Carbon Monoxide Exposure in Workplaces, Including Coffee Processing Facilities

Details

• Personal Author:
  Cox-Ganser, Jean M. ; Cummings, Kristin J. ; Hawley B
• Description:
  We read the recent review of carbon monoxide (CO) poisoning by Rose and colleagues with great interest. To their excellent summary we would add mention of the burden of occupational CO exposure: 13% of non-fatal carbon monoxide poisoning cases seen in U.S. emergency departments over a three-year period were exposed at work, and CO exposure is the leading cause of fatality due to acute chemical inhalation among U.S. workers. Because CO is odorless and tasteless, patients may not be aware of workplace CO exposures. Thus, it is important for clinicians to be familiar with occupational sources of CO. Occupations that are known to have greater risk of CO poisoning include jobs that require working around combustion sources like engines and fires, and include: mechanics, firefighters, longshore workers, diesel engine and forklift operators, and tunnel or toll booth attendants. Other occupations that have been largely overlooked but also carry risk for CO exposure include occupations as varied as warehouse workers, who use propane or diesel forklifts, and restaurant workers, such as charcoal meat grillers and indoor barbeque workers. People who work at coffee processing facilities that make coffee extract are also at risk of CO poisoning (5, 6). Six workers at a coffee extract facility in Japan become symptomatic after they entered or approached a tank that stored coffee extract. One of these workers died, and at autopsy was found to have a carboxyhemoglobin (COHb) level of 26%. Subsequent measurement of CO inside the storage tank showed concentrations of 10,000 to 100,000 ppm, levels at which lethal COHb saturation could be achieved in as little as a few minutes. At a coffee extract facility in the U.S., a worker who entered a storage tank collapsed and was initially resuscitated with oxygen on site; his COHb level was 27% at the hospital. CO concentration inside the tank was found to be 7500 ppm. We recently evaluated the potential for CO exposure at a coffee processing facility that makes whole bean and ground coffee rather than coffee extract. Interestingly, the biggest source of CO was not from the roaster, a combustion source, but rather from the roasted beans themselves. High CO levels were observed where coffee beans were stored or ground. Notably, grinding provides a greater surface area for the off-gassing of CO that occurs following roasting (6). We found worker personal CO exposure levels that ranged from 7 ppm to 30 ppm when averaged over a shift, with a peak CO level of 584 ppm when a worker was standing next to an open hopper of ground coffee. Although not as high as the concentrations inside coffee extract storage tanks noted above, these exposures approach or exceed the levels recommended by the National Institute for Occupational Safety and Health (NIOSH, https://www.cdc.gov/niosh/npg/npgd0105.html) and, as Rose and colleagues point out, have potential health effects. Recognizing an occupational source of CO has diagnostic and therapeutic implications for a patient with CO poisoning and provides an opportunity for prevention in co-workers. We encourage clinicians to consider workplace CO exposure when evaluating patients with symptoms and signs compatible with CO poisoning. Our data indicate that coffee processors should be added to the list of occupations at risk. [Description provided by NIOSH]
• Subjects:
  Automobiles Coffee Occupational Health Safety Vehicle Emissions
• Keywords:
  Carbon Monoxide Poisoning Coffee Workers Diesel Emissions Diesel Engines Emission Sources Motor Vehicles
• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division ; DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  196
• Issue:
  8
• NIOSHTIC Number:
  nn:20050006
• Citation:
  Am J Respir Crit Care Med 2017 Oct; 196(8):1080-1081
• Contact Point Address:
  Brie Hawley, PhD, Respiratory Health Division, National Institute for Occupational Safety and Health,1095 Willowdale Road, MS 2800, Morgantown, WV 26505
• Email:
  ygd2@cdc.gov
• CAS Registry Number:
  Carbon monoxide (CAS RN 630-08-0)
• Federal Fiscal Year:
  2018
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:df37075805953cc56bf3ad2c5d68ca140c5de66dc9d526867d3eda2ed3ed187a3da50b8abad54bdbb262f8f865f49d6a6e01ddf16f7378b0263e57c433923f3b
• Download URL:
  https://stacks.cdc.gov/view/cdc/210564/cdc_210564_DS1.pdf
• File Type:
  [PDF - 429.19 KB ]