Diagnosing carbon monoxide (CO) poisoning is notoriously difficult, as it produces common, non-specific symptoms such as headaches and nausea and mimics other, more common ailments such as flu and food poisoning. Accidental CO poisoning is considered rare, but it is likely not to be as rare as people think and it is preventable.

CO is a poisonous gas that you cannot see, smell or taste. This makes it difficult for those exposed to know a) that they have been poisoned and b) what they have been poisoned by. A healthcare professional is likely to be one of, if not, the first person to be approached by someone suffering from CO poisoning and making an accurate diagnosis is important to prevent further exposure.

The most commonly used biomarker associated with the identification of exposure to CO, carboxyhaemoglobin, is now considered less useful than previously thought and cases of exposure are being missed. The need to identify new biomarkers has been suggested: biomarkers that will ultimately assist clinicians in making a diagnosis of CO poisoning and help them in their assessment of patient outcome and referral decisions.

In response to this, on 7 September 2017, the Gas Safety Trust, supported by the British Toxicological Society held a workshop in central London, Chaired by Baroness Finlay of Llandaff and attended by clinicians and toxicologists working in this area.

Attendees considered current research into new biomarkers, what lessons could be learnt from similar areas of research and how we might explore and challenge thinking, to answer questions relating to the neurological effects associated with CO exposure.

Baroness Finlay of Llandaff said: “The outputs and recommendations from this meeting will help clinicians and researchers. And they will guide the many different Government Departments and Agencies involved in the prevention and treatment of CO poisoning. Evidence to inform guidance and regulation depends on realising the extensive effects of CO.

This workshop has stimulated fundamental research. The findings will feed into better guidance and may reveal far wider harms from low-level exposure than previously thought.

Accidental CO poisoning is a modifiable risk factor, which, if implicated in the occurrence or progression of other diseases, could present itself as a monumental risk to public health.”

Chris Bielby, GST Chair said: “The Gas Safety Trust is committed to supporting the improved diagnosis and treatment of CO poisoning. We were pleased to be able to convene this group of experts to discuss this important issue and how we improve diagnosis.

"What is emerging from other research we are funding is that incidents are being missed and that people may be being poisoned at lower levels for extended periods of time without knowing it. I am optimistic that improved biomarkers will ensure those people are identified sooner.”