CO Research Trust                            AIR0009

 

Written evidence submitted by CO Research Trust

Outdoor and Indoor Air Quality Targets Consultation

Dear Sir / Madam

As the CEO of the CO Research Trust, I am responding to the Environment Audit Committee’s “Outdoor and indoor air quality targets” and providing our views on the adequacy of current measures to promote indoor and outdoor air quality.

 

The CO Research Trust is a registered charity, established in 2005. The objective of the charity is to reduce the incidents of death and serious injury from carbon monoxide (CO) exposure.  We do this by funding evidence-based research relating to CO exposure, the outcomes of which we make freely available to policymakers, campaigning organisations, and those seeking to raise awareness amongst the public.

 

Our interests and expertise are in the prevention of CO exposure through the funding of research and data collection to build the evidence base to inform policy makers, industry, healthcare professionals and other key stakeholders. You can read more find out more about the research we support on our website:- www.coresearchtrust.org

 

CO is a colourless, tasteless, odourless, non-irritating gas produced as a by-product during incomplete combustion of fuels due to there being insufficient oxygen present. Complete combustion occurs when sufficient oxygen is present and leads to the production of carbon dioxide.

 

Given our interests and expertise, we have restricted our comments to carbon monoxide, in response to the following key question:-

 

What are the long-term health impacts of indoor air pollution?

 

It is accepted that the inhalation of carbon monoxide is damaging to health, with the effect upon cardiovascular (1-3), neurological (4-7) and mitochondrial function (8, 9) being well-documented.

 

Furthermore, pregnant women (10-11), children (12) and the unborn (13, 14) are especially vulnerable to its effects.

 

The threshold at which elevated carboxyhaemoglobin causes drowsiness has been placed as low as 3.4 per cent (15) with recent studies showing that lower levels have an effect on brain function (16).  3.4 per cent correlates to approximately 20ppm ambient CO (17).

 

Given this evidence which suggests that even low-level CO exposure may cause significant health and educational outcomes, we believe that a significant public health intervention is required.

 

This would fulfil Marmot Policy Objective 6: strengthening the role and impact of ill-health prevention (18), cited in the UK Government policy document, ‘Health disparities and health inequalities: applying All Our Health” (19). This also concurs with the 2019 NHS Long Term Plan (20).

 

Thank you for the opportunity to respond to this consultation, if you require any further information, please do not hesitate to contact me by email.

 

With kind regards

 

Adrian McConnell

Chief Executive

CO Research Trust

 

 

May 2023

References

 

  1. Misztal T, Rusak T, Tomasiak M. Peroxynitrite may affect clot retraction in human blood through the inhibition of platelet mitochondrial energy production. Thrombosis Research (2014) 133 (3) 403-411. doi: 10.1016/j.thomres.2013.12.016

 

  1. Dallas ML, Yang Z, Boyle JP et al. Carbon monoxide induces cardiac arrhythmia via induction of the late Na+ current. Am J Respir Crit Care Med. (2012) Oct 1;186(7):648-56. doi: 10.1164/rccm.201204-0688OC

 

  1. Meyer G, André L, Tanguy S, et al. Simulated urban carbon monoxide air pollution exacerbates rat heart ischemia-reperfusion injury. Am J Physiol Heart Circ Physiol. (2010) May;298(5):H1445-53. doi: 10.1152/ajpheart.01194.2009

 

  1. Thom SR, Bhopale VM, Han ST, Clark JM, Hardy KR. Intravascular neutrophil activation due to carbon monoxide poisoning. Am J Respir Crit Care Med. (2006); 174:1239–48. doi: 10.1164/rccm.200604-557OC.

 

  1. Thom SR, Bhopale VM, Fisher D, er al. Delayed neuropathology after carbon monoxide poisoning is immune-mediated. Proc Natl Acad Sci U S A. (2004);101(37):13660-13665. doi: 10.1073/pnas.0405642101

 

  1. Ning K, Zhou YY, Zhang N, et al. Neurocognitive sequelae after carbon monoxide poisoning and hyperbaric oxygen therapy. Med Gas Res. (2020);10(1):30-36. doi: 10.4103/2045-9912.279981

 

  1. Pepe G, Castelli M, Nazerian P, Vanni S, Del Panta M, Gambassi F et al, Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study. Scand J Trauma Resusc Emerg Med. (2011) Mar 17;19:16. doi: 10.1186/1757-7241-19-16.

 

  1. Alonso JR, Cardellach F, López S, Casademont J, Miró O. Carbon monoxide specifically inhibits cytochrome c oxidase of human mitochondrial respiratory chain. Pharmacol Toxicol. (2003) Sep;93(3):142-6. doi: 10.1034/j.1600-0773.2003.930306.x.

 

  1. Queiroga CS, Almeida AS, Vieira HL. Carbon monoxide targeting mitochondria. Biochem Res Int. (2012); 2012:749845. doi: 10.1155/2012/749845.

 

  1. Grippo A, Zhang J, Chu L et al. Air pollution exposure during pregnancy and spontaneous abortion and stillbirth. Rev Environ Health (2018) Sep 25;33(3):247-264. doi: 10.1515/reveh-2017-0033. PMID: 29975668; PMCID: PMC7183911.

 

  1. Friedman P, Guo X, Stiller R et al. Carbon Monoxide Exposure During Pregnancy. Obstet Gynecol Surv (2015) Nov;70(11):705-12. doi: 10.1097/OGX.0000000000000238. PMID: 26584719.

 

  1. Macnow T, Waltzman M. Carbon Monoxide Poisoning In Children: Diagnosis And Management In The Emergency Department. Pediatr Emerg Med Pract. (2016) Sep;13(9):1-24. Epub 2016 Sep 2. PMID: 27547917.

 

  1. Levy R. Carbon monoxide pollution and neurodevelopment: A public health concern. Neurotoxicol Teratol. (2015) May-Jun;49:31-40. doi: 10.1016/j.ntt.2015.03.001.

 

  1. Benagiano V, Lorusso L, Coluccia A et al. Glutamic acid decarboxylase and GABA immunoreactivities in the cerebellar cortex of adult rat after prenatal exposure to a low concentration of carbon monoxide. Neuroscience. (2005);135(3):897-905. doi: 10.1016/j.neuroscience.2005.06.058.

 

  1. Wright G, Randell P, Shephard R, Carbon Monoxide and Driving Skills, Archives of Environmental Health: An International Journal, (1973) 27:6, 349-354, doi: 10.1080/00039896.1973.10666400

 

  1. Wilson L & Herigstad M.  Impact of carbon monoxide on neural activation during a reaction time task, Pre-Print, Sheffield Hallam University (2023)

 

  1. Fife C, Otto G, Koch S et al. A Noninvasive Method For Rapid Diagnosis Of Carbon Monoxide Poisoning. The Internet Journal of Emergency and Intensive Care Medicine (2000) Volume 5 Number 2. Available at: https://ispub.com/IJEICM/5/2/3479, accessed 20.02.23

 

  1. Marmot, M. Fair society, healthy lives : the Marmot Review : strategic review of health inequalities in England post-2010. (2010) ISBN 9780956487001

 

  1. Office for Health Improvement and Disparities. Health disparities and health inequalities – applying All Our Health. Available from: https://www.gov.uk/government/publications/health-disparities-and-health-inequalities-applying-all-our-health, accessed 20.02.23

 

  1. NHS. The NHS Long Term Plan (2019). Available from: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf, accessed on 20.02.23