Chronic carbon monoxide poisoning resulting in bilateral cataracts and a cystic globus pallidus lesion

View BMJ Case Report

We do have some toxicologists who we can recommend you try to contact ideally through a solicitor.

Please let us know what your opinion is about your toxicologist, GP etc. so we can help others.

Please email

We would really like to hear from concerned medics or any medics who are interested in CO+ (carbon monoxide and other products of combusion).

We highly recommend Dr Sarah Myhill but she seems too busy to see patients usually.

Dr Myhill has written quite a few books on diet etc. which some sufferers may find helpful.

We have been told of Dr Ray Perrin’s work and his technique by a CO victim.

Stephanie has talked to him on the telephone and liked him very much. We suggest you visit his website

The COMed Group

From: Isabella Myers  
Sent: 09 November 2018 14:03
To: Stephanie Trotter <>
Subject: RE: Victims of CO and the COmed group

Dear Stephanie,

Thank you for your e-mail of 2nd October about the role of COMed and the issues faced by the victims of CO poisoning. The members of COMed discussed your e-mail and the issues you raised at their meeting last week.

The role of COMed:

As a sub-group of the All-Party Parliamentary Carbon Monoxide Group (APPCOG), COMed brings together a range of medical and healthcare professionals to advise policy makers on CO matters, and demonstrate and develop best practice in the healthcare sector.  COMed thereby contributes to APPCOG’s work to reduce deaths and injuries from carbon monoxide (CO) poisoning through informing and influencing policy makers in parliament and government. 

It might be helpful also if I were to make clear that COMed has no authority to provide advice to individuals or make referral recommendations. 

COMed Work:

COMed has been in existence since 2013. Since then we have gathered evidence to support the publication by of a number of APPCOG reports into the effects of CO in order to raise awareness amongst policy makers of the impact of CO on people’s lives and hence of the importance of better research, diagnosis and treatment.

In 2015 the APPCOG published Carbon Monoxide: from Awareness to Action and last year, in October 2017, published a follow-on report Carbon Monoxide Poisoning: Saving Lives, Advancing Treatment.  This report included a number of hard-hitting essays written by specialists across the healthcare disciplines that were currently represented on COMed.

The 26 recommendations made within the report Carbon Monoxide Poisoning: Saving Lives, Advancing Treatment are aimed at raising awareness amongst policy-makers and healthcare professionals: stimulating the provision of appropriate resources, encouraging greater collaboration, and strengthening the evidence base on CO poisoning.  Following the launch of the report (which I recall you attended) the APPCOG and COMed have raised awareness of the report’s recommendations through engagement with policy makers, from the Secretary of State for Health and Social Care, the Chief Medical Officer, to Public Health England.  Work has also been carried out within the healthcare sector to take forward relevant recommendations.

COMed is very sympathetic to your concerns that healthcare professionals are not sufficiently aware of the risk and possibility of CO poisoning.  The inquiry specifically sought to address whether there is an institutional lack of awareness of CO poisoning amongst healthcare professionals because it is considered rare, or due to a lack of training, and to explore the barriers to making a correct diagnosis.  The essays in the report address these issues and the report includes three recommendations that COMed believes are particularly relevant to the concerns you raised in your note.  These, together with some of the progress as a result of COMed work, are set out below:

Recommendation 1.  The Residential Inspection Aid on Carbon Monoxide, produced by Public Heath England and the Chartered Institute of Environmental Health, should be reviewed in line with the current evidence base and be externally validated. The Aid should be made accessible to environmental health professionals and all those involved in carrying out housing inspections and assessing housing standards.

Recommendation 6. Paramedics and other emergency service personnel should be equipped with accurate and reliable personal CO monitors to protect themselves, and non-invasive devices to aid in patient diagnosis.

Recommendation 11.  To accelerate diagnosis of CO poisoning and the initiation of treatment, the Royal College of Emergency Medicine, the College of Paramedics and the joint Royal Colleges Ambulance Liaison Committee should lead the development of a COHb screening protocol and, with industry, a rapid standardised scene assessment procedure to determine indoor CO levels, for use by emergency service personnel and by research scientists.

COMed is in correspondence with Ministers in the Department for Health & Social Care and with PHE about these recommendations, some of which will require the provision of additional funds to take forward.

Good work is happening through COMed members on awareness raising in the healthcare sector:  the London Ambulance Service is raising awareness across front-line responders through the dissemination of a mandatory e-learning module that all London Ambulance Service clinicians will be required complete; London Ambulance Service paramedics have also been provided with an extended guide to aid the detection and recording of a CO exposure. 

COMed is also working with the Gas Safe Charity who have developed an e-learning package targeted at those who work in people’s homes and will be helping with targeted dissemination of this e-learning. Further e-learning opportunities are being discussed within other sectors.

Some local authorities and organisations have provided their fire & rescue service with CO alarms to fit in people’s homes as part of their fire safety work, and COMed will be drawing on these examples in continue to engage Ministers and the healthcare sector.  

There are also a number of recommendations in the report that specifically address the awareness of healthcare professionals in hospitals and GP surgeries, and COMed has a number of strands of action in hand to raise awareness in Emergency Departments and amongst GPs. 

I hope you are reassured by these illustrations of how COMed is helping to raise awareness amongst healthcare professionals of the dangers of CO.

With kind regards as always



Independent Consultant on Health, Policy and the Environment

Updated 29.11.18