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Am J Med Sci. 2010 Nov;340(5):427-8. doi: 10.1097/MAJ.0b013e3181ef712d.

Recurrent carbon monoxide poisoning from cigarette smoking.

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Department of Internal Medicine, Riverside Methodist Hospital, Columbus, Ohio 43214, USA.


Carbon monoxide intoxication remains a major cause of morbidity and mortality in the United States with an estimate of 50,000 cases annually in emergency departments nationwide (Weaver, N Engl J Med. 2009;360:1217-25). Sources of carbon monoxide most often include car exhaust, malfunctioning heating systems and inhaled smoke. It has been well established that there is a dose-dependent increase in carboxyhemoglobin (COHb) concentration with tobacco use. It is generally accepted that heavy smokers have COHb levels <10% to 15% (Ernst and Zibrak, N Engl J Med. 1998;339:1603-8). The authors report a 48-year-old woman with significant tobacco abuse who presented with COHb levels as high as 24.2% in the face of tobacco use.

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