposure to CO but generally experienced more severe symptoms and signs of poisoning. These results underscore the hazard associated with the indoor use of any gas-powered equipment; however, operators of concrete saws may receive a higher dose of CO.

Carbon monoxide exposure in blast furnace workers

This study investigated the occupational exposure to carbon monoxide (CO) of a group of blast furnace workers from an integrated steelworks, compared to a control group having no significant occupational CO exposure from other areas in the same works. The study was undertaken in 1984 at Port Kembla, New South Wales. Carboxyhaemoglobin (COHb) levels before and after an eight-hour work shift were measured in 98 male steelworkers: 52 from two CO-exposed iron blast furnaces and 46 controls from production areas in the same steelworks. The sample was stratified by smoking habits. Environmental air CO levels had been found to be consistently higher on one furnace than on the other. Absorption of CO from the working environment occurred in workers on the blast furnace with higher CO levels, regardless of smoking habits. On this blast furnace, some readings of COHb levels after a workshift in nonsmokers approached the proposed Australian occupational limit of 5 per cent COHb saturation. Overall, workers with the highest occupational exposure who smoked most heavily had the highest absorption of CO over a work shift. Biological monitoring gives an accurate measure of individual worker 'dose' of CO from all sources. Both environmental monitoring and biological monitoring need to be included as part of a program for controlling occupational CO exposure.

Carbon Monoxide: Dosimetry in Occupational Exposures in Denver, Colorado

Abstract The occupational carbon monoxide (CO) exposure of Denver traffic control personnel was evaluated during 8-hr workshifts using three parameters: (1) 98, 8-hr time-weighted average breathing zone air samples (personal dosimetry); (2) before- and after-workshift CO breath samples; and (3) 8-hr moving average, ambient CO levels during the fall and winter months. Different shifts and work experiences were taken into consideration. The data revealed greater CO exposure in subjects working on the street than controls wording inside downtown buildings with respect to breath CO concentration and breathing zone air samples. The CO concentrations in the after-workshift breath samples were closely associated with the 8-hr time-weighted average CO levels. The greatest source of CO to the sampie population was cigarette smoking, followed by occupational-related sources, and finally, the ambient background CO levels.

Carbon Monoxide: Dosimetry in Occupational Exposures in Denver, Colorado

The occupational carbon monoxide (CO) exposure of Denver traffic control personnel was evaluated during 8-hr workshifts using three parameters: (1) 98, 8-hr time-weighted average breathing zone air samples (personal dosimetry); (2) before- and after-workshift CO breath samples; and (3) 8-hr moving average, ambient CO levels during the fall and winter months. Different shifts and work experiences were taken into consideration. The data revealed greater CO exposure in subjects working on the street than controls working inside downtown buildings with respect to breath CO concentration and breathing zone air samples. The CO concentrations in the after-workshift breath samples were closely associated with the 8-hr time-weighted average CO levels. The greatest source of CO to the sample population was cigarette smoking, followed by occupational-related sources, and finally, the ambient background CO levels.