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Nothing's so rare as a day in June - without carbon monoxide.


If a leaking exhaust system on one's car is a potentially fatal hazard to its occupants, what about all those poor mortals who breathe the exhaust fumes from thousands of cars every day? And what about the carbon monoxide from a roomful of smokers in a restaurant or other public gathering place? At least I don't have to worry about lung cancer if I die first from carbon monoxide poisoning, right? And why is carbon monoxide hazardous at all?

A product of incomplete combustion, carbon monoxide is produced in any fire, whether from within a car engine's cylinders or from the tip of a cigarette. When absorbed in the bloodstream, carbon monoxide attaches itself to the hemoglobin in the red blood cells and prevents it from carrying life-sustaining oxygen to the body's other cells. If only 2 to 4 percent of the hemoglobin is thus blocked (about the level most people experience in most major cities), the effect is scarcely noticeable, although some slight impairment of motor skills and thought processes occurs even at this minimal level. If the hemoglobin blockage level rises rapidly (as it may, for example, in a closed room with a faulty space heater), one may experience sudden headache, nausea and mental confusion when 30 to 50 percent of the hemoglobin is blocked by monoxide, followed quickly by brain cell death if ventilation does not immediately improve.

Even at the 2 to 4 percent level, however, cardiac impairment has been known to occur. This information led to a study recently published in The New England Journal of Medicine that showed men with known coronary artery disease to be susceptible to increases in angina attacks and EKG abnormalities when they exercised in atmospheres with high carbon monoxide levels. These levels can usually be found in such everyday situations as smoke-filled meeting rooms, bars or restaurants and cars with defective exhaust systems. Although one would not ordinarily exercise strenuously in any of these situations, it must be noted that any level of carbon monoxide in the blood takes more than five hours to fall by one-half. Thus, the person with coronary heart disease who has left any such situation and soon thereafter finds himself even walking a moderate distance (much less rushing to a subway or climbing stairs) is subject to cardiac disturbances.

For the person with coronary artery disease on an exercise program, the advice is clear--a controlled indoor environment is preferable to a polluted outdoor one. Even for those with normal hearts, outdoor exercise in high traffic areas or during "smog alerts" is best avoided.
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Publication:Medical Update
Date:Jun 1, 1990
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