title: Effect of exhaust emissions on carbon monoxide levels in employees working at indoor car wash facilities.
abstract: BACKGROUND
  Exhaust emissions from motor vehicles threaten the environment and human health. Carbon monoxide (CO) poisoning, especially the use of exhaust gas CO in suicidal attempts is well known in the literature. Recently, indoor car wash facilities established in large shopping malls with closed parking, lots is a new risk area that exposes car wash employees to prolonged periods of high level CO emissions from cars. The aim of this study was to investigate how carboxyhemoglobin (COHb) blood levels of employees get affected in confined areas with relatively poor air circulation.
  
  
  METHODS
  Twenty male volunteers working in indoor parking car wash facilities were included in the study. Participants were informed about the aim of this study and their consent was obtained. Their pulse COHb levels were measured twice, at the beginning and at the end of the working day using Rad-57 pulse CO-oximeter device, allowing non-invasive measurement of COHb blood levels to compare the changes in their COHb levels before and after work.
  
  
  RESULTS
  The mean age of the male volunteers was 29.8 ± 11.9 (range 18-55). While the mean COHb levels measured at the start of the working day was 2.1 ± 2.0 (range 0-9), it was increased to 5.2 ± 3.3 (range 1-15) at the end of work shift (Wilcoxon test, p <0.001). There was a statistically significant difference in COHb levels between the beginning and the end of the work shift in smoker subjects, while the difference was not significant in the non-smoking group (Wilcoxon test, p=0.001, p=0.102, respectively).
  
  
  CONCLUSIONS
  The COHb blood levels of indoor car wash facility employees is directly impacted and gets elevated by motor vechile exhaust emissions. For the health of the employees at indoor parking car wash facilities, stricter precautions are needed and the government should not give permit to such operations.
authors.affiliation: Emergency Department, Istanbul Training and Research Hospital, Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Topacoglu
authors.affiliation: Emergency Department, Okmeydani Training and Research Hospital, Istanbul, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Katsakoglou
authors.affiliation: Emergency Department, Okmeydani Training and Research Hospital, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Ipekci
keywords: Gas poisoning; automobile exhaust; carbon monoxide (CO); carboxyhemoglobin (COHb); occupational exposure