Barrowcliff DF. There are numerous situations in which carbon monoxide is not the only source of hypoxia. Neuronal nitric oxide synthase and N-methyl-D-aspartate neurons in experimental carbon monoxide poisoning. The rat carbon monoxide data were meta-analysed and the internal dose (oxygen delivery by arterial blood) was estimated. 68 August 2014 CO compoundshave shown efcacy animalmodels disease,including postoperative ileus, chronic colitis, necrotizing . Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Chronic carbon monoxide poisoning: a case series. Alveolar ventilation, largely determined by body energy expenditure (exercise), can vary over a wide range and is thus the major physiological determinant of the rate of COHb formation and elimination. In: Penney DG, editor. Annals of the New York Academy of Sciences. There has been no major attempt to recapitulate the review of most studies before roughly 1999. @\g%_gX!(i.a"~ltfX9IfeI-gDWb`{L1bC`.f9mj#|kee OU*bW1c+5kpgM}[8VaVY,TL{WTrYXvcDw\6xQ 9qUmig-Nqs^Bfq[CE[qs~T.&S5:H$)[AQRJ6Umb endstream endobj 39 0 obj[58 0 R] endobj 40 0 obj<>stream It is not clear whether the slightly greater observed effect of COHb in the patients compared to the normal subjects would be considered statistically significant or physiologically meaningful. Ryan CM. startxref Solubility of Carbon Monoxide and Hydrogen in Methanol and Methyl Formate: 298-373 K and 0.3-3.3 MPa. Heart disease mortality among bridge and tunnel officers exposed to carbon monoxide. (154) examined an association between air pollution and daily numbers of hospital admissions for headache in seven Chilean urban centres during the period 20012005. the unsubscribe link in the e-mail. ojn R~6o5i=LB#}VJ:A2NVNk.q(zXIdnfIyZxPh|* l:yIr mMz-[A{cDpF FOgH^FjSZhj l.b\|)AP6Q73 Kw.[Gw1,,tAzvVL,n-/*YfMlKV_F6I/M6/{wv @:A[3 (104), Kowalska (105), Kirkpatrick (106), Jensen et al. ozone, nitrogen oxides, chlorine and its oxides, carbon dioxide, hydrogen sulfide, hydrogen selenide and sulfur dioxide, are re-corded as bulk solubilities; i.e., all chemical species of the gas and its reaction products with water are included. The carbon monoxide support study (89) found that only one case out of 77 was correctly identified (i.e. 20 60 Public perceptions about carbon monoxide in the northern and southern regions of the United States, some relevant to indoor air, were investigated by Penney and published in 2008 (87). In the absence of indoor sources, current concentrations of carbon monoxide in indoor air in European and North American cities are well below the levels of existing air quality guidelines and standards. Measuring human exposure to carbon monoxide in Washington, DC, and Denver, Colorado, during the winter of 19821983. Chronic carbon monoxide exposure: how much do we know about it? Consequently, even in the absence of any indoor sources, the 15-minute I : O for carbon monoxide varies from 0.2 to 4.1 and the daily I : O from 0.4 to 1.2. Evidence is also mounting that carbon monoxide can produce a cascade of cellular events leading to adverse effects that are not necessarily ascribable to hypoxia (i.e. (147), in a case cross-over study carried out on data for Kaohsiung (Taiwan, China), found that carbon monoxide and other air pollutants were significantly associated with increased numbers of admissions for cardiovascular diseases (CVD) on both warm and cool days. The highest incidences, for example, included pallor, cardiac enlargement (cardiomegaly), coldness of the extremities and hyperactive patellar reflex. This, along with cardiomegaly, has been demonstrated numerous times following chronic carbon monoxide exposure in animals (118,119). 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). To be sure, the percentage exercise reduction is greater for the angina patients than for the normal subjects, but this is simply due to the reduction in baseline exercise ability. High-pressure gas solubility in multicomponent solvent systems for [56][57][63] Another method is heating an intimate mixture of powdered zinc metal and calcium carbonate, which releases CO and leaves behind zinc oxide and calcium oxide: Silver nitrate and iodoform also afford carbon monoxide: Finally, metal oxalate salts release CO upon heating, leaving a carbonate as byproduct: Thermal combustion is the most common source for carbon monoxide. In the baseline (no carbon monoxide) condition, the mean maximum exercise time was around 8.2 minutes. In a related reaction, the hydrogenation of carbon monoxide is coupled to CC bond formation, as in the FischerTropsch process where carbon monoxide is hydrogenated to liquid