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Occupational Medicine Advance Access originally published online on September 17, 2004
Occupational Medicine 2004 54(7):483-488; doi:10.1093/occmed/kqh084
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Occupational Medicine Vol. 54 No. 7 © Society of Occupational Medicine 2004; all rights reserved

Carbon monoxide poisoning in two workers using an LPG forklift truck within a coldstore

F. Gallagher1 and H. J. Mason2

1 Health & Safety Executive, Field Operation Directorate Yorkshire and North East, Sheffield, UK.
2 Health and Safety Laboratory, Sheffield, UK.

Background

This report describes carbon monoxide (CO) poisoning in two workers using a hired forklift truck within a coldstore. The diagnosis was not considered until day 6 of the incident, and so measurements of blood or breath CO at the time of acute illness were unavailable.

Aims

To determine whether CO poisoning may be diagnosed retrospectively, where blood or breath CO measurements are unavailable, in the context of this particular incident.

Methods

Detailed clinical histories were obtained. Estimation of possible levels of CO exposure were made based on computer biokinetic modelling based on the Coburn–Foster–Kane equation.

Results

The combined method used supports the diagnosis of CO poisoning in these two cases.

Conclusions

Clinical assessment, in combination with mathematical exposure modelling, may lead to successful retrospective diagnosis of CO poisoning and identify putative work activities. CO poisoning should be suspected whenever internal combustion engines are used within buildings and workers complain of relevant symptoms. Hospital departments should maintain a high level of vigilance towards such incidents as this, and should routinely undertake a direct measure of the saturation of haemoglobin by CO, i.e. blood carboxyhaemoglobin or breath CO.

Keywords      Carbon monoxide; coldstore; confined space; lift trucks; mathematical modelling

Received       11 November 2003
Revised          5 April 2004
Accepted       20 April 2004

Correspondence to: H. J. Mason, Health and Safety Laboratory, Sheffield, UK. e-mail: howard.mason{at}hsl.gov.uk


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