Carbon monoxide hazards in rural Alaskan homes.

Alaska has the highest age-adjusted death rate from unintentional carbon monoxide poisoning in the nation. We conducted a study in five villages to determine carbon monoxide levels and sources. Nearly 10% (10/105) of the homes had elevated levels. Improperly vented propane Paloma water heaters were most commonly responsible and produced the highest levels of carbon monoxide. Other sources were leaking pipes from wood stoves and stoves that had been left on for several hours. We recommend that Paloma water heaters not be used where freezing temperatures create a risk for carbon monoxide poisoning, fires, and explosion. Safety education campaigns should note the risks of Paloma water heaters and defective stove pipes, and the need for increased kitchen ventilation during prolonged cooking. Medical workers need to be informed of the prevalence of carbon monoxide exposures. Homeowners can install carbon monoxide detectors, although expense and false alarms remain barriers to their use.