hydrocarbon fuels. Subjects were also exposed to lower levels of carbon monoxide, producing a maximum of nearly 6% COHb. Institut des Sciences et Ingnerie Chimiques (ISIC), Ecole Polytechnique Fdrale de Lausanne, EPFL-BCH, CH-1015 Lausanne, Switzerland Eventually, the carbon monoxide will be eliminated from the blood through normal ventilation, although often serious health damage may be done before this can occur, so emergency measures should be started immediately. https://www.cdc.gov/co/guidelines.htm. 0000002678 00000 n Signs and symptoms of carbon monoxide poisoning may include: Dull headache Weakness Dizziness Nausea or vomiting Shortness of breath Confusion Blurred vision Loss of consciousness Carbon monoxide poisoning can be particularly dangerous for people who are sleeping or intoxicated. Sumari P. Kliniska observationer vid kronisk gengasforgiftning. High Pressure Phase Behavior of the Homologous Series CO2 + 1-Alcohols. Carbon monoxide poisoning Prevention guidance. Transition metal carbonyls have been recently shown to function as carbon monoxide-releasing molecules (CO-RMs) and to elicit distinct pharmacological activ There is no hyperventilation induced by carbon monoxide poisoning or increased salivation, taste/odour changes, eye watering or coughing, as are produced by carbon monoxide's toxic twin, hydrogen cyanide. Can cause flu-like symptoms that clear up after leaving home. The Ellingham diagram shows that CO formation is favored over CO2 in high temperatures. In: Penney DG, editor. The solubility of carbon monoxide is measured in four different bio-oil compounds (furan, diacetyl, 2-methylfuran, and trans-crotonaldehyde) at temperatures (273.15, 283.15, 298.15, and 323.15 K) and pressures up to 8 MPa using a static-analytical VLE measurement method.The equipment was validated by measuring the solubility of CO 2 in methanol at 298.15 K and pressures (P = 2.9-5.7 MPa). Thom SR, Fisher D, Manevich Y. Fischer SL, Koshland C P. Daily and peak 1 h indoor air pollution and driving factors in a rural Chinese village. Corresponding authors, a A critical analysis of the use of the CFK equation in predicting COHb formation. Salonen RO, et al. 0000031491 00000 n d(ln(kH))/d(1/T) = Temperature dependence constant (K). Carbon monoxide has over a 200-fold greater affinity for hemoglobin than has oxygen (5.15, 5.16). 0000035681 00000 n The authors estimated a peak concentration of 9.6 mg/m3 caused by incense burning and therefore concluded that carbon monoxide concentrations could exceed the USEPA's National Ambient Air Quality Standard of 10 mg/m3 for an 8-hour average, depending on the room volume, ventilation rate and the amount of incense burned. They estimated 25% increases in the odds of increases in carbon monoxide, conditional on the previous day's asthma symptoms. WHO Guidelines for Indoor Air Quality: Selected Pollutants. Of the less severely poisoned patients, 39% had cognitive deficits at six weeks. 0000006975 00000 n 0000003545 00000 n A large quantity of CO byproduct is formed during the oxidative processes for the production of chemicals. (157) assessed the association between ambient air pollution and daily elementary school absenteeism in Washoe County, Nevada in the period 19961998. Contamination would occur if a sufficient quantity of carbon monoxide wouldn't just bubble through but. Inhalation is the only exogenous exposure route for carbon monoxide. 79 0 obj<>stream Raw GJ, et al. Slightly soluble in water; soluble in alcohol and benzene. Hydroformylation is coupled to the Shell higher olefin process to give precursors to detergents. All rights reserved. 637642. Initial compounds were lipid soluble, whereas morerecently developed compounds watersoluble. Carbon monoxide poisoning - Symptoms and causes - Mayo Clinic Carbon monoxide can also be produced by high-temperature electrolysis of carbon dioxide with solid oxide electrolyzer cells. Environmental emergencies: carbon monoxide poisoning. Penney (81) recently reviewed pitfalls in making diagnoses of carbon monoxide poisoning, especially chronic poisoning. Thus, a separate guideline is recommended to address 24-hour exposures. They are not mathematically trivial, but with modern computation tools the necessary calculations are readily performed (3,75). Carbon Monoxide | CO - PubChem Peterson JE, Stewart RD. Indoor and outdoor PM2.5 and CO in high- and low-density Guatemala villages. Exposure to high, potentially lethal levels are not considered here at any length and delayed effects are not examined because neither would be seen in indoor carbon monoxide exposure situations under normal circumstances. Gupta