title: Carbon monoxide from neighbouring restaurants: the need for an integrated multi-agency response.
abstract: BACKGROUND
  Carbon monoxide (CO) is a colourless, odourless toxic gas produced during incomplete combustion of carbon-based fuels. Most CO incidents reported to the UK Health Protection Agency (HPA) are due to faulty gas appliances, and legislation exists to ensure gas appliances are properly installed.
  
  
  METHODS
  We present three CO poisoning incidents of unusual origin reported to the HPA. In each, residents living above restaurants were poisoned after workers left charcoal smouldering overnight in specialist or traditional ovens whilst ventilation systems were turned off. This led to production of CO, which travelled through floorboards and built up to dangerous concentrations in the flats.
  
  
  RESULTS
  Working with local authorities, these incidents were investigated and resolved, and work was conducted to prevent further occurrences.
  
  
  CONCLUSIONS
  The novel nature of these CO incidents led to delays in recognition and subsequent remedial action. Although previously undescribed, it is likely that due to the number of residences built above restaurants and the rising popularity of traditional cooking methods, similar incidents may be occurring and could increase in frequency. Multi-agency response and reporting mechanisms could be strengthened. Awareness raising in professional groups and the public on the importance of correct ventilation of such appliances is vital.
authors.affiliation: Centre for Radiation, Chemical and Environmental Hazards, Health Protection Agency, Buckingham Palace Road, London SW1W 9SZ, UK. catherine.keshishian@hpa.org.uk
authors.forename: C
authors.initials: C
authors.lastname: Keshishian
authors.forename: H
authors.initials: H
authors.lastname: Sandle
authors.forename: M
authors.initials: M
authors.lastname: Meltzer
authors.forename: Y
authors.initials: Y
authors.lastname: Young
authors.forename: R
authors.initials: R
authors.lastname: Ward
authors.forename: S
authors.initials: S
authors.lastname: Balasegaram
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000331:legislation & jurisprudence / Q000517:prevention & control; D002248:Carbon Monoxide / Q000009:adverse effects / Q000032:analysis / Q000592:standards; D002249:Carbon Monoxide Poisoning / Q000209:etiology*; D002606:Charcoal / Q000009:adverse effects; D003296:Cooking / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D058735:Environmental Policy; D006801:Humans; D019982:Organizational Case Studies; D012147:Restaurants / Q000295:instrumentation / Q000331:legislation & jurisprudence / Q000592:standards*; D006113:United Kingdom; D014691:Ventilation / Q000331:legislation & jurisprudence / Q000379:methods / Q000592:standards*
chemical_list: D002606:Charcoal; D002248:Carbon Monoxide