Evaluating the Carbon Monoxide Monitoring and Response Framework in Long-term Care Facilities: A Brief Guide (2017).
A review of available literature found that there is limited human evidence on the effects of physiological deficits relevant to CO kinetics to support indoor air CO guidelines. This peer-reviewed article examines susceptibility-specific modeling that accounts for physiological deficits that may alter CO-carboxyhemoglobin relationships. A review of the experimental evidence on the toxicokinetics of carbon monoxide: the potential role of pathophysiology among susceptible groups (Barn et al., 2018).Implementing the Framework in long-term care facilities is intentional as residents include those with underlying heart conditions that increase their susceptibility to the harmful effects of CO. The Framework provides a method to assist long-term care facilities in ensuring indoor CO is below Health Canada’s maximum exposure limit of 10 ppm over 24 hours, which is intended to protect the entire population from the health effects associated with short-term and long-term exposures to CO ( Health Canada, 2010). With support from Health Canada, this framework was developed through consultations between NCCEH/BCCDC and Saskatoon Health Region ( Fong, 2016). Finally, tools were developed to increase the capacity for health agencies to implement the Carbon Monoxide (CO) Monitoring and Response Framework in LTCFs. We then performed an evaluation of Saskatoon Health Region’s CO monitoring and reporting policy that indicated its utility in the prevention of CO exposures in LTCFs ( Fong, 2016). To advance the development of a health-protective CO management strategy in LTCFs across Canada, the NCCEH/BCCDC convened a consultation with experts to discuss the development of a framework and practical means for implementation ( Barn and Kosatsky, 2013). Subsequently, Saskatoon Health Region implemented a policy to identify, monitor, and respond to elevated indoor CO in these facilities ( CBC News, 2016). In 2010, a CO exposure incident at a long-term care facility (LTCFs) in Saskatchewan resulted in 31 individuals being sent to hospital and contributed to three deaths ( CBC News, 2010). Dangerously high levels can result in unconsciousness, convulsions, and death. Higher levels or chronic low-level exposure can result in irritability, drowsiness, or dizziness. At low levels of exposure, symptoms can include headache, nausea, and shortness of breath. Cigarette smoke and vehicle exhaust also contribute to indoor CO levels. As a by-product of incomplete combustion, CO is produced by fuel-burning appliances including boilers, furnaces, fireplaces, kitchen stoves, and laundry dryers. Carbon monoxide (CO) is an odourless, colourless, and non-irritating gas that is harmful to humans.
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