Carbon monoxide mass exposure in a pediatric population

Objectives: To describe the outcomes of a mass carbon monoxide (CO) intoxication, and to calculate the CO half-life in a pediatric school-aged population. Methods: A retrospective chart review was performed based on Regional Poison Center database information, hospital laboratory data, and medical records of the pediatric patients who sought care at one of 3 St. Louis area hospitals, after exposure to high levels of CO. Exposures occurred on January 5, 1996, after evidence of a CO leak was discovered at an area elementary school. Charts were reviewed for major demographics, symptoms reported, carboxyhemoglobin (COHb) levels and times, and level of effect. Results: Information about 177 (35%) of the 504 children in attendance at school that day was available. Mean age was 8.7 +/- 1.8 years (range 4-12 years). Symptoms were present in 155 (88%) of the 177 children for whom data were available. Initial COHb levels were obtained for 147 (83.1%) of the 177 children. First mean COHb level was 7.0% (95% CI = 6.6-7.5%). Second COHb level was obtained for 26 children with a mean of 2.7% (95% CI = 2.2-3.2%). Calculated half-life of COHb, on 100% O-2 at 1 atm, was 44.0 minutes (95% CI = 39.6-48.2 minutes). Conclusion: Some children had symptoms at COHb levels that traditionally have been considered nontoxic. The elimination of COHb was found to be more rapid in this population of children than reported in other studies.