Rationale:

• CO is an odorless, colorless, tasteless gas that results from incomplete combustion of carbon.
• Any combustion appliance can produce elevated levels of CO if the device malfunctions or if ventilation is limited.
• Methylene chloride in paint strippers can be inhaled or absorbed through the skin and subsequently converted to CO by the liver.

Evidence:

• Electronic, audible CO detectors can prevent 50% of unintentional CO poisoning deaths as shown in this epidemiologic study of 136 CO-related death(1).
• A review of national media services showed that cities with CO detector ordinances had a 0.4% fatality for all CO exposures, whereas cities without CO detector requirements had fatality rates of 1.3% to 25% for exposed persons, suggesting that CO detectors allow early recognition of exposure and prevent death (2).
• Case series of all CO-poisoning deaths in California from 1979 to 1988 showed significant ethanol use in 30% of cases (3).
• Case reports show that indoor combustion tools such as concrete saws (4), ice-surfacing machines (5), and forklift trucks (6) are associated with CO poisonings if not maintained and used properly.
• Case reports have shown that enclosed recreational vehicles such as boats (7) and single-engine aircraft (8) can lead to CO poisoning if not maintained and used properly.
• Case series studies have shown increased risk of CO poisoning during winter months (9), ice storms (10), and power outages (11).

Comments:

• None.