Carbon Monoxide Exposure in Youth Ice Hockey.
OBJECTIVE
To examine the effect of ice resurfacer type on carboxyhemoglobin levels in youth hockey players. We hypothesized that players in arenas with electric resurfacers would have normal, stable carboxyhemoglobin levels during games, whereas those in arenas with internal combustion engine (IC) resurfacers would have an increase in carboxyhemoglobin levels.


METHODS
Prospective cohort study.


METHODS
Enclosed ice arenas in the northeastern United States.


METHODS
Convenience sample of players aged 8 to 18 years old in 16 games at different arenas. Eight arenas (37 players) used an IC ice resurfacer and 8 arenas (36 players) an electric resurfacer.


METHODS
Carboxyhemoglobin levels (SpCO) were measured using a pulse CO-oximeter before and after the game. Arena air was tested for carbon monoxide (CO) using a metered gas detector. Players completed symptom questionnaires.


METHODS
The change in SpCO from pregame to postgame was compared between players at arenas with electric versus IC resurfacers.


RESULTS
Carbon monoxide was present at 6 of 8 arenas using IC resurfacers, levels ranged from 4 to 42 parts per million. Carbon monoxide was not found at arenas with electric resurfacers. Players at arenas with IC resurfacers had higher median pregame SpCO levels compared with those at electric arenas (4.3% vs 1%, P < 0.01). Players in the IC group also had a significant increase in their SpCO level during a hockey game compared with those in the electric group (2.8% vs 1%, P = 0.01). There were no significant differences in symptom scores.


CONCLUSIONS
Players at arenas operating IC resurfacers had significantly higher SpCO levels.


CONCLUSIONS
Youth hockey players in arenas with IC resurfacers have an increase in carboxyhemoglobin during games and have elevated baseline carboxyhemoglobin levels compared with players at arenas with electric resurfacers. Electric resurfacers decrease the risk of CO exposure.
*UMass Memorial Children's Medical Center, Worcester, Massachusetts; †University of Massachusetts Medical School, Worcester, Massachusetts; ‡Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts; §Harvard Medical School, Boston, Massachusetts; ¶Brain Injury Center, Boston Children's Hospital, Boston, Massachusetts; ‖The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts; #Sports Concussion Clinic, Boston Children's Hospital, Boston, Massachusetts; and **Division of Sports Medicine, Boston Children's Hospital, Boston, Massachusetts.
Theodore
T
Macnow
Rebekah
R
Mannix
William P
WP
Meehan
D000293:Adolescent; D000393:Air Pollutants / Q000032:analysis*; D002248:Carbon Monoxide / Q000032:analysis*; D002263:Carboxyhemoglobin / Q000032:analysis*; D002648:Child; D004781:Environmental Exposure; D005260:Female; D006688:Hockey; D006801:Humans; D008297:Male; D009511:New England; D010092:Oximetry; D011446:Prospective Studies; D019876:Sports Equipment; D000067009:Youth Sports
D000393:Air Pollutants; D002248:Carbon Monoxide; D002263:Carboxyhemoglobin