This story originally appeared in PARADE Magazine on April 28, 1996.

"How to Stop a Silent Killer"

      Crystal-Lynn May Brooks, 20, was washing her car the last time her mother saw her alive. The pretty college student was hard at work in the family garage, where all was warm and cozy and shut up tight against the wintry cold of Pittsfield, Maine.

      The car’s engine purred as Crystal-Lynn hummed to music from the cassette player in her fully restored 1972 Mercury Comet--her pride and joy.

      When Bonnie Brooks later entered the garage, she found her daughter lying dead on the floor, as the motor steadily chugged out lethal exhaust fumes of carbon monoxide (CO). That was in 1992. Now, upon request, Mrs. Brooks mails out information on how to protect yourself against CO.

      Crystal-Lynn, an engineering major in her junior year at Cornell University in Ithaca, NY, must have known that CO is deadly. But feeling protected and secure in her parents’ home may have lulled her into underestimating its virulence. Mrs. Brooks said her daughter probably had run the motor to keep the battery charged for her trip to Cornell the next day.

      Carbon monoxide is a poisonous gas--a silent killer. It also is odorless, colorless, tasteless, textureless and undetectable by our five senses. It has been killing humans since we first lighted fires in caves. Primitive fuels produced not only lots o CO but also irritating substances that announced their presence. Today’s cleaner fuels, however, give us no warnings.

      Accidental deaths from poisoning by this gas are doubly tragic because, in most cases, they are avoidable. The National Center for Health Statistics says CO is to blame for 3500 accidental deaths and suicides each year in the U.S. It is the No. 1 cause of all deaths by poisoning.

      A report in the Nov. 22, 1995, issue of The Journal of the American Medical Association estimates that CO exposure causes 10,000 persons to seek medical care or to lose at least one day of normal activity. (See box on medical facts.)

      Outdoors, carbon monoxide is all around us, diluted by the air. Indoors, it becomes concentrated and even small quantities can harm or kill us. It is critical, then, to find the sources of this poison so you can prevent exposure to it.

      Carbon monoxide detectors will provide you with basic help if you install one or more inside your home--especially in sleeping areas and near the door that leads to your garage. Also put them in your workplace and, if you have a power boat, in its sleeping cabin. Detectors sound an alarm when a danger level in the air is reached. (Concentrations are measured in parts of CO per million parts of oxygen.) The alarm warns you to ventilate the area and to search for the poison’s source. Some detectors sound alarms intermittently till the air level is safe. There are plug-in and battery-run models, priced from about $40 to $80. Consult the public library for published consumer reviews.

UNSUSPECTED DANGERS

      Carbon monoxide usually lurks in familiar, unsuspected sources. For instance, CO from a gas swimming-pool heater killed the tennis star Vitas Gerulaitis, 40, in 1994. At least one of every five cases of accidental poisoning by this gas involves heating or cooking, according to federal statistics.

      Carbon monoxide comes from incomplete combustion; it can be produced by any flame-fueled device, including:

• Gas ranges, ovens with pilot lights, clothes dryers, gas or oil furnaces.
• Fireplaces, coal stoves, wood-burning stoves, charcoal grills (use outdoors only).
• Hot-water heaters, space heaters fueled by propane or natural gas or by oils. If you use kerosene-oil heaters (illegal in many states), keep a nearby window slightly open. But only models tagged as approved by Underwriters Laboratories.
• All gasoline-powered equipment--generators, engines, cars and trucks. Federal statistics indicate that at least three out of five accidental carbon monoxide deaths involve vehicle exhaust.

      But perhaps the gravest danger from CO poisoning lies in the mind of anyone who thinks, "It can’t happen to me."

LIVES NEARLY LOST

      Setting out to visit relatives last Thanksgiving Day, Herbie Newsome, his wife, Antoinette, their three adult children and seven younger children and grandchildren, aged 1 to 12, got into the family station wagon on Staten Island, N.Y. Herbie and two adult sons sat in front, in the back were Antoinette, an adult daughter and all the youngsters. Within a half-hour, Antoinette said, she felt ill, and many of the children were unconscious. Those in front felt fine.

      Medics arrived, saw the symptoms of carbon monoxide poisoning and took the children to nearby hospitals. The youngsters next were flown by helicopter to Jacobi Medical Center in The Bronx and placed in a hyperbaric chamber.

