Epidemiology and Prevention of Accidental Poisoning by Carbon Monoxide in the East of France

Abstract

Carbon monoxide (CO) is the major cause of accidental poisoning and death due to poisoning in France even though it probably occurs less frequently today due to elimination of CO from town gas. Risk factors include a lack of knowledge about the basic maintenance rules for heating appliances and the ventilation of buildings. Technical enquiries are now carried out after each case of accidental poisoning to determine the devices respon sible and to find what caused the production ofthe CO. In the east of France, these are conducted by the Toxic Sur veillance Network which collects and centralises infor mation about CO poisoning. A statistical study is de scribed based on the 94 cases of accidental poisoning involving 593 patients. The results showed that the device mostly responsible as the main source of CO pro duction was the main heating appliance, with, in particu lar, gas boiler in 50% of cases. In the majority of cases poisoning occurs in a domestic setting, and in 71% of cases overall the poisoning affects a group. When the concentration of CO in the atmosphere where an incident had occurred was measured, it was commonly found to bear little relationship to blood levels in those poisoned. Reasons for this are discussed. Clinical presentation includes a variety of symptoms which are mostly neuro logical and particularly headaches. Most of the patients brought into hospital survived, often with no medium- or long-term sequelae.