Numbers affected by CO+

  1. Summary – Numbers affected

It’s virtually impossible to know how many people are affected even in the UK, even by CO, let alone CO+ (i.e. CO and/or the other products of combustion see https://www.co-gassafety.co.uk/about-co/other-toxins/) because of the lack of monitoring or testing for CO.

Impact – could be 3-5 million people affected or even more.

Research commissioned from University College London, published in a press release dated 02.10.06 by HSE, (click here) to inform its gas safety review highlights the dangers of CO poisoning in people’s homes, coupled with a lack of public awareness of the risks.

The early findings of the research include:

* 23% of homes had one or more defective gas appliance;

* 8% of homes were judged to be at risk of dangerous levels of CO;

UCL’s report

Ben Croxford’s report found that 50 out of 270 homes (18%) had levels of CO, which exceeded the WHO 8-hour average guidelines of 9 ppm. Of this 50, 26 (9.4%) exceeded the WHO 1-hour level (26ppm) and 10 (3.6%) exceeded the WHO 30-minute guideline value of 52ppm.

Nearly one in five had levels of CO, which exceeded the WHO 8-hour average guideline value (9ppm), nearly one in ten had levels of CO, which exceeded the WHO 1-hour average guideline value (26ppm) and nearly one in twenty-seven had levels of CO, which exceeded the WHO 30-minute guideline value of 52ppm.

Note https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/families/bulletins/familiesandhouseholds/2017 In the UK there were 27.2 million households in 2017, resulting in an average household size of 2.4.27 million times 2.4 = 64,800,000. 8% of 64,800,000= 5,184,000 so 5 million people.            

  • 45% of homes had received no information on the dangers of CO; and
  • A higher prevalence of problem appliances was found in the homes of vulnerable people (young, old, those in receipt of benefits).

Further research with similar findings has been undertaken by John Moore’s university (http://www.ljmu.ac.uk/NewsUpdate/index_123350.htm But this link doesn’t seem to work anymore so see https://www.emeraldinsight.com/doi/full/10.1108/SASBE-07-2013-0041) More than 27, 000 properties were visited. We have been trying for some years to obtain the original research and also an update.

The All-Party Parliamentary Carbon Monoxide Group strongly supports the inclusion of carbon monoxide poisoning as a high risk. The All-Party Parliamentary Carbon Monoxide Group’s inquiry ‘Preventing Carbon Monoxide Poisoning’, heard evidence that carbon monoxide poisoning causes 50 deaths a year (revised to 40 in the latest report by the Cross Government Group on Gas Safety and Carbon Monoxide Awareness), 200 serious injuries, and 4000 minor injuries – which costs the Department for Health in England and Wales approximately £178m a year in medical and care costs, as well as creating immeasurable human suffering.

Furthermore, it is thought that the number affected by CO poisoning is considerably higher – a study conducted by Liverpool John Moores University in 2011 measured CO levels in 109 homes over a number of weeks: it found that 24 homes had CO levels greater than 50 ppm (parts per million) – a level in which symptoms of poisoning, such as headaches, tiredness, and drowsiness can be experienced. A further 53 homes contained CO levels between 10 and 50 ppm see link to

‘Investigation of audible carbon monoxide alarm ownership’

https://www.emeraldinsight.com/doi/full/10.1108/SASBE-07-2013-0041

CO-Gas Safety states:- This article https://www.emeraldinsight.com/doi/full/10.1108/SASBE-07-2013-0041 published in 2014 refers to the study done by John Moores Liverpool University in 2011-12 at 81.

‘Stage two fitted 173 homes with Lascar EL-USB data loggers. There were 109 properties in Liverpool with 73 homes in deprived areas and 36 in non-deprived areas. In Coventry 64 homes were targeted but these homes had not had a HFSC (Home and Fire Safety Checks) conducted. 40 were in deprived areas and 24 from non-deprived areas. The monitoring period ran from November 2011 until the following spring.

Homes equipped in Liverpool had been through the HFSC (Home and Fire Safety Check) in stage 1. However, homes that received a data logger in Coventry had not been assessed by a HFSC.

‘Approximately 29 per cent in Liverpool and 39 per cent of properties in Coventry had readings less than 10 Parts Per Million (PPM). According to WHO guidelines (see more about these further on) residents could stay in the property for eight hours before beginning to feel the effects of CO poisoning. In total 48 and 42 per cent of homes monitored in stage 2 in Liverpool and Coventry respectively had CO readings between 11 and 49 PPM; WHO guidelines recommend that residents would have between 30 and 60 minutes before they begin feeling the effects of CO. Lastly 22 percent and 18 per cent had dangerous readings of over 50 PPM, which would result in the effects of CO poisoning to manifest within 15 minutes of being indoors.’

