Video: Family saved from carbon monoxide

By JoNel Aleccia Health writer
msnbc.com
updated 1/6/2009 9:05:22 AM ET 2009-01-06T14:05:22

Severe winter weather and a stormy economy could combine to make one of the season’s common killers, carbon monoxide poisoning, even worse this year, public health and safety officials say.

Coast-to-coast snowstorms and power outages, paired with spiking rates of utility shutoffs spurred by record unemployment, are likely to increase the accidental exposures that typically send more than 20,000 people to the emergency room and kill nearly 500 each year.

“I’m pretty sure we’re going to see a big bump in carbon monoxide poisonings this winter,” said Dr. Eric J. Lavonas, associate director of the Rocky Mountain Poison and Drug Center in Denver. “This economy is the perfect storm.”

Deprived of power, people are firing up gas-powered generators and bringing barbecue grills indoors, forgetting the deadly consequences of the colorless, odorless, tasteless gas that can lead to illness, brain damage — and death.

“We see it during power outages and we see it during bad economic times,” said Jim Burns, past president and spokesman for the National Association of State Fire Marshals. “Unfortunately, people in desperate times take all means to stay warm.”

In Redwood City, Calif., eight members of a large family, including several children, were sickened Dec. 17 when they fired up a gasoline-powered generator in the basement of a house where electricity had been disconnected for nonpayment.

“We get a front row seat to a bad economy, honestly,” said Menlo Park Fire Chief Harold Schapelhouman, whose crew responded to the incident.

Across the country, the number of terminated utility accounts among the nation’s 95.6 million residential energy customers is skyrocketing as the economy sinks, said Mark Wolfe, executive director of the National Energy Assistance Directors’ Association.

“Where it might be 2 percent to 3 percent used to get shut off, now it’s 7 percent to 8 percent getting getting shut off,” he said. “Families that were middle class last week are not middle class anymore.”

In some places, it’s much worse than that. In Detroit, hard hit by unemployment and bad weather, utility terminations in October were up 9 percent over 2006 levels and 20 percent over 2007 levels, a rise that may be partially attributed to a new recording system, said Len Singer, a spokesman for DTE Energy, the electric and natural gas supplier. That means 14,000 households were cut off from power, out of a customer base of about 3 million.

It’s too early in the season to document a trend in carbon monoxide poisonings, said Lavonas, an emergency room doctor who has focused on the issue. But cases of carbon monoxide poisoning have been on the rise, according to an August report by the federal Centers for Disease Control and Prevention.

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The number of patients seen in the nation’s emergency rooms for carbon monoxide poisoning climbed by 36 percent, from 15,200 a year between 2001 and 2003 to 20,636 a year between 2004 and 2006, the report said.

Generators, charcoal grills indoors
Recent anecdotal reports show that families cut off from utilities have resorted to dangerous measures, including bringing generators indoors for power and firing up everything from barbecue grills to portable patio warmers for heat.

In Paramount, Calif., a mother and two teens ages 14 and 18 were overcome by the gas in November when they used a charcoal grill to heat their home. And in Minneapolis, two men and a 13-year-old boy died of carbon monoxide poisoning in October when they used a gas generator in a basement after the power was cut off.

Overall, at least nine incidents of carbon monoxide poisoning reported to the Consumer Product Safety Commission in 2008 were directly related to nonpayment of utility bills, according to agency reports.

There’s reason to fear those numbers could rise, health and energy officials said. A survey of more than 1,200 low-income families released this week by Wolfe’s group found that nearly 50 percent couldn’t pay their entire energy bills and nearly 40 percent had received a notice of disconnection. Almost 30 percent were unable to use their main source of heat because the fuel was disconnected for nonpayment or the system was broken and they couldn’t afford to fix it.

In addition, an October survey of 1,000 people by the American Red Cross and the National Fire Prevention Association found that nearly 80 percent were worried about affording winter heating costs — and that at least half expected to use one or more alternative sources of heat, including wood stoves and space heaters. About 7 percent of respondents said they intended to use their ovens to keep kitchens warm.

