Overview Carbon Monoxide What are the health risks Who is at risk CO in LTCFs What are the issues What is being done to address these issues CO Monitoring and Response Framework CARBON MONOXIDE ID: 913502
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Slide1
Carbon monoxide monitoring and response in long-term care facilities (LTCFs)
Slide2Overview
Carbon Monoxide
What are the health risks?Who is at risk?
CO in LTCFs
What are the issues?
What is being done to address these issues?CO Monitoring and Response Framework
Slide3CARBON
MONOXIDE
Slide4CARBON MONOXIDE
Typical sources of CO are
(but not limited to
)
:Fuel-burning (propane, oil, wood, gasoline) appliances BoilersLaundry equipment
Water heaters
Fireplaces
Kitchen equipment, gas-stoves
Generators
Exhaust from cars, delivery trucks (garages, loading bays)
A gas that you cannot see, smell, or
taste
A combustion by-product
Must
be monitored by a CO detector
Slide5CO impairs oxygen delivery to cells in the bodyBinds tightly to hemoglobin, competing with oxygen
Particularly affects high-oxygen demand organs like the heart and brain
You may not experience symptoms (or not obvious) and still be exposed to unsafe CO levelsExposure to low levels of CO for long periods
CARBON MONOXIDE
Slide6What are the health risks?If inhaled at sufficient levels, for sufficient period of time…
Slide7Who is at risk?
Everyone
, all agesResidents and staffParticularly among young, pregnant, and
elderly
Lower tolerance to CO
Individuals with chronic lung and cardiovascular conditions are more susceptibleCoronary heart diseaseRespiratory disease
Slide8Examples in the media
Regina, Saskatchewan
– Fire department and gas utility provider responded to elevated CO levels detected by security and maintenance personnel. CO levels from approx. 20 to 33 ppm were reported on all three floors of the facility.
CBC News. Carbon monoxide leak at Regina seniors residence. 2016 Available from:
http://www.cbc.ca/news/canada/saskatchewan/carbon-monoxide-regina-seniors-residence-1.3564003
Wakaw, Saskatchewan – Code brown (hazardous releases) activated in response to elevated CO levels detected in a boiler room and service wing; three staff and one resident reported feeling unwell.
Giles, D. ‘Code Brown’ alerts staff to CO leak at care home. 2013. Available from:
http://globalnews.ca/news/771806/code-brown-alerts-staff-to-co-leak-at-care-home/
Slide9CO IN LTCFs
Slide10Background
CO incident in Humboldt, Saskatchewan, 2010
Staff and residents were exposed to CO from an improperly ventilated appliance in a long-term care facility
Resulted in evacuation of one wing
Contributed to 3 deaths
Slide11CO is colourless, odourlessCan only be detected through monitoring
CO detectors are not routinely required to be installed, especially in older buildingsInitial symptoms may be non-specific
mimic other diseases (especially low-level exposure)
What are the issues?
Slide12CO detectors do not alarm or notify at low levels They are designed to prevent CO poisoning
(acute, high level exposure) and are not designed to prevent
sub-acute exposures*Installation of CO detectors alone is
not enough
to mitigate this risk
Residents at long-term care facilities may have conditions which make them more susceptible to the effects of low-level CO exposure (10-25 ppm)
What are the issues?
Slide13What is being done to address CO risks in LTCFs?
Saskatoon Heath Region (SHR) has developed and implemented a CO monitoring, reporting, and response framework in their LTCFs
Adopted by the province of Saskatchewan in 2014
Health Canada, BC Centre for Disease Control, and National Collaborating Centre for Environmental Health were involved in evaluating the CO framework and promoting the implementation of the
CO Monitoring and Response Framework
in LTCFs.This work is built upon a stakeholder consultation meeting in 2013 to promote the development of a health-protective CO management framework that incorporates education, monitoring, prevention, and mitigation, with practical means to support program implementation and evaluation.
Slide14CO MONITORING AND RESPONSE FRAMEWORK
Slide15Objectives
Implement a health-protective CO management framework
that incorporates education, monitoring, prevention, and mitigation Enhance the capacity of health regions and LTCFs
to prevent and reduce CO exposure in LTCFs
Reduce the risk of harmful CO exposure
among residents and staff
Slide16EDUCATION
Increase staff awareness
of CO health effects, sources, and importance of monitoring
Train staff
on established CO monitoring and response protocols
Slide17MONITORING
Develop protocols
for CO monitoring
Installation of CO detectors near sources of CO
Identify all potential sources
Daily monitoring and recording of detector readings (instant and peak level)
Identify elevated CO levels (>10 ppm)
Slide18REPORTING
Data to be recorded on weekly log
Facility Maintenance personnel
Other team members as required for coverage when Facility Maintenance not available
Submit weekly logs on a monthly basis to regional management
Retention of monitoring records for 12 months
Slide19PREVENTION AND MITIGATION
Develop resources related to identification and maintenance of CO sources
Maintenance plans, schedules, etc.Perform routine maintenance on combustion appliances
Establish protocols for
responding to elevated CO levels
Respond to elevated readings or alarmsInvestigate potential sources, procedures in placeMount instructions by all CO monitors Familiarize staff with procedures, including actions taken depending on level of CO
Slide20Resources
BC Safety Authority
Licensed gas fitters in BChttp://safetyauthority.ca/contact/find-contractor
Health Canada Residential Indoor Air Quality Guideline for Carbon Monoxide:
http://healthycanadians.gc.ca/publications/healthy-living-vie-saine/carbon-monoxide-carbone/index-eng.php
US EPA CO fact sheets (information for older adults and their caregivers)http://www2.epa.gov/healthresearch/aging-factsheets-carbon-monoxide-poisoning-prevention