S, Khare M, Goyal R. Sick building syndrome a case study in a multistorey centrally air-conditioned building in the Delhi City. For more information, see - Carbon Monoxide's Impact on Indoor Air Quality, Carbon Monoxide's Impact on Indoor Air Quality. (136) characterized their patients as having acute carbon monoxide poisoning, when in actual fact most had chronic poisoning since the authors cite coal stoves and water heaters as carbon monoxide sources. The writers have devised a method for the determination of carbon monoxide in serum and plasma. Group A1 was exposed to 58291 mg/m3, Group A2 to 701595 mg/m3, Group B to < 23 mg/m3 and Group C to < 12 mg/m3 carbon monoxide in the course of their normal work. Engineering ToolBox - Resources, Tools and Basic Information for Engineering and Design of Technical Applications! Any person with some form of impaired oxygen uptake and delivery would be more sensitive to the acute hypoxic effects of carbon monoxide exposure. Preliminary evaluation, using passive tubes of carbon monoxide concentrations in outdoor and indoor air at street level shops in Genoa Italy. Because of carbon monoxide's role in the body, abnormalities in its metabolism have been linked to a variety of diseases, including neurodegenerations, hypertension, heart failure, and pathological inflammation. SOLUBILITY OF CARBON MONOXIDE IN SERUM AND PLASMA - ScienceDirect Moolgavkar (139) investigated non-accidental cardiovascular, cerebrovascular and chronic obstructive pulmonary disease deaths over eight years in three American metropolitan areas: two in California and one in Illinois. Because multiple cardiac, vascular and pulmonary diseases in one person are not uncommon, it would not be surprising if some impaired people were adversely affected by even small increases in COHb. This technology allows coal or biomass to be converted to diesel. This review extends the discussion of those issues involving carbon monoxide exposure in humans summarized in the 1999 WHO and 2005 European Union reports (77,78). Effects of air pollutants on acute stroke mortality. McCartney ML. Thom SR, et al. Kleinman MT. Thus for non-hypoxic effects, it is frequently necessary to use less general evidence from empirical environmental data to make estimates of critical exposures. Maroni M, et al. These results suggest that loss of consciousness is not a requirement for carbon-monoxide-induced brain damage, and that carbon-monoxide-related cognitive (and other) outcomes may be independent of poisoning severity when that severity is based on COHb saturation. Penney D, Benignus V, Kephalopoulos S, et al. 0000011624 00000 n Carbon monoxide is a strong reductive agent and has been used in pyrometallurgy to reduce metals from ores since ancient times. The outdoor air carbon monoxide concentration at the point of measurement may be significantly higher or lower than the concentration at the point of ventilation air intake. Hearing disturbances were noted in 78.3% of the patients suffering from chronic carbon monoxide poisoning. Also, at maximum exercise, no further increase in blood flow to the muscle was possible. and the carboxyl moiety acted as the water-soluble unit. Prochop (132) reports on the case of four people chronically exposed to carbon monoxide in an apartment building in Florida as the result of a faulty gas heater. Follow-up examinations revealed that typical hearing losses improved only slightly or not at all. Results of recent studies on carbon monoxide concentrations in indoor air are summarized in Table 2.1. This prevents oxygen from reaching your tissues and organs. The information required for regulatory guidance setting is some measure of the biologically critical concentration and duration of carbon monoxide exposure in inhaled air. . Allred EN, et al. 501505. Yang CY, et al. Follow the links above to find out more about the data Cookies are only used in the browser to improve user experience. Holleman, A. F.; Wiberg, E. "Inorganic Chemistry" Academic Press: San Diego, 200. They found a 6% increase in the rate of hospital admissions for asthma related to carbon monoxide, with a three-day lag. Jo WK, Lee JY. The threshold of hearing was about normal at frequencies up to 1000 Hz. Experiments, however, are not usually good simulations of actual scenarios of interest. Benignus VA. Neurotoxicity of environmental gases. Tikuisis PF, et al. In: Penney DG, editor. National Institutes of Health. the Solubility - Chemistry - University of Hawaii From these searches, 952 articles were found and, from these, 52 were deemed relevant and used in the review. Chronic carbon monoxide poisoning. [72], Carbon