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Occupational Medicine Advance Access published online on September 17, 2004
Occupational Medicine, doi:10.1093/occmed/kqh084
Copyright © 2004 Society of Occupational Medicine.
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Received November 11, 2003
Revised April 5, 2004
Accepted April 20, 2004

Article

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

F. Gallagher 1 and H. J. Mason 2*

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

* To whom correspondence should be addressed. E-mail: howard.mason{at}hsl.gov.uk.


  Abstract

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.
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