Carbon monoxide (CO) has been called a “silent killer.” It is formed by the incomplete combustion of hydrocarbon fuels and, as it is both clear and odorless, is undetectable by the human senses. It rapidly diffuses into the pulmonary circulation and competes with oxygen to bind the hemoglobin molecule, thereby impairing oxygen delivery.
The toxic effects of CO poisoning have been known for centuries. As early as the 4th century BC, Aristotle cautioned that coal fumes lead to a “heavy head” and death.1 Until the mid 20th century, coal was the primary heating fuel in the urban United States, and accidental CO-related fatalities from improper ventilation or heater malfunction were not uncommon.2
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