monoxide has been proposed for use as a fuel on Mars. 0000006391 00000 n Here the subjects were also given maximal exercise tests, but the criterion for stopping was not exhaustion but the onset of angina. It was found that platelet activating factor was involved in the adherence of neutrophils to brain endothelium after carbon monoxide poisoning and that the process required nitric-oxide-derived oxidants (163). Scotto di Marco G, et al. Relative risks for migraine associated with interquartile-range increases for carbon monoxide was 1.11 (95% CI 1.061.17) for a 1.3-mg/m3 increase in carbon monoxide concentration. The purpose of the simulations is to be able to simulate any environment of interest without having direct experimental evidence. The concomitant behaviour of people exposed to carbon monoxide can also make them more sensitive to its effects. Jin Y, et al. This parameter more accurately represents the total dose of carbon monoxide received in long-term carbon monoxide exposure, since duration of exposure is explicitly present. Air pollution exposure of adult population in Milan (Expolis Study); Proceedings of Indoor Air 2002, The 9th International Conference on Indoor Air Quality and Climate; Monterey, CA. In: Penney DG, editor. Neurocognitive and neurobehavioral sequelae of chronic carbon monoxide poisoning: a retrospective study and case presentation. A 1.2-mg/m3 increase in same-day daily 1-hour maximum carbon monoxide was associated with a 0.96% (95% CI 0.791.12) increase in risk of cardiovascular admissions. This can lead to serious tissue damage, or even death. Carbon monoxide-induced cardiac hypertrophy. Thom SR, et al. Chaloulakou A, Mavroidis I, Duci A. Indoor and outdoor carbon monoxide concentration relationships at different microenvironments in the Athens area. Ap/.Wo{tO0nC}S7XI;Zn` h Although this process certainly takes place and is undoubtedly important in higher-level and acute carbon monoxide poisoning, other processes not previously known result in endothelial inflammation and immune activation, causing interference with blood flow and the destruction of cellular machinery. Increased body temperature from external heat or inappropriate clothing would increase pulmonary ventilation. Using Pearson analysis, there were significant correlations between COHb level and P-wave duration, maximum QT height, QT duration and corrected QT duration. In: Penney DG, editor. Stieb et al. In a recent clinical study, Keles et al. This leads to the conjecture that non-hypoxic mechanisms may be responsible for some of the effects. In: Penney DG, editor. Other recent studies indicate that carbon monoxide poisoning can cause immune system dysfunction (164) that causes decrements in learning not observed in immunologically tolerant animals. The ability to avoid or flee danger could also be impaired by carbon-monoxide-induced limitations on exercise. A large number of behavioural studies were critically reviewed by Benignus (183,184) involving sensory, psychomotor, vigilance, cognitive and schedule-controlled behaviour in both humans and rats. As such, it is relatively undetectable. It is highly toxic in nature. Positive associations between ambient carbon monoxide exposure and ED visits and hospital admissions for ischemic heart disease, congestive heart failure and cardiovascular disease are seen in multiple locations where ambient carbon monoxide concentrations ranged from 0.6 to 10.9 mg/m3. * If you think you or someone you're with may have carbon monoxide poisoning, get into fresh air and seek emergency medical care. The interacting effects of altitude and carbon monoxide. Cognitive and affective outcomes of more severe compared to less severe carbon monoxide poisoning. To request permission to reproduce material from this article, please go to the 0000031423 00000 n Delayed neuropathology after carbon monoxide poisoning is immune-mediated. Laboratory doseeffect experiments with human subjects with stable angina exposed to carbon monoxide (173178). %%EOF Carbon monoxide | chemical compound | Britannica Health Effects Associated with Carbon Monoxide. Air pollution and daily mortality in three U.S. counties. A third questionnaire study (C) of 61 individuals sustaining chronic carbon monoxide poisoning was recently reported by Penney (121). Air pollution and hospitalization for headache in Chile. In an oven, air is passed through a bed of coke. In addition to affecting oxygen delivery, carbon monoxide also binds to other hemoproteins such as myoglobin and mitochondrial cytochrome oxidase, metallic and non-metallic cellular targets to affect many cell operations. Here, a 