It seems helpful to average the percentages of Liverpool and Coventry.

We refer to ‘In total 48 and 42 per cent of homes monitored in stage 2 in Liverpool and Coventry respectively had CO readings between 11 and 49 ppm; WHO guidelines recommend that residents would have between 30 and 60 minutes before they begin feeling the effects of CO.’

The average of 48 and 42% = 45% had CO readings between 11 and 49 PPM, which according to WHO guidelines mean that residents would have between 30 and 60 minutes before they begin feeling the effects of CO.

We refer to, ‘Lastly 22 percent and 18 per cent had dangerous readings of over 50 PPM, which would result in the effects of CO poisoning to manifest within 15 minutes of being indoors.

The average of 22% and 18% = 20% had readings of over 50 PPM, which would result in the effects of CO poisoning to manifest within 15 minutes of being indoors.  

Note https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/families/bulletins/familiesandhouseholds/2017 In the UK there were 27.2 million households in 2017, resulting in an average household size of 2.4.

27 million times 2.4 = 64,800,000.

45% of 64,800,000 i.e. nearly 65 million people in the UK = 29,160,000 so 29 million being exposed to CO by between 11-49 PPM for eight hours.

20% of 64,800,000 = 12,960,000 i.e. nearly 13 million people in the UK being exposed to dangerous readings of over 50 PPM, which would result in the effects of CO poisoning to manifest within 15 minutes of being indoors.

In total this is 42 million people in the UK could be being exposed to CO in levels far greater than those recommended by the World Health Organisation and as a consequence significant numbers, running into millions some of whom will as a result of this exposure eventually suffer chronic ill health.

https://www.ljmu.ac.uk/about-us/news/life-saving-research-into-carbon-monoxide 12.03.2015 The research above was of huge concern but it was looking at relatively small numbers. Obviously a larger study would assist so the charity was delighted to read from the link above that this was planned. ‘The Gas Safety Trust (GST) also awarded a grant to LJMU to expand the study from two city centres to five counties by partnering with five Fire and Rescue Services, Merseyside, Cornwall, Bedfordshire, West Midlands and Oxfordshire. The funding is also supported by an in-kind contribution from the Council for Gas Detection and Environmental Monitoring (CoGDEM) whose members have supplied CO alarms and data loggers to undertake a comprehensive CO investigation covering 75,000 households.’

That was five years ago – where is this research?

Stephanie Trotter brought this up at an APPCOG stakeholder meeting on 10.03.20 but didn’t really follow the response. However, in the minutes it was reported that Chris Bielby stated that progress was being made but it was not yet ready for publication. Considering the serious implications of the existing small studies, we continue to lobby for this study to be finished and to be published.

We have since been told that this study has not been undertaken due to cut backs in the fire service. We are deeply disturbed that this did not seem to be revealed until we questioned this and pursued it. We also consider that due to these avoidable delays and lack of transparency, action should be taken now to remedy the continuing trauma suffered by people who are continuing to be poisoned and/or unable to prove poisoning. Therefore we are lobbying HSE, Ofgem and government to insist that the original recommendation made by HSC/E in 2000, that the gas emergency service should carry and use equipment to test gas appliances for CO, be implemented. We are also lobbying for any CO found to be recorded and for the parts per million of CO where found to be given in writing to those survivors and their families.

It seems from the research that high levels of CO are widespread in the UK. Symptoms of CO are similar to those of any virus, including Covid-19. Therefore the charity considers that the gas emergency service should action testing of emissions of gas appliances for CO and for the air in the house or workplace, by autumn and winter 2020.

  1. WHO guidelines for indoor air quality: selected pollutants 15.12.10

ISBN 978 92 890 0213 4

See page 70 second para from the bottom.

‘Walker (130) states that the incidence of chronic carbon monoxide exposure in Great Britain is officially 200 per year, while at the same time “250 000 gas appliances are condemned annually”. He speculates that if only 10% of these appliances give off significant amounts of carbon monoxide that reach the breathing space of residents, as many as 25,000 people every year may be exposed to carbon monoxide in their homes. The carbon monoxide support study (89) found that “only one case out of 77 was correctly identified (i.e. diagnosed) on the basis of symptoms alone” and that medical professionals were the least likely group to “discover” the fact of the carbon monoxide poisoning.’

See also https://apps.who.int/iris/bitstream/handle/10665/141496/9789241548885_eng.pdf?sequence=1 at page 12, which provides a table of mean concentrations over an average time of 10, 15, 30 minutes then 1, 8, 24 hours. This was published in 2014 but refers to WHO 2010.         

