As children and adults spend more time indoors, caregivers must be aware of carbon monoxide (CO), a silent killer. Colorless, odorless and tasteless, CO can be extremely difficult to detect.
It is produced when a fuel containing carbon (gas, wood, oil, charcoal, kerosene and coal) is incompletely burned. Common household appliances that use gas, such as furnaces, refrigerators, clothes dryers, ranges, water heaters, fireplaces, charcoal grills, and wood burning stoves can produce CO if there are malfunctions and/or not enough air exchange.

If a building is vented properly, CO will most likely be safely vented to the outside; however, in today’s “energy efficient” dwellings, this may not be the case. These tightly-sealed homes or buildings are havens to trap CO polluted air inside year-round with no place to escape.

Each year, children and adults die of carbon monoxide poisoning due to malfunctioning or improperly used fuel-burning appliances. Even more die of CO produced by idling cars. Carbon monoxide poisoning also can impact boaters.

Unborn infants, babies, elderly people, and people with anemia or with a history of heart or respiratory disease can be especially susceptible.

If you suspect CO exposure or if you have a carbon monoxide detector that alerts you to the presence of high levels, get everyone out of the building immediately. Since CO can affect your mental processing, open doors and windows to reduce CO exposure while getting children out. If possible, turn off any combustion appliance immediately to avoid explosion.

Call 911 or your local emergency services from a cell phone or neighbor’s phone. Do not go back into the building until the emergency response personnel tell you it is okay to do so.

Since you cannot see, smell, or taste it, CO can make you sick before you know it is there. Carbon monoxide deprives the body’s tissues of oxygen. The symptoms of CO poisoning often mimic the flu; mild symptoms may include headache, dizziness, fatigue, nausea, and diarrhea.

As exposure increases, symptoms become more severe and may include confusion, shortness of breath, fast heart rate, convulsions, and unconsciousness. CO exposure can lead to brain damage or death.

Red blood cells pick up carbon monoxide quicker than they pick up oxygen. So if there is a lot of carbon monoxide in the air, the body may replace oxygen in blood with CO. This blocks oxygen from getting into the body, which can damage tissues and result in death.

CO is particularly dangerous for children. CO is heavier than air, so when present it tends to collect on or near the floor--at the children’s level. Caregivers should pay attention to sudden changes in a child’s behavior, such as sudden lethargy, sleepiness, or irrational behavior.

There are a number of safety steps that childcare programs can do to help prevent carbon monoxide exposure.

• Make sure major appliances are professionally installed and inspected according to local building codes. Have older appliances checked for malfunctions and leaks.
• Choose vented appliances when possible.
• Have heating systems inspected and cleaned by a qualified technician annually. Make sure the chimney is clean and with a proper draft control to ensure a proper vent for flue gases.
• Check the color of the gas in the burner and pilot light flames. A yellow-colored flame indicates the fuel is not burning efficiently and could be releasing more carbon monoxide.
• Never use a gas oven to heat your facility.
• Do not burn charcoal indoors.
• Never operate gasoline-powered engines or generators in confined areas in or near the building.
• Never leave a vehicle running in a garage or closed area. Even if the garage door is open, normal circulation will not supply enough fresh air to prevent a buildup of CO gas.

Just as smoke detectors provide early warning of fires, the use of carbon monoxide detectors also can save lives. Install CO alarms in each room on every level of your home based childcare or center facility, especially outside any areas in where children sleep; and make certain people can hear the CO alarm in each room.

To reduce the number of nuisance alarms, install the alarms at least 15 feet away from potential CO sources, such as furnaces, hot water heaters, gas stoves, clothes dryers, and fireplaces.

It also is wise to keep alarms away from ceiling fans, heat vents, air conditioners, or open windows. Blowing air may prevent carbon monoxide from reaching the CO sensors. For ease of viewing, you can locate the alarm five feet above the floor.

If and when your carbon monoxide alarm sounds, the first thing to remember is not to panic. Quickly move everyone to a place, preferably outdoors, that provides a source of fresh air.

Once there, call 911 or the fire department. Do not re-enter the building until it is thoroughly aired out and emergency personnel have determined that there is no risk. As a follow-up, it is wise to call a qualified professional to inspect your facility and determine the cause of possible CO buildup.

Maintain the CO alarm just as you maintain a smoke detector. Set a maintenance schedule to replace batteries and test the alarm. Changing batteries at one or both of the Daylight Savings Time changes is an easy schedule to remember.

In addition, test alarms each month by pressing and holding the test/silence button until the alarm sounds. If an alarm signals a malfunction, first check to see if the battery is installed properly. If this does not fix the malfunction, replace the alarm.

All carbon monoxide alarms should be replaced every five years. Note the date of the installation on the detector using a sticker or permanent marker. When checking the operation of the detector, it may be helpful to keep a record of this check in your program’s files so that staff knows when the detectors were examined as well as when to replace them.

Many states require childcare programs to have working carbon monoxide detectors as part of their licensing standards. Some states require that childcare staff receive an orientation in how to check and operate CO detectors. Check with your state licensing agency to learn more about what your state requires.

Your health department or childcare health consultant may be able to connect you with a local agency that provides no or low-cost carbon monoxide detectors as well as provide training for your staff on safe operation of the detectors.

Tania Cowling
Early childhood teacher resource books author, freelance writer and former teacher

Poison Control Center, 800-222-1222

U.S. Environmental Protection Agency, Office of Radiation and Indoor Air, Indoor Environments Division, 1200 Pennsylvania Ave. NW, Mail Code 6609J, Washington, DC 20460; 202-343-9370; www.epa.gov/iaq/pubs/coftsht.html

Carbon Monoxide Kills, www.carbonmonoxidekills.com

Iowa State Extension Service, www.extension.iastate.edu/Pages/communications/CO/

Keep Kids Healthy, www.keepkidshealthy.com/welcome/firstaid/carbon_monoxide_poisoning.html