Barbecues - An unusual cause of carbon monoxide exposure reported to the UK National Poisons Information Service 2010-2011

Objective: Carbon monoxide (CO) is a colourless and odourless poisonous gas formed from the incomplete combustion of substances containing carbon (fossil fuels). The majority of the reported cases are due to smoke inhalation occurring in house fires or faulty appliances. In the UK, more than 50 people die from accidental carbon monoxide poisoning every year, and 200 people are seriously injured. However, due to the unspecific nature of symptoms, undiagnosed cases could be much higher. A great deal of revenue is spent on CO exposure prevention, although these tend to focus on faulty domestic appliances. Significant exposure to CO can also result from other sources. Methods: Calls reported to the UK National Poisons Information Service (UK NPIS) during 2010–2011 were analysed, focusing on exposures that did not originate from domestic appliances or house fires. Results: In 2010/2011 there were 286 carbon monoxide related enquiries to the NPIS (NPIS annual report) involving at least 385 patients. While the majority of cases (64%) were regarding CO exposure from domestic appliances and 19% came from domestic fires, there were a number of interesting cases that resulted in raised carboxyhaemoglobin levels from other sources. Noticeable was the increased number of CO exposure originating from barbecues being brought into enclosed areas such as homes or tents. There were five enquiries involving ten patients during this time that resulted from inhalation of fumes from a barbecue; all resulted in symptoms and most had raised carboxyhaemoglobin levels recorded. There was one fatality that resulted from intentional inhalation of fumes from several barbecues in an enclosed space. Conclusion: Recently there have been several media-reported carbon monoxide fatalities from people moving barbecues into tents. It is quite obvious from our data that although this type of exposure is rare it is not isolated and can lead to severe morbidity and in some cases fatalities. This type of exposure is not specifically mentioned in the document from the department of health PL/CMO/2010/02 that is aimed at increasing public awareness of carbon monoxide poisoning. We recommend that the public should be made aware that outdoor activities, like barbecues, can cause significant CO exposure.