title: Carbon monoxide poisoning in two workers using an LPG forklift truck within a coldstore.
abstract: BACKGROUND
  This report describes carbon monoxide (CO) poisoning in two workers using a hired forklift truck within a coldstore. The diagnosis was not considered until day 6 of the incident, and so measurements of blood or breath CO at the time of acute illness were unavailable.
  
  
  OBJECTIVE
  To determine whether CO poisoning may be diagnosed retrospectively, where blood or breath CO measurements are unavailable, in the context of this particular incident.
  
  
  METHODS
  Detailed clinical histories were obtained. Estimation of possible levels of CO exposure were made based on computer biokinetic modelling based on the Coburn-Foster-Kane equation.
  
  
  RESULTS
  The combined method used supports the diagnosis of CO poisoning in these two cases.
  
  
  CONCLUSIONS
  Clinical assessment, in combination with mathematical exposure modelling, may lead to successful retrospective diagnosis of CO poisoning and identify putative work activities. CO poisoning should be suspected whenever internal combustion engines are used within buildings and workers complain of relevant symptoms. Hospital departments should maintain a high level of vigilance towards such incidents as this, and should routinely undertake a direct measure of the saturation of haemoglobin by CO, i.e. blood carboxyhaemoglobin or breath CO.
authors.affiliation: Health & Safety Executive, Field Operation Directorate Yorkshire and North East, Sheffield, UK.
authors.forename: F
authors.initials: F
authors.lastname: Gallagher
authors.forename: H J
authors.initials: HJ
authors.lastname: Mason
mesh_terms: D002249:Carbon Monoxide Poisoning / Q000175:diagnosis*; D002263:Carboxyhemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009784:Occupational Diseases / Q000175:diagnosis*; D001335:Vehicle Emissions / Q000032:analysis
chemical_list: D001335:Vehicle Emissions; D002263:Carboxyhemoglobin