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Killer gas that's getting away with murder

There was no more stark demonstration of the silent killer than the tragedy of Christi and Bobby Shepherd.

In October last year, a maid entered a Greek holiday apartment to find the two youngsters dead, their father and his partner slumped in a coma.

As police, baffled by the scene, began their investigations, initial rumours suggested the four from Horbury in West Yorkshire may have been poisoned by mushrooms. But the real cause lay within the bungalow at the Corcyra Hotel in Corfu, a faulty gas fired water heater which had been pumping out lethal carbon monoxide fumes, killing seven-year-old Christi and her six-year-old brother.

In wake of the tragedy, MPs demanded tighter European safeguards and the family, struggling to come to terms with their loss, gave their backing to the campaign, but despite such high profile cases, many doctors in this country remain ignorant of the symptoms.

A survey carried out by the charity Carbon Monoxide Support has shown only one out of 77 cases of poisoning was correctly identified on the basis of symptoms alone, and while 50 people each year are believed to die from breathing in the fumes, hundreds more suffer permanent neurological damage.

"The number of cases of exposure to carbon monoxide are traditionally quoted as 200 a year," says Dr Ed Walker, West Yorkshire accident-and-emergency specialist and advisor to the national group CO Awareness.

"However, annually up to 250,000 gas appliances are condemned and even if you assume that only 10 per cent of those were giving off significant amounts of carbon monoxide, it would suggest the official figures are only the tip of the iceberg.

"The reality is that the majority of case go unrecognised, unreported and untreated. There was one particularly tragic case where a family of four died overnight from a gas fire with a blocked flue.

"The old lady next door also died, but her death was put down to natural causes until someone from a support charity actually rang the local coroner and got the pathologist to specifically look for traces in her system.

"It emerged she had also been killed by the fumes, because the terraced houses shared a chimney ,and tragically, the day before they all died the mum had taken both her children to the doctors complaining of aches, pains and nausea. They were told it was a virus and to go home."

With diagnosis of CO conditions not currently included on medical teaching curriculums, Dr Walker, who is about to spearhead a national awareness campaign, says such a response is not unusual and lack of public understanding only compounds the problem.

According to a report by gas safety watchdog CORGI, Yorkshire is the worst-hit region for CO poisoning and, with people about to switch on their central heating systems, the number of cases could start to rise again,

"Throughout the world, people continue to die unnecessarily from CO exposure or are forced to live with debilitating illnesses when the cause of their symptoms are misdiagnosed", Dr Walker says.

"In one case a couple who had been feeling unwell, mainly with headaches for sometime noticed the symptoms were worse when they were in their house where they had just had a brand new oil-fired range cooker and hot water system installed.

"Things got so bad that one weekend they ended up in Accident and Emergency and specifically asked whether their symptoms could be related to CO, but the doctor assured them it wasn't because, 'You only get CO from gas fires'.

"They continued to be poisoned, albeit low-level for another two years before the faulty appliance was finally fixed. They now have long-term and probably permanent neurological damage, including short-term memory loss and poor concentration.

"While CO poisoning is usually caused by heating appliances, blocked flues, chimneys and vents, you can get CO from anything that burns, smoulders or smokes. A couple of years ago a young surfer died after he took some smouldering charcoal from his barbecue inside his tent in an attempt to keep warm overnight. It may sound like common sense, but at the moment too few people know the risks."

Earlier this year Michael Mackay died and his wife Patricia was left seriously ill after breathing in fumes at their home in Doncaster. The couple's family have called for all homes to be fitted with detectors.

While costing as little as 20, research has shown that 69 per cent of homes don't have an alarm and 42 per cent of households fail to have annual checks on appliances which could be pumping out the odourless fumes.

"The tragic thing is that because of a missed diagnosis, patients may be discharged back to the very environment which is poisoning them," says Dr Walker, who is appealing to people who think they may have suffered from CO poisoning to come forward.

"When deaths are investigated it's not uncommon to find that the victim and sometimes several members of the same family have visited a doctor in the days before death.

"Simple non-invasive testing devices could dramatically lessen the chances of such tragedies, but to achieve this we must also see increased awareness of the problem among both patients and their doctors.

"What we want is to see every A&E department and every GP surgery equipped with a way of testing patients for traces of carbon monoxide. Historically this used to mean a blood test, but in recent years there has been major developments in technology which means it can be done via a simple breath test or something called an CO-oximeter which measures traces by placing a light probe on a finger.

"Carbon monoxide is the most common toxin people encounter and doctors need to be more aware of it or these unavoidable tragedies will keep on happening."

The Symptoms

Carbon monoxide is produced when fuels such as gas, oil, wood or coal is burned. The amount of CO produced is not normally harmful but becomes hazardous when appliances are faulty or flues and chimneys are blocked

Breathing in the fumes leaves the bodies organs and cells starved of oxygen and those who suffer from anaemia, respiratory problems or heart disease are most susceptible.

Symptoms include headaches, nausea, dizziness, sore throat and dry cough. In children the symptoms are similar to those of stomach upset, including nausea and

vomiting.

More severe symptoms include fast and irregular heartbeat, hyperventilating, drowsiness and seizures.

Between 10 and 15 per cent of those who suffer severe poisoning may suffer long-term problems.

Alarms can be bought from most hardware or DIY stores and should be placed in the hallway or sleeping area.

If you think you are suffering from CO poisoning, experts recommend immediately getting out into the fresh air, ventilating the premises and contacting the doctor. If symptoms are more serious go straight to Accident and Emergency.

An annual CO awareness week will be launched at the House of Lords on October 15 followed by an even in Dewsbury Town Hall on October 19. Anyone who thinks they may have been affected by CO poisoning should email LynnCoAwareness@aol.com or visit www.co-awareness.co.uk


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