‘I think we're going to see more of it’
That kind of attitude troubles experts such as Dr. David Dabell, a hyperbaric physician at Virginia Mason Medical Center in Seattle. The hospital treated dozens of victims of a 2006 outbreak of carbon monoxide poisonings that sickened more than 300 people and killed eight after a severe windstorm.

Public education campaigns have reduced incidents since then, but this winter may be different, he said.

“It’s always a worry going forward,” said Dabell. “The combination of a poor economy and bad weather is a predisposing factor for carbon monoxide poisoning. I think we’re going to see more of it this year.”

The problem, Dabell explained, is that many people don’t realize how dangerous carbon monoxide can be.

Carbon monoxide harms people by blocking oxygen from getting into the blood. The gas molecules bind more quickly than oxygen to hemoglobin, a protein in red blood cells, effectively smothering vital organs such as the heart and brain. Dabell said he’s seen cases where people come in with hemoglobin saturation of 40 percent carbon monoxide, compared to normal levels of about 2 percent.

The level becomes dangerous at about 25 percent, Dabell said. In mild cases, victims might suffer flu-like symptoms of headache, dizziness and nausea. But the poisoning can quickly lead to unconsciousness, neurological problems, coma, heart and breathing failure — and death.

Nearly three-quarters of carbon monoxide poisonings occur in homes and more than 40 percent occur in winter, according to the CDC. 

On average, the nation posts 110 carbon monoxide poisonings a day in December, 96 a day in January and 76 each day in February.

‘A preventable exposure’
“We rank the problem of carbon monoxide poisonings as quite high because it’s a preventable exposure,” said Fuyuen Yip, an epidemiologist with the CDC’s division of Environmental Hazards and Health Effects.

But prevention depends on a combination of awareness and action that may elude the population most at risk. Recent immigrants, those who don’t speak English and the desperately poor may not know or fully understand the risks of carbon monoxide poisoning, experts said.

Becky Mullins runs an overnight shelter for homeless families in Portland, Ore., operated by the social service agency Human Solutions. She frequently works with families who resort to dangerous sources of heat when they can’t pay their utility bills.

“I’ve seen everything from propane tanks in the house to burning trash,” she said. “I’ve seen extension cords run from other houses. People get pretty MacGyver-ish.”

I don't think we understood it could be that bad’
One family, Ryan James, 29, and his partner, Rachel Johnson, 22, warmed their three kids, the youngest of whom is 2 months old, by putting them in a truck with the engine running or using a propane-powered heater indoors. 

“I don’t think we understood it could be that bad,” said James, known as R.J., who is looking for work to pay for a safe place to live. “It was a way to keep the house warm.”

In most states, customers who can’t pay their power bills are protected from shutoffs under certain circumstances, such as when the weather is expected to be severe or when someone in the household is disabled, ill or has a life-threatening condition.

Many utilities offer arrangements that include year-round payment plans or deferred billing. DTE Energy in Detroit makes every effort to keep clients connected during winter months and beyond, Singer, the spokesman said.

But the rules can be complicated and most states and utilities frown on repeat nonpayments. For most people, avoiding shutoffs means applying for emergency assistance through social service agencies.

Resolving the problem of the nation’s need for energy assistance is a tall order. Congress doubled allocations for energy help to $5.1 billion, but that still won’t be enough, Wolfe said.

In the meantime, health and safety officials hope small steps will help decrease carbon monoxide injuries and deaths. On Jan. 1, Georgia became the 16th state with laws requiring carbon monoxide detectors. Most recent CDC statistics showed that the detectors were present and activated in less than 18 percent of exposures.

“They call this the silent killer with the audible solution,” Lavonas, of the Rocky Mountain Poison and Drug Center, said.

But the real push has got to be to raise awareness, so that even hard-to-reach groups understand the danger of the potentially deadly gas, he added.

“We’ve got to make people stop doing things that will kill them and their families,” Lavonas said.

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