Reducing the threat of carbon monoxide poisoning
Betty Norman, BSN, MBA, CPHRM
Last summer, 150 residents of a New Jersey senior living facility were evacuated. Security guards alerted local police to a problem around 9 a.m., and police and fire personnel arrived shortly thereafter. Later, the county's Hazardous Materials Unit inspected the building, and residents were not able to reenter the building until after 3 p.m.
Was there a fire? What about a gas leak? Thankfully, the answer is “no” to both those questions, but the guards did detect an equally dangerous threat: high levels of carbon monoxide.
Due to the properties of carbon monoxide and symptoms of carbon monoxide poisoning, it poses a particularly insidious threat to residents in long-term care facilities.
Why It's Dangerous
Carbon monoxide, or CO, is a toxic but difficult to detect gas. It is colorless, odorless and tasteless. When inhaled, it can cause severe illness, commonly referred to as carbon monoxide poisoning. It shares initial symptoms with many illnesses: headache, dizziness, weakness, sleepiness, nausea and vomiting.
CO exposure is particularly dangerous for vulnerable populations like seniors. In people with heart disease, it can lead to irregular heartbeat. But even healthy adults can be killed by prolonged or heavy CO exposure. Higher concentrations of the gas can cause disorientation, coma and convulsions, eventually leading to death.
If someone exhibits symptoms of CO poisoning, they need fresh air and a doctor immediately. However, because these symptoms are shared with many other common illnesses, CO poisoning can be difficult to detect before it becomes deadly—particularly among the elderly.
A Product of Combustion
To prevent tragic deaths, it helps to understand why large concentrations of CO can build up in a facility. CO is a product of combustion, and it doesn't matter if you're burning gasoline, natural gas, propane, kerosene, charcoal or wood. All of these fuel sources produce CO when burned.
Common sources of CO include:
- Space heaters and kerosene heaters
- Gas stoves and ovens
- Wood stoves and fireplaces
- Hot water heaters
- Clothes dryers
If these fuel-burning appliances are not installed, maintained and used properly, CO can accumulate to dangerous or deadly levels in your facility, particularly in poorly ventilated areas.
Minimizing the Risk
Every long-term care facility should be equipped with carbon monoxide detectors. These are available as stand-alone units, much like the smoke detectors in your home, or as system-connected, monitored devices. These systems are monitored by a central station, which can alert authorities even before your staff realizes there's a problem.
Your goal should be to minimize any potential for a high concentration of CO. Your first line of defense is eliminating the source of emissions by confirming regularly that fuel-burning appliances and heating units are working properly. You can also take the following precautions:
- Capture emissions through local ventilation at the source and exhaust to the outside.
- Dilute emissions with fresh air adequately distributed to the work area and exhausted to the outside.
- Reduce the concentration of the emissions from the source.
- Install and operate natural gas-fueled appliances according to the manufacturers' instructions.
- If using a portable generator, place it outside and at a distance from the building.
- Do not use unvented gas or kerosene heaters in closed spaces, especially near or in sleeping areas.
- Keep chimneys and flues free of blockages, corrosion, and loose connections.
More than 400 Americans die from unintentional CO poisoning every year, and fatalities are highest among older adults. Though CO is a threat to every residential facility, long-term care facilities should be thoughtful and thorough in addressing the risk of CO poisoning.
Betty Norman, BSN, MBA, CPHRM, is Risk Control Director at Glatfelter Healthcare Practice, part of Glatfelter Program Managers, a strategic business unit dedicated to Glatfelter Insurance Group's program business.