Clearing the air: The quiet dangers of carbon monoxide

An estimated 414 Canadians died of carbon monoxide poisoning between 2000 and 2007, according to statistics provided by provincial coroners and compiled by The Canadian Press. Hundreds more are treated each year for exposure to the colourless, odourless gas.

A family's tragedy sheds light on treatment and prevention issues

There was no way Const. Laurie Hawkins should have been alive.

When her police colleagues kicked down the front door of her Woodstock, Ont., bungalow last December, they got a tragic snapshot of a family killed three days earlier from carbon-monoxide poisoning.

Const. Laurie Hawkins, second right, is pictured with her daughter Cassandra, husband Richard Hawkins and son Jordan. (Handout/Canadian Press)

The petite, 41-year-old Ontario Provincial Police officer lay in her underclothes halfway through the doorway of her son Jordan's room.

Hawkins had apparently gone to check on Chippewa Avenue's eager 12-year-old paper-boy, whom she had picked up from the YMCA a few hours earlier.

In the next room, 14-year-old Cassandra was on the floor beside her bed. The gregarious Grade 9 student had had her braces removed a few days earlier, and had been at her friend's house that evening baking cookies and sending messages on MSN.

Quintessential hockey dad Richard Hawkins was on the floor of the bathroom in his pyjamas. He had turned on the fireplace in the basement to warm things up a bit while he watched the tube and ate popcorn.

What Richard Hawkins didn't know was that the small exhaust vent that funnelled carbon monoxide from the gas fireplace out through the chimney was completely blocked from years of use.

A grim picture

And the caption to this grim picture: they did not own a carbon monoxide detector and did not get their chimney checked.

Carbon monoxide is a colourless, odourless, non-irritating gas that can inflict significant brain damage and even kill its victims. Some symptoms of poisoning to watch for:

Low levels: Headache; fatigue; shortness of breath; impaired motor functions

High levels: Nausea; dizziness; chest pain; fatigue; poor vision; difficulty thinking, confusion

Very high levels: Convulsions; loss of consciousness; coma

(Sources: Health Canada; Centers for Disease Control and Prevention)

OPP Sgt. Jack Rutkauskas was the first to arrive on the scene. It was Monday, and his pal Laurie hadn't been into work since Thursday.

He tried to peer into the windows, but the curtains were drawn and the glass appeared to be steamed up on the inside. He called for backup from the local Oxford County police force.

Adrenaline pumping hard, Rutkauskas barrelled in.

He looked at each body in the stiflingly hot home and determined they had been dead for some days — it turns out probably since Thursday evening.

Then Rutkauskas opened a window and nearly jumped out of his skin.

Medical mystery

"That's when Laurie did cough and she started to breathe," he says, recalling the shock.

Incredibly, Laurie Hawkins was still hanging on to life after more than three days inside the carbon monoxide-choked home. She lasted another eight days before she, too, passed away.

How Laurie Hawkins survived when the rest of her family did not remains a medical mystery. And it only added to the impact of a story that continues to reverberate through the province as another home-heating season is underway.

An estimated 414 Canadians died of carbon monoxide poisoning between 2000 and 2007, according to statistics provided by provincial coroners and compiled by The Canadian Press. Hundreds more are treated each year for exposure to the colourless, odourless gas.

Police, emergency workers, doctors and several communities were able to draw valuable lessons about treatment and prevention from the Hawkins family tragedy.

That morning, Dec. 1, Rutkauskas quickly pulled Laurie Hawkins' body out to the cold and into a waiting ambulance. He did chest compressions to keep up her shallow breathing, then a mask was quickly placed over her mouth to deliver pure oxygen.

After a brief stop at Woodstock General Hospital, she was sent to Toronto General Hospital for treatment in a hyperbaric oxygen chamber.

Dr. Randy Wax of neighbouring Mount Sinai Hospital oversaw her care. He says Hawkins may have had the highest levels of carbon monoxide of any known survivor.

When the levels were formally registered by emergency workers, they were extremely high, but nowhere close to what Wax had been expecting.

Oxygen key to outcome

This confirmed what doctors had long suspected about carbon monoxide poisoning — that the simple act of giving a person oxygen as quickly as possible can have the biggest impact on the ultimate medical outcome.

