Validation of the end-expired method for measuring carboxyhaemoglobin levels for the use in occupational and environmental exposure studies

Abstract

Carbon monoxide is one of the most common toxins encountered in work settings, the gas being emitted in situations where there is incomplete combustion of carbon-containing substances. Its acute and chronic health effects have been well-documented. While identification of dangerous situations and evaluation of control measures are conducted by environmental monitoring, the body burden due to inhalation of carbon monoxide is measured by an individual's blood carboxyhaemoglobin level. Carboxyhaemoglobin level can be measured directly from a blood sample or, indirectly, by measuring the end-expired carbon monoxide level and using the charts provided to read the corresponding carboxyhaemoglobin level. As the end-expired method is not an intervention method, and is therefore easy to conduct, it is being used widely in epidemiological studies and it could also be used for individual measurements. This study presents a better statistical method for validating the end-expired method than the correlation method used and described in previous studies.

The measurement of endogenous carbon monoxide production

“…Permutt and Pearse (20) have discussed some of these errors that occur when the expired [CO] measurement is made in patients with lung diseases. Expired [CO] correlates with blood COHb levels (16,23,30); thus an expired [CO] measurement likely produces the same information as obtained from a blood COHb measurement.…”