Carbon monoxide (CO) exposure has been described ever since humans developed products of combustion (e.g. fire, burning charcoal). The Romans realized that CO poisoning leads to death (Penney 2000). Coal fumes were used in ancient times for execution, and the deaths of two Byzantine emperors are attributed to CO poisoning (Lascaratos and Marketos 1998). Admiral Richard E. Byrd developed CO poisoning during the winter he spent alone in a weather station deep in the Antarctic interior (Byrd 1938). Further, CO poisoning took the life of tennis player Vitas Gerulaitis (“Died, Vitas Gerulaitis,” 1994; Lascaratos and Marketos 1998) and may have contributed to Princess Diana’s accidental death in 1997 (Sancton and Macleod 1998). Carbon monoxide is a colorless, tasteless, odorless gas by-product of the combustion of carbon-containing compounds such as natural gas, gasoline, kerosene, propane, and charcoal. The most common sources of CO poisoning are internal combustion engines and faulty gas appliances (Weaver 1999). Carbon monoxide poisoning can also occur from space heaters, methylene chloride in paint removers, and fire (Weaver 1999). The most frequent causes of pediatric CO poisoning are vehicle exhaust, dysfunctional gas appliances and heaters, and charcoal briquettes (Kind 2005; Mendoza and Hampson 2006). Less common sources of CO poisoning include riding in the back of pickup trucks, and while swimming and recreational boating (Hampson and Norkool 1992; Silvers and Hampson 1995). Among pediatric populations, minorities are disproportionately affected by CO poisoning compared to Caucasians, and Latinos and non-Latino blacks were more commonly poisoned by charcoal briquettes used for cooking or heating (Mendoza and Hampson 2006). Carbon monoxide is the leading cause of poisoning injury and death worldwide (Raub et al. 2000) and accidental and intentional poisoning in the United States. In the United States carbon monoxide poisoning results in approximately 40,000 emergency department visits (Hampson 1999) and 800 deaths per year (Piantadosi 2002). Children are particularly venerable to CO poisoning. The Center for Disease Control reports children younger than 4 years have the highest incidence of unintentional CO poisoning but the lowest death rates (2005).
Economic implications of unintentional carbon monoxide poisoning in the United States and the cost and benefit of CO detectors