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Carbon Monoxide and Fire Toxicity: A Review and Analysis of Recent Work

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Abstract

People may die from what some think to be “low” levels of carbon monoxide (CO) without implicating other toxic agents. This behavior is only now beginning to be identified and understood.

Fire and nonfire CO incidents involve very different subsets of the population. Fire victims are characteristically the old and the young. On the other hand, automotive CO accidents or suicides tend to involve predominantly 20- to 50-year-old men. In both populations, a substantial minority have significant blood alcohol levels, although fire victims with alcohol in their blood tend to have higher levels of it than do nonfire victims. Alcohol at levels less than 0.3% protects against CO poisoning, although being drunk may have gotten the victim into the incident in the first place. However, a 50% threshold of carboxy hemoglobin (COHb) does not exist in lethal levels of CO. CO toxicity is not due simply to the reduced oxygen-carrying capacity of the blood. A victim with 25% COHb may die purely of CO. This paper presents an analysis of the reasons for and the significance of these observations.

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Nelson, G.L. Carbon Monoxide and Fire Toxicity: A Review and Analysis of Recent Work. Fire Technology 34, 39–58 (1998). https://doi.org/10.1023/A:1015308915032

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