4.5% increase in COHb level reduced the maximum exercise from a total expenditure of about 112 kcal to some 90 kcal. Gas-Liquid Solubilities of Carbon Monoxide, Carbon Dioxide,Hydrogen The CFK equation (3) was used to calculate exposure levels to which a normal adult under resting conditions can be exposed for various intervals without exceeding 2% COHb to calculate guideline levels. It can be argued that when considering exposure to air pollution in human residential and work environments, these studies have limited significance and model rather poorly human responses to long-term carbon monoxide exposure. Abstract. CO 2 is soluble in water, forming carbonic acid, although high amounts of impurities are known to reduce water solubility. would react with water to form an unhealthy product or. C. A. Ohlin, P. J. Dyson and G. Laurenczy, All rights reserved. Chapter 5.5 Carbon monoxide General description Carbon monoxide (CO) is one of the most common and widely distributed air pollutants. Akland GG, et al. The model has also been tested under a wide variety of carbon monoxide exposure conditions and found to predict COHb more accurate ly than empirical methods (54,5966). Carbon monoxide is an industrial gas that has many applications in bulk chemicals manufacturing. For example, during World War II, a gas mixture including carbon monoxide was used to keep motor vehicles running in parts of the world where gasoline and diesel fuel were scarce. Carbon monoxide. hY]T7+l;#J-}@Rlq2%-lQO["m- Y[r`kQ-h^*[IxT%}U-R{%nJQY1JI[-/59H3@R,Ko$Y,fHl@v`*\ 1 \!8$5@$k8Iz[5g. This process has been described by a multicompartmental physiological model (68,69). (156) followed the Los Angeles study with an investigation on birth weight in Boston, MA, Hartford, CT, Philadelphia, PA, Pittsburgh, PA, Springfield, IL and Washington, DC. It should be noted that, for all five studies, average COHb levels fall within the less severe carbon monoxide poisoning group as defined by Chambers et al. Carbon monoxide (CO) is a colorless, practically odorless, and tasteless gas or liquid. Lee K, Park E. Residential air quality in wood burning houses in Costa Rica; Proceedings of Indoor Air 2002, The 9th International Conference on Indoor Air Quality and Climate; Monterey, CA. (144) analysed nearly 12 000 diagnoses of infant bronchiolitis between 1999 and 2002 in south-west British Columbia. He speculates that if only 10% of these appliances give off significant amounts of carbon monoxide that reach the breathing space of residents, as many as 25 000 people every year may be exposed to carbon monoxide in their homes. The solubility of H 2 in methanol and methyl formate is lower than that of CO in methanol and methyl formate. Hiramatsu M, Kameyama T, Nabeshima T. Carbon monoxide-induced impairment of learning, memory and neuronal dysfunction. Hazucha MJ. Twenty-four-hour averages of carbon monoxide and nitrogen dioxide exhibited the most consistent associations with cardiac conditions: 2.1% (95% CI 0.04.2) and 2.6% (95% CI 0.25.0) increase in visits, respectively, for myocardial infarction and angina per 0.8 mg/m3 carbon monoxide. There is a problem with Given this critical tissue dose, one can estimate the various environmental concentrations, subject characteristics and subject activities that will produce the critical tissue dose. Carbon monoxide level was particularly found to have a stronger association with mortality than level of particulate matter. A special search for behavioural and neurological effects used PubMed with the following keyword statement: (carbon monoxide OR CO) AND (human behaviour OR nervous system OR CNS OR sensory OR human performance OR vision OR hearing OR auditory) NOT co- NOT smoking. Thus, the setting of a guideline for indoor carbon monoxide involves other considerations than simply scientific considerations of carbon monoxide's toxicity. At higher COHb, however, the curve is nearly linear. Effect of carbon monoxide on oxygen transport during exercise. Hydrogen (H 2) 288.15 1.510 10-5 A = -48. . Hajat et al. 0000004714 00000 n When working with solvents at home, use them only outdoors or in well-ventilated areas. Carbon monoxide: association of community air pollution with mortality. It mixes freely with air in any proportion and moves with air via bulk transport. A metal-free coumarin-based fluorescent probe for the turn-on Jetter et al. Thus, daily average concentrations of carbon monoxide and nitrogen dioxide exhibited the most consistent associations with emergency department visits for cardiac conditions. 