CO Support was founded by Debbie Davis in 1995 after her health was destroyed by a leaking flue from a gas fire in the living room. Her aim was to set up a support group for other sufferers, and to gain as much information as possible about the long term health effects of CO. Even with limited publicity, a large number of people have sought help from the group, and the membership of CO Support has grown rapidly.
The objectives of CO Support are to:
- provide support and advice to those who have suffered from exposure to CO;
- raise awareness amongst the medical profession and the public generally of the symptoms of chronic exposure to CO, a condition which is often undiagnosed;
- prompt further research into the long term effects of chronic exposure;
- and identify the circumstances of chronic exposure with a view to identifying who might be at risk.
CO Support found that currently there is little medical evidence on the effect of long term (chronic) exposure to CO. This is in marked contrast to the effects of a sudden acute exposure to CO, which has a considerable medical literature. The most recent medical article to explore chronic exposure to CO was published in 1936. Sixty years later, in 1996, the members of CO Support decided that it was time to revisit the problem in a rigorous way. Those contacting CO Support, having been affected by CO, were asked to complete a comprehensive questionnaire. This report describes their experiences.
Purpose of the Study
The study was conducted by CO Support in order to:
- identify the health effects of long term exposure to CO;
- identify who is at risk of exposure;
- establish the circumstances of the exposure and how it was discovered;
- explore how successful doctors were in diagnosing the problem; and to
- learn from the suffering of victims, to provide guidelines for the future.
The key findings of the study are:
- Those suffering from chronic exposure to CO experienced a wide range of symptoms, including memory loss, severe muscular pain, headaches, tiredness and dizziness.;
- In many cases, these symptoms continued for years after the exposure ceased. Although some people have recovered completely, a significant proportion remain permanently incapacitated and unable to work;
- GPs failed to diagnose chronic exposure to CO. In only one case out of the 77 studied was exposure identified on the basis of symptoms alone;
- Misdiagnoses included flu, viral infection, depression, ME, and psychosomatic illness. Often no diagnosis was given at all;
- In the majority of cases, the presence of CO was discovered by servicing or investigation of the offending appliance. In some cases warning was given by an alarm or detector. In others, the collapse of one family member drew attention to the problem;
- In many cases, regular servicing of the appliance failed to identify the problem. In some cases servicing took place regularly during an exposure lasting several years;
- Around 70% of chronic exposures took place in people’s own homes, often in houses;
- Two thirds of sufferers were women, with most aged between 30 and 45 years;
- Very few sufferers were offered a carboxy haemoglobin (COHb) test to determine the extent of their exposure. Where tests were performed, there was also evidence of misinterpretation of the results by hospitals and GPs.
Between September 1996 and March 1997, all those who called CO Support and claimed to have suffered exposure to CO were asked if they would be willing to participate in the study. To this group were added the seventeen people who had participated in the pilot study. The anonymity of all respondents was preserved by giving each respondent a unique number reference.
Of the 120 questionnaires sent out, a total of 87 replies were received. Of these, 10 were excluded from the sample because significant amounts of information were missing. Of the 43 questionnaires not used, 24 were from females, 15 from males and 4 of unknown sex. The questionnaires for the very young children were completed by their parents.
Twelve of the respondents had collapsed or been unconscious as a result of CO, and these were treated separately for the purpose of the analysis. Thus the paper distinguishes between two groups: a group of 65 "chronic" cases and a group of twelve "unconscious" cases.
For 10 of those who were unconscious, exposure to CO continued for months or years before the individual collapsed. The reason for treating these separately from those suffering from chronic exposure (without collapse) is that the medical profession believes that chronic exposure has no long term effects if the sufferer did not become unconscious.
The 65 chronic exposures occurred in 38 separate incidents, and the 12 unconscious exposures occurred in 11 separate incidents. The non-response and excluded questionnaires were from a total of 30 different incidents.
For each respondent included in the unconscious or chronic groups, a control was obtained from someone of the same sex, similar age and income bracket. The control group formed a benchmark against which the health of the exposed could be compared. Where possible, the control was found by the respondent. However, where they were unable to find anyone suitable, or if the control questionnaire was invalid, CO Support found an alternative control. 31 of the 65 chronic cases and 5 of the unconscious group provided their own controls. CO Support found matching controls for the other 41 respondents.
An initial pilot survey was conducted, the responses to which informed the design of the main questionnaire. Where possible, questions were in the form of "tick-box" choices, with space for explanatory comment where appropriate. The questions asked of the control group were identical to those asked of the exposed group in 20 categories. Different questions were asked in 10 categories, as these related to the specific circumstances regarding the cause, method of discovery and treatment of CO exposure.
Copies of the questionnaires are included as Appendix A. The statistics forming the basis of the analysis are included as Appendix B. The raw data is also available in spreadsheet form upon request.
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