Adrian McConnell, Chief Executive, the CO Research Trust
Following our brand re-launch in 2021, what we heard from our stakeholders and colleagues was the clear intention to work collaboratively to move the knowledge, understanding and awareness of carbon monoxide (CO) forward.
Throughout 2022 our clear focus has been to facilitate this collaboration by delivering events and promoting open dialogue between interested groups. In January we resumed our lecture series. These are monthly events which provide the opportunity to share key findings of projects. They are open to everyone, and we have been delighted to see how the number of attendees has increased throughout the year.
We kicked off In January with Euan Sandilands, Director of the Edinburgh unit of the National Poisons Information Service. Euan presented the findings of the study looking at the “Health impact of CO poisoning in the UK: a study of CO exposures reported by healthcare professionals to the UK NPIS”.
While this is part of an ongoing four-year project, they found that unintentional CO exposures in the UK commonly occur in domestic settings. Although they are generally of low severity, fatalities continue to occur. It also found that while Carboxyhaemoglobin measurement is important to confirm exposure, further work is required to assess its validity as a prognostic indicator in CO exposure.
This was followed by a presentation by Isabella Myers in February, who talked about “The Medical Examiner - closing the loop on CO data.” The presentation focused on the introduction of the new Medical Examiner role in the coronial system at post-mortem in England and Wales. Collecting information on deaths related to CO poisoning has been a challenge for many years. There is an opportunity with this new role to collect better data.
Following on from the theme of better data collection, Professor Heather Jarman presented the EDCO study in March’s lecture. The EDCO study looks to understand the diagnosis of CO exposure in emergency departments.
The aim of this research has been to reduce the misdiagnosis of CO poisoning so that patients can be treated appropriately and not sent back to the site of exposure before it is safe to do so.
This is also part of a longer-term project. It is hoped the findings will go some way to establishing a more accurate estimate of the prevalence of CO poisoning in the UK. We also hope it will contribute towards improving diagnosis and treatment for those affected by CO poisoning.
In April we heard from Dr Sophie Duggan, who has now completed a preliminary study into CO levels within passenger vehicles. The study was set up by Dr Duggan after her own car exposed her family to CO fumes.
Unbelievably, to date, no comparable study has been published within the UK. While Dr Duggan’s study included a small sample, the findings were very concerning. The results showed that from a sample size of 32 cars, 19 showed signs of CO leakage into the passenger cabin. We are now looking at ways to take this work forward.
Following our lecture series, we reviewed our grant funding process to include a sandpit-style event ahead of the application process. This was launched at our first-ever face-to-face Research Conference, which took place in London in July 2022.
During the 2-day event, over 75 researchers, academics, charities, first responders and many others, got together to hear about the latest research findings, delivered by experts in the field of carbon monoxide research.
We are thankful for so many of these people giving their time freely to share their progress. The Sandpit event took place on day two of the conference and was facilitated by external experts. The focus of this event was to look at three of the key areas in CO research, improving diagnosis, treatments and therapeutics, and the effects of CO on vulnerable groups.
We have subsequently received several excellent grant applications for projects focusing on these areas. The next round of grant awards will be announced in March 2023.
Our lecture series resumed in October, with the presentation of some groundbreaking research into a possible new biomarker for the diagnosis of CO poisoning. PhD student Sean England from the University of Hertfordshire presented his project on Pupillometry.
Pupillometry is the measurement of pupil size and reactivity. It is a key part of the clinical neurological exam for patients with a wide variety of neurological injuries. Sean’s work is providing compelling evidence that pupillometry could provide the much-needed breakthrough to find a reliable biomarker for CO exposure. We look forward to hearing more from Sean in 2023, as the project progresses.
In November we heard from Hilary Wareing, Director of IPIP, a consortium of public health practitioners. This project looked at the effect of CO exposure on the unborn child. The findings of this project were alarming. The fetus in utero is extremely vulnerable to carbon monoxide exposure. Chronic exposure can cause disproportionate harm to the fetus, placing them at greater risk of damage than the mother.
This project found that due to multiple causes, there is a significant public health concern relating to the lack of awareness around the exposure of unborn children to CO, among both pregnant women and midwifery staff. There are no clear protocols or treatment pathways to identify those who are in danger of harm.
This is a critical area of research which has identified the potential risk to thousands of unborn children. The research calls for several changes to be made and has identified some key actions. We will continue to work towards raising awareness of these issues into 2023.
Our final lecture of the year was given by first-year PhD student Lucie Wilson, whose project is looking at ‘The impact of low-level CO exposure on the brain’. Whilst plenty of research exists on the impact of acute, high-level CO exposure in humans, the effects of low-level exposure remain largely unexplored.
Most individuals are exposed to ambient levels of CO every day. Relatively low exposure levels (6 ppm) have been linked with cardiovascular diseases, such as stroke and heart disease. Levels of only 3 ppm have been sufficient to cause neuromuscular changes in humans.
Lucie’s project is using Magnetic Resonance Imaging (fMRI) and Transcranial Doppler Ultrasound (TCD) techniques on healthy adult volunteers who are exposed to low levels of CO. It is hoped that this project will address the many gaps in knowledge in this area. We look forward to hearing more from Lucie throughout 2023 as the project progresses.
In November we were delighted to support #COAW once again, which this year was able to celebrate the major step forward with the changes to CO alarm requirements. We hope this contributes to an increase in CO safety and awareness.
Looking back at 2023, we have seen many developments in terms of research projects and activities that we have delivered to support them. Our team has grown to allow us to deliver more, and we have some exciting plans for 2023.
However, we can’t look back at 2022 without mentioning the devastating loss of our former Chair, Chris Bielby MBE. Chris passed away on Friday 22nd July. He had been diagnosed with Motor Neuron Disease and had faced this terrible condition with great stoicism, bravery, and dignity.
Chris spent his whole career in the gas industry, advancing steadily through the ranks, with safety being the common thread of all his work. He was our Chair for more than ten years, remaining an active contributor despite his illness.
His commitment to improving the industry he devoted his professional life to was second to none. I know he was proud of how far we have come in moving forward our understanding of CO. I speak for all of us at the CO Research Trust when I say thank you for everything you did Chris, we will miss you.
I would like to thank Baroness Finlay, who has stepped into the role of Chair of the Board of Trustees and has provided us with tremendous advice and leadership. We are so lucky to be supported by a Board of Trustees, whom each brings with them tremendous knowledge, experience, and expertise in their respective areas.
As we look towards 2023, we have a lot to be excited about.
Merry Christmas all.
Adrian McConnell
Chief Executive, the CO Research Trust.