CARBON MONOXIDE POISONING
• More and more of the homeless are sleeping in their cars
• Most are older, and the vast majority are women (many with children)
• Their carbon monoxide poisoning symptoms are often misdiagnosed
“Carbon monoxide intoxication is one of the main causes of diagnostic errors in emergency medicine because presenting symptoms are particular and confounding, even more in infants: it’s often misdiagnosed as influenza ill, gastroenteritis, headache.”
— Journal of Neurology and Neuroscience
Living in cars + cold weather + idling with the heater running to stay warm = a massive risk of acute and chronic carbon monoxide poisoning for the homeless.
Who’s most at risk? Older women and women with children. For the details, check out this month’s CCHS newsletter.
As always, all of our information comes from actual research done by actual researchers. To view our list of external sources (with links), please refer to the bottom of this newsletter.
Almost 60% of the homeless
in Los Angeles live in their cars …
A 2022 study found: “Vehicular homelessness—referring to individuals and households living in cars, vans, recreational vehicles (RVs), and other vehicles—is one of the fastest growing segments of the unhoused population. Estimates range in size and, due to the difficulty of counting those who live in vehicles, are likely undercounted. In San Francisco, 35% of the unhoused population lives in a vehicle compared to 50% in Seattle and almost 60% in Los Angeles.”
With a high risk of CO misdiagnosis
Per a 2023 Medscape article for physicians, “Carbon monoxide (CO) toxicity is often misdiagnosed because of the vagueness and broad spectrum of complaints; symptoms often are attributed to a viral illness. … For nonfatal nonintentional non–non-fire-related exposures, the most common symptom was headache (37%) followed by dizziness (18%)
The following are findings from recent CCHS interviews on the risk of exposure to carbon monoxide poisoning for the homeless:
1) Car dwellers are at exceptional risk. Here’s Elizabeth’s story (link to video here):
“I’m Elizabeth … and I’m 60-years-old and I am, unfortunately, dealing with carbon monoxide poisoning at this time. I got that by being in my car. I had a window that was busted open and over a few months period I was breathing it without knowing it. I became weaker and weaker over a couple of months and did not realize what was happening to me at all to the point of battling to survive … driving myself to St. Mary’s hospital which I showed up unresponsive there and waking up in the ICU close to death. It’s been a really scary experience and I feel a lot of people need to understand how dangerous it is. We don’t hear enough about it.
It’s like a silent killer.”
2) People who use camp stoves are at risk. Here’s Mama Stacy’s story (link to video here):
“I set up my cookstove — normally I have two cookstoves one for coffee and stuff and one for food — in the areas where it is away from other people to cut down on the carbon monoxide from the fire.”
3) People who live in tents are at risk. Here’s Brandon’s story (link to video here):
“My camp is setup to where my tent is away from my fire so it’s not going into my tent because it’s not good to have smoke go inside your tent so I have it like ten feet away … and then it’s also dug in a pit … an 18 inch pit, because then it keeps the smoke down more ….”
“In the USA, comparatively small changes in ambient levels of CO as a result of pollution have been shown to affect rates of presentation to emergency departments with various complaints. This raises the possibility that large numbers of patients may be seen in … emergency departments with symptoms caused by, or disease states worsened by, exposure to CO without staff being aware of the fact.”
— Wright, J. “Chronic and Occult Carbon Monoxide Poisoning: We Don’t Know What We’re Missing.” Emergency Medicine Journal 19, no. 5 (September 1, 2002): 386–90. https://doi.org/10.1136/emj.19.5.386.
Sources:
More and more of the homeless are living in their cars (https://www.tandfonline.com/doi/full/10.1080/10511482.2022.2117990)
CO poisoning is often misdiagnosed https://www.itmedicalteam.pl/articles/carbon-monoxide-intoxication-a-case-of-misdiagnosis-with-neuroradiological-follow-up-107402.html)
Older women and women with children commonly live in cars (link)
Low-level chronic CO poisoning is a huge concern (https://emj.bmj.com/content/19/5/386)
Credits: CCHS Foundation
Leave a Reply