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(C) 2005 Albert Donnay
Carbon Monoxide Conundra
in Federal Poli= cy & Regulation
(Lessons in Misapplied Toxicology)
Presented by Albert Donnay, MHS
Univer= sity of Maryland
Dept of Epidemiology & Preventive Medicine
Toxico= logy Seminar
14 April 2005
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(C) 2005 Albert Donnay
2
CAR= BON MONOXIDE
<= span style=3D'color:white'>•“paradoxical or difficult problems”
<= span style=3D'font-family:Arial;font-size:117%'>• Ubiquitous Pollu= tant: more released ann= ually
   in USA than all other toxic= gases combined !
•<= /span> Deadly Exogenous Poison
  #1 cause of toxic death and poiso= ning in USA
•<= /span> Vital Endogenous Neurotransmitter
  produced by all red-blooded animals
  from breakdown of heme proteins by HO-1,2&3
  and bioactive in over 100 mammali= an pathways
CONUNDRA
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(C) 2005 Albert Donnay
3
U.S. Federal Agencies with
   CO-Related Conundra
= •ATSDR= 3;
= •CDC =
= •CPSC = 3;
= •DOD =
= •DOE =
= •DOI̵= 7;s NPS
•DOT̵= 7;s NHTSA
• EPA =
• FAA =
• FDA =
• HUD =
• NIH’s NIEHS =
• NIH’s NIOSH =
• OSHA
• SSA
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(C) 2005 Albert Donnay
Carbon Monoxide Realities, Regulat= ions & Recommendations
•      0 to 1 ppm =3DNormal CO level in fresh air and exhaled breath of healthy non-smokers&= #13;
•      2 to 3 ppm =3DAvg. outdoor ambient CO level associated with significant increases in =
        = ;            ER visits and hospitalizations for asthma and cardio-vascular disease
= •      5.5 ppm = =3DAvg. outdoor ambient CO level in third trimester of pregnancy associated
        = ;         with significant increase in low birth weight babies. <= /span>
<= span style=3D'mso-special-format:nobullet;display:none'>•      5 to15 pp= m =3D CO level in exhaled breath associated with many chronic diseases <= /div>
= •      9 ppm =3D= Max 8-hour avg. outdoor ambient CO level allowed by EPA
<= span style=3D'mso-special-format:nobullet;display:none'>•    10 to 30 ppm =3D CO l= evel in exhaled breath of smokers more than one hour after smoking
= •    30 ppm =3D Min. CO le= vel allowed to be displayed in home CO detectors by CPSC
•    35 ppm =3D Max 1-hour= avg. outdoor ambient CO level allowed by EPA,
        = ;      also Max 8-hour avg workplace ambient CO level recommended by NIOSH
= •    50 ppm =3D Max 8-hour= avg workplace ambient CO level allowed by OSHA (highest on earth) <= /div>
= •    70 ppm =3D Min. CO le= vel for home CO detector alarm, but only if exceeded for 1 to 4 hours <= /div>
= •  100 to over 1000 ppm =3D CO level= exhaled by smokers while smoking
<= span style=3D'mso-special-format:nobullet;display:none'>•  200 ppm =3D CO level at which NIO= SH recommends immediate evacuation of any workplace
<= span style=3D'mso-special-format:nobullet;display:none'>•  400 ppm =3D Max CO level for home= CO alarm, but only if exceeded for 4 to 15 minutes
= •  800 ppm =3D CO level allowed from= gas ovens & range tops (combined) by ANSI’s 1925 std
= •1200 ppm =3D CO level N= IOSH considers “Immediately Dangerous to Life and Health”
= •3000 ppm (0= .3%) =3D CO inhaled in DLCO test as part of standard lung function testing
= •5000 to 15,000 ppm =3D = CO level in gas engine exhaust without working catalytic converter
= •Pure CO (10= 0 %) =3D single inhalation is lethal; used by veterinarians to euthanize animals
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(C) 2005 Albert Donnay
4
CO Conundrum of Agency for Toxic Substances and Disease Registry
•GIVEN that CO is the leading cause of unintentional toxic deaths and poisonings
and= the most ubiquitous air pollutant in USA …
•WHY has ATSDR not published a detailed Toxicological Profile on CO or even a “ToxFAQ” sheet on CO as i= t has for over 250 = other toxic chemicals to which most people are less frequently and less significantly exposed?
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(C) 2005 Albert Donnay
5
CO Conundrum of Centers for Disease Control & Prevention
<= span style=3D'font-size:94%;color:white'>•GIVEN that CDC’s mission is “to insure that critical health information gets = out to the people who ne= ed it most ... to protect public health and safety” ...
•WHY have no CDC Centers ever funded or published any research on CO’= s role as an endogenously produced neurotransmitter (as only obscure US NIDCD has) or on the diagnosis or treatment of CO poisoning ?
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(C) 2005 Albert Donnay
6
CO Conundrum of Consumer Product Safety Commission
<= span style=3D'font-size:94%;color:white'>•GIVEN that CPSC’s mission is “Saving <= /span>Lives and Keeping Families Safe”...
•WHY do CPSC statistics never include CO deaths from vehicles (only appliances) and  why did it force UL to change its CO a= larm standard in 1998 to prohibit home alar= ms below 70ppm and even any display of CO= levels below 30ppm, when EPA’s l= imit for outd= oor exposure is only 9ppm ?
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(C) 2005 Albert Donnay
7
CO Conundrum of
Department  of Defense
•GIVEN that DOD recognizes hazards of CO indoors, requiring CO alarms in all Na= vy, Air Forc= e and Army base housing worldwide ...
 =
<= span style=3D'font-size:94%;color:white'>•WHY has DOD not studied the effects of exposure to CO in the Gulf War from fi= ring and exploding munitions, engine exhaust,  and tent heaters, esp. since CO poison= ing
is known to cause= all the “undiagnosed” symptoms of Gulf War Syndrome?
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(C) 2005 Albert Donnay
8
CO Conundrum of
Department of Ener= gy
•GIVEN that DOE funds weatherization programs in every state that reduce ai= r leaks in low-income housing and upgrad= e gas appliances ...
<= span style=3D'font-size:94%;color:white'>•WHY doesn’t DOE require any standardized testing of appliances to find and corr= ect any CO s= ources that may be made worse by weatherization ?
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(C) 2005 Albert Donnay
9
CO Conundrum of Interior Depart= ment’s National Park Service
•GIVEN that NPS  recognizes the hazards of CO indoors, requiring CO alarms in all NPS staff housing & recommending t= hem in all houseboats used in national parks...
 
<= span style=3D'font-size:94%;color:white'>•WHY doesn’t NPS recommend CO alarms <= span style=3D'position:absolute;top:24.48%;left:3.83%;width:92.14%;height:26.53= %'>in cars, motor homes and campers since= these CO sources also kill people in <= /span>national parks ?