Reportable Environmental & Occupational Diseases, Poisonings & Conditions

Unvented kerosene and gas space heaters; leaking chimneys and furnaces; back-drafting from furnaces, gas water heaters, wood stoves, and fireplaces; gas stoves; generators and other gasoline powered equipment; automobile exhaust from attached garages; and tobacco smoke. Incomplete oxidation during combustion in gas ranges and unvented gas or kerosene heaters may cause high concentrations of CO in indoor air. Worn or poorly adjusted and maintained combustion devices (e.g., boilers, furnaces) can be significant sources, or if the flue is improperly sized, blocked, disconnected, or is leaking. Auto, truck, or bus exhaust from attached garages, nearby roads, or parking areas can also be a source.

At low concentrations, fatigue in healthy people and chest pain in people with heart disease. At higher concentrations, impaired vision and coordination; headaches; dizziness; confusion; nausea. Can cause flu-like symptoms that clear up after leaving home. Fatal at very high concentrations. Acute effects are due to the formation of carboxyhemoglobin in the blood, which inhibits oxygen intake. At moderate concentrations, angina, impaired vision, and reduced brain function may result. At higher concentrations, CO exposure can be fatal.

It is most important to be sure combustion equipment is maintained and properly adjusted. Vehicular use should be carefully managed adjacent to buildings and in vocational programs. Additional ventilation can be used as a temporary measure when high levels of CO are expected for short periods of time.

• Keep gas appliances properly adjusted.
• Consider purchasing a vented space heater when replacing an unvented one.
• Use proper fuel in kerosene space heaters.
• Install and use an exhaust fan vented to outdoors over gas stoves.
• Open flues when fireplaces are in use.
• Choose properly sized wood stoves that are certified to meet EPA emission standards. Make certain that doors on all wood stoves fit tightly.
• Have a trained professional inspect, clean, and tune-up central heating system (furnaces, flues, and chimneys) annually. Repair any leaks promptly.
• Do not idle the car inside garage.

The U.S. Consumer Product Safety Commission (CPSC) recommends that every home should have a CO alarm. CPSC also urges consumers to have a professional inspection of all fuel- burning appliances -- including furnaces, stoves, fireplaces, clothes dryers, water heaters, and space heaters -- to detect deadly carbon monoxide leaks. CPSC recommends that every home should have at least one CO alarm that meets the requirements of the most recent Underwriters Laboratories (UL) 2034 standard or International Approval Services 6-96 standard.

Several known species of harmful algal blooms occur throughout the world. The kind most frequently found in Iowa are called blue green algae, or cyanobacteria. Cyanobacteria occur when algae that are normally present in water grow exuberantly. Within a few days, a bloom can cause clear water to become cloudy or covered in a scum layer. The cloudy or scummy water often smells bad. Algal blooms usually float to the surface and can be many inches thick, especially near the shoreline. Blue green algae often form in warm, slow moving waters that are rich in nutrients, such as fertilizer runoff or septic system overflows. Blooms can occur at any time, but most often occur in late summer or early fall. Algal blooms can appear quickly and can last a few hours, days or weeks.

Blue green algae can produce toxins that can cause people to get sick. Not all algal blooms produce toxins, however. The IDNR's Beach Monitoring program tests the water of many of Iowa's beaches and currently also tests for the presence of some toxins caused by harmful algal blooms.

Blue green algae, or cyanobacteria, can produce toxins that can cause illnesses in people and animals. Microcystin is one of the cyabobacterial toxins that can be released from bacteria in the water during the life cycle of a blue-green algae bloom. People who accidentally swallow water or breathe in water droplets containing microcystin can develop gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. Other symptoms can include cough, runny eyes and nose, sore throat, and asthma-like symptoms. Skin rashes can also develop. In severe cases, liver failure can occur.

Suspected and confirmed cases of exposure to blue green algae (microcystin poisoning) is required to be reported to Iowa HHS by health care providers.

Iowa HHS is specifically asking health care providers to report cases that meet the following criteria:

• Gastrointestinal symptoms OR
• Respiratory symptoms OR
• Dermal symptoms OR
• Elevated serum GGT (gamma glutamyl transpeptidase)
• AND/Or a history of exposure within the past seven days to water testing positive for microcystin