Status:
Active
Health advisory:
AL180007
Date Issued:
08 Jun 2018 update to 29 March 2018
Issued by:
Dr Angie Bone, Deputy Chief Health Officer (Environment), Victoria
Issued to:
General practitioners, hospital emergency departments and the Victorian public

Key messages

  • There is an increased risk of accidental carbon monoxide poisoning from domestic gas heaters during winter.
  • ‘Open-flued’ gas heaters, especially Vulcan or Pyrox Heritage gas space heaters, should not be used until serviced and tested, due to possible unsafe levels of carbon monoxide under certain conditions.
  • Inadequate ventilation, or operating bathroom exhaust fans or kitchen range hoods while using the gas heater, can draw carbon monoxide into living areas. The risk is increased if the heater and associated components such as the flue are not regularly serviced and tested.
  • All gas heaters, especially open-flued heaters, should be serviced at least once every two years by a qualified gasfitter.
  • Test for carboxyhemoglobin levels in any cases of suspected carbon monoxide poisoning. Notify the Department of Health and Human Services on 1300 761 874 of any elevated results.
  • Doctors should exercise a high level of suspicion if similar symptoms are occurring in other members of the household, and if the patient reports feeling better when outside the house. 

What is the issue?

The use of open-flued gas heaters, especially Vulcan or Pyrox Heritage gas space heaters, may produce increased indoor carbon monoxide levels under certain conditions. The combination of inadequate ventilation, as well as operating bathroom exhaust fans or kitchen range hoods at the same time as the heater, can draw carbon monoxide into living areas. The risk is increased if the heater and associated components such as the flue are not regularly serviced.

This issue may result in an increase in visits to emergency departments or general practitioners from people presenting with health concerns about potential carbon monoxide exposure from these gas heaters.

Confirm diagnosis via a blood test and advise the Department of Health and Human Services of all elevated results.

Who is at risk?

All Victorians using open-flued gas heaters, especially Vulcan or Pyrox Heritage gas space heaters, may be at risk of increased indoor carbon monoxide levels under certain conditions. Children, pregnant women and their unborn babies, older people, and people with other chronic illnesses are at increased risk.

Symptoms

Carbon monoxide (CO) is an odourless, colourless gas that may cause symptoms including tiredness, shortness of breath, headaches, dizziness, nausea, weakness, confusion or chest pain if inhaled.

Anyone experiencing any of these symptoms should:

  • immediately turn off all gas appliances (heater, stove) and kitchen rangehood or bathroom fans
  • open the doors and windows to ventilate the area
  • leave the property, keeping the doors and windows open if possible
  • seek medical advice immediately or call the NURSE-ON-CALL on 1300 60 60 24 (24/7). In an emergency call 000. 

Diagnosis

The diagnosis can often be challenging as symptoms are similar to many other ailments that are common in winter, such as viral infections and flu. Health care workers should exercise a high level of suspicion if similar symptoms are occurring in other members of the household, and if the patient reports feeling better when outside the house.

Carboxyhaemoglobin levels and symptoms will decrease when the patient is removed from the CO source or when they receive high-flow oxygen.

The diagnosis of CO poisoning is therefore based on history and examination, in conjunction with an elevated carboxyhaemoglobin level determined by using pulse CO-oximetry and/or blood gas analysis. Measure Carboxyhemoglobin levels in any case of suspected CO poisoning when the patient is first seen.

Notify the Department of Health and Human Services on 1300 761 874 of any elevated results.

Recommendations

People with an open-flued heater should:

  • limit use and use alternative heating if possible; do not bring outdoor appliances inside such as a patio heater or barbeque. This is dangerous and could also lead to carbon monoxide poisoning
  • not use Vulcan or Pyrox Heritage space heaters until the units have been service by a qualified gasfitter. See the Energy Safe Victoria website for specific information about these heaters
  • replace all open-flued heaters with a room sealed gas heater or split system at the next opportunity
  • continue to service all gas heaters at least once every two years irrespective of make or model
  • be aware of the symptoms of carbon monoxide exposure and seek medical attention if necessary
  • consider buying an audible carbon monoxide alarm that meets US or EU standards (see below) 
  • check on neighbours, family and friends that they are aware of the safety precautions around potential carbon monoxide poisoning from open-flued gas heaters, and are able to use safe alternative heating sources.

To check whether you have an open-flue heater, contact the manufacturer for advice or check with your local gasfitter.

If you are considering purchasing one or more audible carbon monoxide alarms:

  • select alarms that meet US or EU carbon monoxide standards, including recommendations for use and installation. To identify these alarms, either the packaging or the alarm will indicate that it complies with one of the following standards:
    • UL2034 (US) or
    • EN50291 (EU)
  • select audible alarms that indicate when the sensor has expired
  • while these alarms may provide some indication of gas levels, their readings are limited to the location where the sensors are placed, as levels elsewhere in the room may vary.

Follow the manufacturer’s instructions provided on installation, maintenance and use.

Carbon monoxide alarms can be a useful back-up precaution, but should not be considered a substitute for the proper installation and maintenance of gas heating appliances.

Regular maintenance of gas heating appliances (every two years) is the best way to reduce the possibility of carbon monoxide poisoning in your home. For more information visit the Energy Safe Victoria website.

More information

Clinical information

Information about diagnosing carbon monoxide poisoning

Consumer information

Better Health Channel Gas heating - health and safety issues

Energy Safe Victoria: Program in place to address CO risk in Heritage gas heaters

Contacts

Clinicians should notify the Department of Health and Human Services on 1300 761 874 of any cases of confirmed carbon monoxide poisoning.

DHHS housing tenants can contact the department’s Housing hotline on 1800 148 426 for more information.

Other consumers with a Pyrox or Vulcan Heritage gas heater should call the manufacturer, Climate Technologies on (03) 8795 2462.

Anyone experiencing symptoms that may be due to carbon monoxide exposure should seek medical advice or call the NURSE-ON-CALL on 1300 60 60 24 (24/7). In an emergency call 000.

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