The Soldier and the Industrial Base Chapter 11 Carbon Monoxide
Carbon Monoxide Chapter 11 CARBON MONOXIDE TIMOTHY B. WEYANDT, M.D., M.P.H.* AND CHARLES DAVID RIDGELEY, Jr., M.D., M.S.† INTRODUCTION TYPICAL SOURCES OF EXPOSURE Steel Manufacturing Combustion Engine Exhaust Methylene Chloride Smoking MILITARY EXPOSURES World War I: Combat Mining Operations World War II: Tank Warfare The Modern Era: Armored Fighting Vehicles Military Aviation Household Heating PATHOPHYSIOLOGY OF EXPOSURE Carbon Monoxide’s Hemoglobin-Binding Affinity Carboxyhemoglobin and Oxyhemoglobin Dissociation HEALTH EFFECTS Autopsy Findings Signs and Symptoms of Carbon Monoxide Poisoning Staging of Signs and Symptoms Exposure and Muscular Exertion Central Nervous System Effects Circulatory Effects Chronic Effects DIAGNOSIS AND TREATMENT Clinical Diagnosis Treatment HEALTH STANDARDS Occupational Safety and Health Administration American Conference of Governmental Industrial Hygienists Committee on Toxicology Military Standards MEDICAL SURVEILLANCE SUMMARY *Director, Occupational Health Program, Pennsylvania State University, University Park, Pennsylvania 16802; Lieutenant Colonel, U.S. Army (ret); formerly, Medical Advisor for Clinical, Occupational, and Environmental Health; U.S. Army Biomedical Research and Development Laboratory, Fort Detrick, Maryland 21702-5010 †Lieutenant Colonel, U.S. Army; Occupational Medicine Physician, Occupational and Environmental Medicine Division, U.S. Army Environmental Hygiene Agency, Aberdeen Proving Ground, Maryland 21010-5422 397 Occupational Health: The Soldier and the Industrial Base INTRODUCTION Carbon monoxide is a colorless, odorless, taste- Many of the effects of what we now recognize as less and nonirritating gas formed as a by-product in carbon monoxide poisoning were discussed in an- the incomplete combustion of carbonaceous materi- cient literature. During the Middle Ages, these effects als. Frequently, but not reliably, the presence of were sometimes considered to be the work of demons carbon monoxide is accompanied by the odor of un- and witches.
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