Research In Action

Carbon monoxide (CO) poisoning is a very real threat to families during the winter months and during hurricane season when storms knock out power to homes. That threat is magnified when people are unaware of the danger posed by improperly using gas-powered generators, grills, and cooking stoves during electrical power outages. CO injuries from vehicle exhaust pipes blocked by snow or debris can also occur.

CO, often known as the “silent killer,” is an odorless, tasteless, colorless toxic gas produced by faulty appliances that burn oil, gas, propane, kerosene, coal, or wood. Although CO is always created when fuels are burned, more may be made by malfunctioning appliances and more may accumulate by poorly vented appliances. CO poisons the body’s ability to use oxygen or make energy, which leads to symptoms similar to cold and flu, including headaches, dizziness, drowsiness, nausea, and vomiting. In severe cases, CO poisoning can lead to fainting, coma, seizures, and death.

Children under the age of 5 have the highest incidence of CO poisoning-related visits to the emergency room, with children in minority populations having an increased risk. Each year, the Poison Control Center at Children’s Hospital of Philadelphia (CHOP) receives numerous calls during and in the wake of snowstorms and natural disasters about carbon monoxide poisoning, and outreach and education must be stepped up to prevent CO poisoning from occurring.

CO Poisoning Prevention Tips

It’s important for healthcare providers to make families aware of CO poisoning prevention and to share these evidence-based tips:

• Install CO monitors in the home and make sure all monitors have working batteries by replacing them regularly
• Regularly check all furnaces, chimneys, wood stoves, and heaters to ensure they are in good working condition
• Never use barbecue grills or gasoline-powered equipment inside the house, in a garage or in other enclosed areas
• If a power outage occurs, use gas-powered generators outdoors, away from vents or windows, and at least 25 feet from the house
• Never use gas ovens to heat the home
• Never run a vehicle inside a garage attached to the house as car exhaust contains CO. Be especially careful with keyless vehicles and always ensure that the engine is turned off when parked inside the garage
• Avoid sitting in a vehicle with the engine running if the exhaust pipe is blocked by deep snow, mud, or other debris
• If dangerous amounts of CO are suspected in your home, shut off the heating system, open windows and doors, and call 911 or the heating company
• Leave home immediately if any family member has symptoms of CO poisoning and call 911 or the nearest poison control center

Toward Safer Generators

Safeguards should be put in place to prevent tragic CO poisoning events from occurring when families use portable generators. Poison centers have long prioritized poisoning prevention, and they recognize from long experience that it depends far more on making safer products than on education alone. In an article published in the American Journal of Public Health, I joined colleagues from CHOP, the University of Pennsylvania, Rutgers, and Boston Children’s Hospital in recommending and advocating the following safety modifications to portable generator manufacturers:

• Pair CO detectors with every generator at time of purchase
• Attach longer cords on generators to enable placement at a safe distance
• Use technology currently available to reduce CO emissions on generators by 90 percent or more
• Use technology currently available to include automatic shutoff systems on generators

While this outreach and advocacy message to manufacturers is important, we must continue to advocate for policies that will compel manufacturers to only sell safe generators. We must also continue to promote policies to facilitate the installation and maintenance of battery-operated CO detectors in every home and hotel, particularly in bedrooms or other areas where they would wake sleeping family members. CO poisoning is predictable and preventable. The time is now to take action, before the next storm.