0000014381 00000 n Carbon monoxide and volatile organic compounds as indicators of indoor air quality in underground parking facilities. The data examined covered the period 19962004. Longo LD. Urban angina in the mountains: effects of carbon monoxide and mild hypoxemia on subjects with chronic stable angina. There was also a diminution of the sense of smell. provided correct acknowledgement is given. The conclusion was that, when arterial oxygen content was used as the internal dose and extraneous effects were subtracted, the behavioural effects of carbon monoxide hypoxia and hypoxic hypoxia were of equal magnitude for humans and were equal in rate to the magnitude of carbon monoxide hypoxia. Journal of the American Medical Association. Other possible sensitive groups are pregnant women, whose endogenous COHb is greater, and fetuses, whose haemoglobin has somewhat greater affinity to carbon monoxide than that of adults. It is very flammable in air . It results from incomplete oxidation of carbon in combustion. From these articles, 101 were deemed relevant and were used. 0000061715 00000 n *)Pf*%PsKK2n/2 iVVYMP A,+ if%YzjI A$M[5Y$r. Doseeffect relationships are suggested in some epidemiological studies. privacy practices. gabor.laurenczy@epfl.ch. Delayed sequelae may occur and cumulative exposure may be needed to become effective. (150) reported an association between ambient carbon monoxide levels in seven United States cities and hospital admissions for congestive heart failure among elderly people, which showed a consistent association with daily variations in ambient carbon monoxide. Foster M, et al. The initially produced CO2 equilibrates with the remaining hot carbon to give CO.[65] The reaction of CO2 with carbon to give CO is described as the Boudouard reaction. In 2000,Greiner & Schwab (91) reviewed engineering aspects of carbon monoxide as it occurs in the living space. Your institution may already be a subscriber. In the second study, a significantly increased risk of 1.06 (95% CI 1.021.09) was found for carbon monoxide, with a one-day lag. Google use cookies for serving our ads and handling visitor statistics. Hauck H, Neuberger M. Carbon monoxide uptake and the resulting carboxyhemoglobin in man. Average vital capacity was significantly less for members of Group A at any age than for members of Groups B or C. Average back strength was significantly less for members of Group A at age 3040 years than for same-age members of Group C. The difference from members of Group B was very large and significant over the entire age range of the two groups. Smokers' polycythemia. 0000003980 00000 n All four suffered transient loss of consciousness immediately prior to discovery of the problem. A review of the effect of chronic or intermittent hypoxia on cognition in childhood (125) included carbon monoxide poisoning; it concluded that adverse effects have been noted at even mild levels of oxygen desaturation and that studies of high-altitude and carbon monoxide poisoning provide evidence for causality. Carbon monoxide Formula: CO Molecular weight: 28.0101 IUPAC Standard InChI: InChI=1S/CO/c1-2 IUPAC Standard InChIKey: UGFAIRIUMAVXCW-UHFFFAOYSA-N CAS Registry Number: 630-08- Chemical structure: This structure is also available as a 2d Mol file or as a computed 3d SD file The 3d structure may be viewed using Java or Javascript . Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. The release of nitric oxide from platelets and endothelial cells inside blood vessels, forming the free radical peroxynitrite, further inactivates mitochondrial enzymes and damages the vascular endothelium of the brain. Long-term exposure to air pollution and incidence of cardiovascular events in women. Air quality criteria for carbon monoxide. Carbon monoxide (CO) is a stable oxide of carbon that is produced when there is partial oxidation of carbon-containing compounds. Benignus (183) meta-analysed the carbon monoxide literature, fitting doseeffect curves and attempting to relate the rat and human carbon monoxide data and the human hypoxia data. Carbon Monoxide | CO | CID 281 - structure, chemical names, physical and chemical properties, classification, patents, literature, biological activities, safety/hazards/toxicity information, supplier lists, and more. Journal of Emergency Nursing. Other studies looking at neuropsychological aspects of chronic carbon monoxide exposure such as those of Ryan (108), Myers et al. Bell et al. Carbon monoxide is produced indoors by combustion sources (cooking and heating) and is also introduced through the infiltration of carbon monoxide from outdoor air into the indoor environment (7).
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