Epidemiology and Prevention of Accidental Poisoning by Carbon Monoxide in the East of France

Carbon monoxide (CO) is the major cause of accidental poisoning and death due to poisoning in France even though it probably occurs less frequently today due to elimination of CO from town gas. Risk factors include a lack of knowledge about the basic maintenance rules for heating appliances and the ventilation of buildings. Technical enquiries are now carried out after each case of accidental poisoning to determine the devices responsible and to find what caused the production of the CO. In the east of France, these are conducted by the Toxic Surveillance Network which collects and centralises information about CO poisoning. A statistical study is described based on the 94 cases of accidental poisoning involving 593 patients. The results showed that the device mostly responsible as the main source of CO production was the main heating appliance, with, in particular, gas boiler in 50% of cases. In the majority of cases poisoning occurs in a domestic setting, and in 71% of cases overall the poisoning affects a group. When the concentration of CO in the atmosphere where an incident had occurred was measured, it was commonly found to bear little relationship to blood levels in those poisoned. Reasons for this are discussed. Clinical presentation includes a variety of symptoms which are mostly neurological and particularly headaches. Most of the patients brought into hospital survived, often with no medium- or long-term sequelae.