      "Breathing in oxygen is the main antidote," explained Dr. Michael Touger, associate medical director of the Emergency Department at Jacobi. "Placing patients in the hyperbaric chamber allows them to breathe oxygen under pressure. This helps to purge the gas from various parts of the body, minimizing its effect. The treatment helps, but it is not a cure. Medical follow-up visits are advised." Herbie Newsome said that each of the children has fully recovered.

      It seems Suzanne Hamilton of Pacific Grove, Calif., had less luck. Hamilton said that, while living in a rented house in Montana, she’d been exposed to the gas from September 1994 until January 1995 and no longer can work as an occupational therapist. Hamilton said she was left with poor short-term memory, reading difficulty and hypersensitivity to sound. A gas-company inspection of the house traced the CO to a leak in the furnace, she said.

MAKE SAFETY CHECKS

      To supplement CO detectors, hire experts to check your home and vehicles regularly. (Herbie Newsome said inspectors later found a defect in his car’s exhaust system.) Before the cold weather, schedule utility-company checkups of fuel-burning heating equipment; also look for leaks in flues, chimneys and chimney connectors. Check some things yourself, including:

• Home: In heating season, clean furnace filters monthly. Check flames on gas-burning appliances--if yellow-tipped instead of blue, carbon monoxide is being released. Have the burner adjusted.
• Vehicles: At least yearly, check for holes in mufflers or pipes through which CO could reach passengers. Repair.
• Winter idling--Keep a window open and tailpipes clear. Many dies while warming up "for a minute," as a snow-blocked exhaust pipe fills the car with CO.
• Summer idling--When cooling down "for a minute," crack open a window while the motor and air conditioner run.
• Garage: Be sure the door joining your garage and house shuts automatically and tightly seals this poison from your home.

      Don’t sit in a closed idling car, particularly in a closed garage. Before starting the motor, fully open the garage door, then drive out quickly. After an engine starts or stops, air the garage well.

      Never leave keys in the ignition when parked in a garage. Warning: Some older cars with worn ignition switches may keep running even with keys removed.

IF CARBON MONOXIDE STRIKES

      If your CO detector sounds an alarm, call 911 or your Fire Department; ask for emergency CO monitoring. Suspect furnace or appliance leaks? Ask your utility company for an emergency check. If you feel ill, get out! Call for medical help from a neighbor’s home.

      Don’t underestimate this lethal gas.

For more information, write: The CLMB Foundation, Dept. P, P.O. Box 333, Pittsfield, Maine 04967. (recheck address) Please enclose a return address and $1 for materials.

MEDICAL FACTS ABOUT CARBON MONOXIDE

      Dr. Michael Touger, associate medical director of the Emergency Department at Jacobi Medical Center in The Bronx, N.Y., answered some questions for PARADE:

Q. Why is carbon monoxide fatal?
      A. In effect, CO fumes suffocate us, because the body’s red blood cells absorb carbon monoxide more than 200 times faster than they absorb oxygen. As a result, the oxygen in our blood--vital to life--is replaced by CO.

Q. How quickly does carbon monoxide kill the victims?
      A. Death can follow in minutes or hours, depending on one’s age and general health, the length of exposure time and the concentration of CO (how many parts of CO there are to one million parts of air). You are most vulnerable if you are very young, very old, pregnant or if you have cardiovascular or lung problems.

Q. Are there symptoms of carbon monoxide poisoning to watch for?
      A. Initially, the symptoms are flulike: headache, fatigue, nausea, dizzy spells and irritability. As CO blood-levels rise, expect such symptoms as confusion, unconsciousness, brain damage and, ultimately, death.

Q. What about survivors of CO exposure? Do they have any aftereffects?
      A. Survivors of heavy doses of CO often develop angina-like chest pains. Cardiograms may indicate heart-rhythm disturbances, heart damage or heart attack. Those with heart problems are at great risk. So are older persons with an underlying vascular disease, like high blood pressure. Most vulnerable are unborn babies, infants, children, seniors and those who have coronary or respiratory problems. About 10% of CO survivors might suffer neurological effects for weeks, months or even years afterward. Children especially are at risk for such learning disabilities as faulty concentration, temporary or permanent memory loss, and loss of skills and reasoning powers. Parkinsonian symptoms--unsteady balance, poor coordination and tremors--also may occur.

Q. Will exposure to carbon monoxide always leave its mark?
      A. Not always. You stand an especially good chance of recovery if you are in good health and your exposure to CO is diagnosed and treated quickly.