July 21, 2005

Carbon monoxide poisoning tied to generator use

By Anthony J. Brown, MD

NEW YORK (Reuters Health) - In a study of 10 hospitals in
Florida, the vast majority of carbon monoxide (CO) poisonings
that occurred during the 2004 hurricane season were related to
the use of gasoline-powered portable generators. Six of the
generator-related poisonings proved fatal.

"To avoid CO poisoning, portable generators need to be
operated outside of any building and far away from doors,
windows or air conditioners," study co-author Dr. David Van
Sickle, from the Centers for Disease Control and Prevention in
Atlanta, told Reuters Health.

"This is the first time we've looked at exposure to CO from
portable generators after a warm weather disaster," he added.

As reported in the CDC's Morbidity and Mortality Weekly
Report, four major hurricanes hit Florida between August 13 and
September 25 of last year. The Florida Department of Health
noticed an increase in CO poisonings in hurricane-affected
counties and the CDC was called in to assist with the

In the present analysis, the CDC reviewed the medical
records of all individuals who were diagnosed with
unintentional CO poisoning at one of the study hospitals
between August 13 and October 15, 2004.

A total of 167 nonfatal cases, representing 51 exposure
incidents, were identified and all but 6 involved individuals
who had been using portable generators. As noted, six fatal
cases, stemming from five exposure incidents, occurred and all
were associated with portable generator use.

The most common symptom, present in 80 percent of cases,
was headache, followed by nausea and dizziness, each seen in
about 50 percent of patients.

With the nonfatal poisonings, the generator was usually
located outdoors, typically near a window or air conditioner,
or inside a garage. By contrast, in the cases of fatal
poisonings, an indoor location was invariably cited.

"Our findings emphasize that when used outside, portable
generators need to be placed a significant distance from the
house," Van Sickle said.

"We are continuing to investigate generator-related CO
poisoning in detail to determine why the victims located the
generators where they did," Van Sickle added. "The possibility
that the extension cord may be too short has been discussed and
it's something we're looking into."

SOURCE: Morbidity and Mortality Weekly Report, July 22,