Smoking cessation clinics provide a new opportunity to detect early carbon monoxide poisoning

Smoking cessation clinics provide a new opportunity to detect early carbon monoxide poisoning, the Health Protection Agency has discovered.

Results from routine carbon monoxide (CO) testing in the breath of people attending such clinics or GP support services can alert healthcare professionals to patients who are suffering from chronic, low-level CO poisoning.

A recent incident at a smoking cessation clinic in Surrey alerted the HPA to this opportunity when a patient attending the clinic continued to have high levels of CO in their exhaled breath, even after they had stopped smoking. Further investigation led to the discovery that the patient was being exposed to low levels of CO in their home due to a faulty gas appliance. This case highlighted an extra opportunity to detect CO exposure in the home.

Chronic exposure to levels of CO which do not produce immediately recognisable adverse effects, can nonetheless harm health. If a patient is found to have higher than expected levels of CO in their exhaled breath sample, the Agency suggests the following steps should be taken by healthcare professionals:

• Inform the patient that raised CO levels may be due to faulty or badly ventilated devices that burn fossil fuels e.g., gas cookers, fires, boilers, water heaters, coke or oil fired boilers. It is important to stress that fuels other than gas may be the cause of exposure;
• If the individual does not have any symptoms, then urge them to contact a suitably qualified engineer to check their devices urgently and advise on further action to ensure the safety of occupants;
• If the individual has symptoms they should be referred to their local Accident and Emergency Department.

Professor Robert Maynard from the Agency said: “CO is found in cigarette smoke and therefore smokers will produce breath samples containing higher levels of CO than non-smokers. However, if a patient has given-up smoking, but still has high levels of CO in their exhaled breath, CO exposure should be considered as a possible cause.

“This new opportunity to detect CO exposure in patients trying to give-up smoking could prevent illness or even the death of the patient and their family. The Agency is keen to highlight this very important additional opportunity to diagnose CO poisoning through smoking cessation consultations and clinics.“