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A silent killer that is often associated with colder weather is carbon monoxide poisoning. The leading cause of poisoning deaths in the United States, carbon monoxide is an odorless, colorless, toxic gas produced by burning any fuel. The main sources of carbon monoxide are motor vehicles, heaters and appliances that burn carbon-based fuels. Space heaters, poorly maintained chimneys and other heat sources can create a toxic buildup of the gas when its used with inadequate ventilation.

Doctor T. James Gallagher, a professor of anesthesiology and surgery and the chief of critical care medicine at the University of Florida College of Medicine, explained, "During the winter season we see a higher number of patients with carbon monoxide poisoning due to malfunctioning heating systems and the way that some people use heaters to try and stay warm. However, carbon monoxide poisoning is not only a wintertime issue. Probably the largest number of exposures are from cars. Usually, it's the last thing on someone's mind."

Carbon monoxide poisoning kills more than 3,000 people each year and sends about 10,000 more to hospital emergency rooms for treatment. Ken Giles, a spokesman for the U.S. Consumer Products Safety Commission, said, "I personally think the 3,000 figure is somewhat misleading because it includes fire-related deaths. Most people who die in fires actually die from carbon monoxide poisoning. However, carbon monoxide poisoning from the use of fuel-burning appliances does kill more than 200 people each year, and these are deaths that could be prevented with carbon monoxide detectors."

In the recent severe winter storms that caused widespread loss of power to people in Canada and the Northeast United States, more than ten people reportedly lost their lives to carbon monoxide poisoning and hundreds more thad to be treated for its effects.

According to Dr. Gallagher, anyone who doesn't feel well and who suspects exposure to carbon monoxide should seek a medical attention. He said, "Through recent studies here at UF, we have found indications that carbon monoxide can remain in the brain and tissues, affecting memory, reasoning and other brain functions, even though blood tests do not reveal abnormal levels of the gas."

The warning signs of carbon monoxide poisoning include: headaches, nausea, sleepiness, dizziness and disorientation. In high concentrations, carbon monoxide can cause loss of consciousness and death. Many victims die in their sleep.

Anyone who suspects carbon monoxide should turn off the heater or source of the gas, go outside, get fresh air and seek emergency medical assistance. When inhaled, carbon monoxide is quickly absorbed into the blood. It displaces oxygen by combining with the blood's oxygen-carrying molecule, hemoglobin, with a bond 240 times stronger than oxygen's.

Most people diagnosed with carbon monoxide poisoning are treated in a hyperbaric chamber, which helps to deliver high concentrations of oxygen to the patient. The high concentration of oxygen speeds the separation of carbon monoxide from the hemoglobin.

Statistics shows heaters are a major, though not the only, source of winter carbon monoxide poisonings. Sue Stearns, a registered nurse and certified hyperbaric technologist, says that many cases of carbon monoxide poisoning probably go undetected each year.

Stearns said, "Victims often mistake the early symptoms of carbon monoxide poisoning for something else, such as the flu."

One of the things that can save more lives each year is a $25-50 carbon monoxide detector that are now readily available. Other steps that can be taken to increase safety is having fuel-burning household heating equipment checked each year.

The National Fire Protection Agency offers these other safety tips:

- Remove vehicles from the garage immediately after starting the ignition. Do not run a vehicle or other fueled engine or motor indoors, even if the garage doors are open.

- Have your vehicle inspected for exhaust leaks if you have any symptoms of carbon monoxide poisoning.