Carbon monoxide poisoning: Prevent and treat it this winter

by James Hubbard, M.D., M.P.H.

There are always scary stories about carbon monoxide deaths this time of year.  It can happen any time, but in the winter, people have the heat on and the house sealed.

A family of four were guests in an Aspen, Colorado, mansion recently and died in the night.  I remember a famous tennis player died a few years ago staying in someone’s guest room.  Carbon monoxide, a colorless, odorless, tasteless gas, does not discriminate against any social class.  It can affect anyone.  In fact, a draft or two in an old house might help a little to ventilate it out.

Carbon monoxide is a product of carbon fuel combustion from things like fireplaces, heaters, exhaust fumes, pollution or volcano eruptions.  The modern day poisoning usually comes when you combine an inefficient or malfunctioning heat source with a relatively sealed space.  It’s popular way to commit suicide, with 2,000 deaths per year from breathing exhaust fumes in a closed garage.

And then there are the accidental exposures.


In the U.S. each year, around 500 people die and over 20,000 go to the ER because they unintentionally inhaled carbon monoxide.  Many had no clue they were breathing the fumes.  If you’re lucky, you’ll develop signs of carbon monoxide poisoning: generalized flu-like symptoms (without fever) like headache, dizziness, fatigue or grogginess. If you have heart disease, you may develop chest pain.  But as you can see, the diagnosis can be missed unless there’s a high suspicion.

What can you do?

  1. Everyone should have a carbon monoxide detector and alarm.  Put one in your bedroom and on every other floor of the house.
  2. Make sure your heating system is in working order.  Have an expert tune it yearly.  Check that your fireplace or stove smoke is drafting up that chimney.
  3. Let in a little fresh air occasionally.
  4. Don’t idle your car in a closed garage.
  5. If the alarm goes off, get fresh air immediately and call 911.
  6. Everything mentioned goes for your office or workplace also.


The main way carbon monoxide kills is that it takes the place of oxygen in your blood hemoglobin.  You smother to death without knowing it.

Normally, your blood flows through your lungs and picks up fresh oxygen to carry to the rest of your body.  It does this by the oxygen molecules sticking to your blood hemoglobin.  Carbon monoxide is about 250 times stickier to the hemoglobin than oxygen, so the CO displaces the O2.  The blood has very little oxygen then to carry to your vital organs.

Treatment is to flush you lungs with oxygen.  That means breathe fresh air until you can be hooked to a 100 percent oxygen breathing device.

I had a minor scare once when I was at a dinner with multiple beautiful candles and a burning fireplace.  Everyone started complaining of how sleepy they were.  Fortunately, someone thought we all might need fewer candles and more fresh air.

How about you?

Doctors and business owners: Send customized issues of James Hubbard’s My Family Doctor to your customers or patients. E-mail for details.

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9 Responses to “Carbon monoxide poisoning: Prevent and treat it this winter”

  1. Tom Rooney Says:

    Very scary stuff indeed Dr. Hubbard. Thanks for the information

    Tom Rooneys last blog post..Secrets of a Successful Weight Loss Diet

  2. James Hubbard, M.D., M.P.H. Says:

    You’re welcome, Tom. Just want to remind people to play it safe with monitors.

  3. Pamela Reinsel Cotter Says:

    We went to sleep a few nights back after closing down the fireplace — thinking the fire had extinguished. A couple of hours later our (new and very sensitive!) CO2 detectors went off. Luckily, we were able to get fresh air in the house and air things out quickly. But now I wonder how bad it could have been for my whole family. Good information, thanks.

  4. Dr. J Says:

    We lost a close family friend, while I was in college, because of carbon monoxide pinioning! It was quite devastating to us all. Thank you for reminding people about this danger!

    Dr. Js last blog post..Nibbles: Cutting calories can improve memory, peanut plant had sanitation violations, and looking in on Dunkin’ Donuts

  5. James Hubbard, M.D., M.P.H. Says:

    Sounds like the detectors were worth it, Pamela.

  6. James Hubbard, M.D., M.P.H. Says:

    Dr. J,

    That is terrible. A tragedy which seems to come out of nowhere.

  7. Sagan Says:

    Yikes. That’s really awful. Thanks for the information; makes you appreciate a draft more!

    Sagans last blog post..Eat Your Veggies!

  8. Sheila Says:

    My family and I live in a 209 year old house with many, many drafts. I never dreamed that we would have elevated levels of CO in our house but we were woken last night by the alarms. The fire fighters found elevated levels near the master bedroom and our kid’s rooms. The cause was our gas burner and it is now shut off until we have it inspected/repaired. We live in Massachusetts and carbon monoxide detectors are state mandated.
    Please don’t think that drafts can save you!

  9. James Hubbard, M.D., M.P.H. Says:

    Sheila, thanks for sharing a very valuable and potentially life saving message.

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