Pollutant Mean concentration over averaging time
   10 min 15 min 30 min 1 hour 8 hours 24 hours 1 year
CO (mg/m3) 100   35 10 7

WHO 2010 (13)’

Using the Lenntech converter – https://www.lenntech.com/calculators/ppm/converter-parts-per-million.htm  

7 mg/m3 equals 5.68 ppm (parts per million).

Guidelines See also page 86

The 24-hour guideline

‘Chronic carbon monoxide exposure is different from acute exposure in several important respects, as noted above. Thus, a separate guideline is needed to address minimal exposure over 24 hours, rather than the 8-hour period used in the acute guidelines. The latest studies available to us in 2009, especially those epidemiological studies using very large databases and thus producing extremely high-resolution findings, suggest that the appropriate level for carbon monoxide in order to minimize health effects must be positioned below the 8-hour guideline of 10.5 mg/m3, possibly as low as 4.6–5.8 mg/m3. This is also essential since the minimal exposure time for this guideline is three times longer.’

Note to explain these levels

10.5 mg/m3 = 8.9 Parts Per Million so call it 9 PPM

4.6 mg/m3 = about 4 PPM

Extract first published in our press pack 2014 pages 6 & 7

The All-Party Parliamentary Carbon Monoxide Group strongly supports the inclusion of carbon monoxide poisoning as a high risk. The All-Party Parliamentary Carbon Monoxide Group’s recent inquiry, ‘Preventing Carbon Monoxide Poisoning’, heard evidence that carbon monoxide poisoning causes 50 deaths a year (revised to 40 in the latest report by the Cross Government Group on Gas Safety and Carbon Monoxide Awareness), 200 serious injuries, and 4000 minor injuries – which costs the Department for Health in England and Wales approximately £178m a year in medical and care costs, as well as creating immeasurable human suffering.

What is the impact on the UK population?

CO+Savi (group of victims and victim groups) suggests that the following statement(s) is/are being used instead or at least in conjunction with any existing numbers in presentations, press releases, publications, etc.

Short Version

There is currently no conclusive and comprehensive way of accurately establishing the actual number of people harmed to whatever level by carbon monoxide and other toxins (CO+ for short).

It is recognised that there are many sources of data collated over the years. However, this data is scientifically inconclusive at this point in time. We know that some people can suffer temporary illness, irreversible chronic ill health or death as a consequence of exposure to either low-level, chronic and high-level, acute CO+ poisoning. Unfortunately, we do not know how many more are affected and we have no way of objectively and responsibly estimating the true figures.

There is also a long version, which has not quite been finalised yet. When it has been finalised, we will put it on our website.

This longer version has been agreed so far between Roland Wessling and CO-Gas Safety. We hope that others will also support this.

Longer Version

Carbon monoxide and other Toxins (CO+ for short) are a by-product from burning fossil fuels as well as alternative, comparable fuels created synthetically or from renewable sources. Depending on the type and the amount of fuel burned, the effectiveness of the exhaust system, such as chimneys or extraction flues, and the quality of the burning process itself, there can be high or low quantities of CO+ produced. CO+ can harm us in different ways. It can kill in minutes through high concentration (acute poisoning), while at the other end of the spectrum, CO+ can cause illness or death slowly through low concentrations (chronic poisoning). In both cases, the general health of individuals and potential, underlying conditions may influence the impact.

In order to quantify the impact that CO+ has on a population, it needs to be recorded and the recorded data analysed. In order for it to be recorded, there need to be methods of measuring and detecting the impact of CO+ as well as a systematic application of these methods. It is recognised that there are many sources of data collated over the years, but, this data is scientifically inconclusive at this point in time. However, this data only represents one section of the true impact and we currently do not know what percentage of the true impact the existing data represents. There is currently no conclusive and comprehensive way of accurately establishing the true number of people harmed to whatever level by CO+. In other words, any existing numbers of deaths or injuries caused by CO+, only represent a currently unknown percentage of the true impact on the population.

While any activity on gathering data is positive, helpful and important, it should not inadvertently lead to the misunderstanding that any such numbers represent the true impact of CO+. And because we simply do not know how many people are currently suffering from the impact of CO+, we suggest that this statement is being used instead or at least in conjunction with any existing numbers in presentations, press releases, publications, etc.

The burning of fossil fuels and the inevitable production of CO+ is going to be part of our lives for the foreseeable future. We all benefit from the warmth, electricity and transport it creates. This makes it even more important that we handle the information about the impact of CO+ on the UK population objectively, responsibly and carefully. This statement is not designed to be alarmist. It simply promotes an honest, respectful and responsible way of informing the public about the true impact of CO+ on their lives until we have a comprehensive and conclusive way of measuring, recording and analysing data that will represent the true impact of CO.