Carbon-monoxide detectors

How they work: Carbon monoxide detectors continuously monitor levels of carbon monoxide in the air and sound an alarm when a harmful level is reached.

Buying a detector: Detectors can cost from $30 to $60, and can come combined with a smoke detector. Some more expensive detectors will include a memory that monitors and records levels of carbon monoxide in the home. Some are battery-operated, others can be plugged into a standard electrical outlet. Ensure your detector has been certified by the Canadian Standards Association.

Maintenance: Read the manufacturer's instructions carefully. If it requires batteries, they should be regularly checked and changed. Note the expiry date of the device if it is indicated. If it is not, replace the detector after five years.

Where to put the detector: Because carbon monoxide can have the greatest impact on people as they sleep, detectors should be placed near sleeping areas so they can be heard, in addition to other areas. Plug-in models will limit users to where there are outlets, but the area around the detector should not be blocked. Do not connect them to an outlet that is controlled by a switch.

Other models can be placed up to knee height. They should not be in the immediate area of air vents, heating or cooking appliances, chimneys or unheated areas of the home.

If the alarm sounds: Do not ignore the alarm even if you do not feel symptoms.

If you know what the source is, evacuate the house first and then remove or turn off the source. Ventilate the house and reset the alarm. Call 911 if anyone is feeling flu-like symptoms.

If you don't know what the source is, evacuate the house. Otherwise, call the gas utility, a heating contractor or the fire department to have the house tested.

(Sources: Canada Mortgage and Housing Corp.; Ontario Fire Marshal's Public Fire Safety Council)

"By them administering oxygen, they were able to accelerate the process of getting rid of the carbon monoxide," said Wax, who relayed his observations to the police and emergency workers on the scene.    "So the efforts of the first responders were absolutely critical in trying to give her the best chance of survival."

Inside Laurie's body, the parasitic carbon monoxide literally sucked the life out of her blood cells.

Carbon monoxide attaches itself inside blood cells to hemoglobin, the agent that helps carry oxygen. The CO, as the gas is known, limits the ability of the hemoglobin to take on oxygen and the brain, organs and other tissues become oxygen-starved.

Victims can experience flu-like symptoms, such as headaches and nausea, and so the poisoning often goes misdiagnosed — such as the case of William Hart of Nelson, B.C.

Hart nearly died from carbon monoxide poisoning when his furnace malfunctioned.

A tenant downstairs heard Hart "flipping around like a fish" on the floor after his convulsing body fell out of bed.

Paramedics gave him oxygen at the scene immediately, but when he arrived at hospital down the road, the oxygen was removed. He stayed without it for two hours while he lay unconscious. 

"I found myself in hospital with a doctor shouting at me, 'Tell me what you took!' because he thought it was a drug overdose, and I had no idea where I was," said Hart, who struggled for year with confusion, an inability to concentrate and other neurological aftershocks.

"The longer it stays in the system, the higher the likelihood of damage and the higher the likelihood of permanent damage."

Laurie Hawkins was the community services officer for the Oxford County OPP, and one of the most familiar faces around Woodstock and Ingersoll.

Every school kid from junior kindergarten to Grade 8 would see Hawkins at least once a year at her energetic talks on seat-belt safety, drugs, alcohol and bullying. People at seniors' homes knew Laurie for her frequent visits, as did the families of the "at risk" children she supervised at Camp Hope during the summers.

She had been policing for 19 years, and was preparing to take on the role of chief media spokesperson.   

"Laurie to me was the best community services officer that I have seen within the OPP," said Cmdr. Jack Goodlett. "People would phone up and request her, and if they couldn't have her they'd just as soon wait than have someone else."

The irony was obvious.

Detectors save lives

How was it possible that a woman who spoke day in, day out about public safety — and whose brother was a firefighter — did not own a carbon-monoxide detector? 

The Hawkins family also did not have their gas fireplace serviced by a qualified heating and ventilation expert. Had they done so, they would have discovered that the pipe that was supposed to draw carbon monoxide out of the house and up the chimney was completely blocked from years of buildup.

When doctors finally determined Hawkins' brain damage was too severe for her ever to recover, she was flown by helicopter with her sister Tracey and mother Donna Gignac to North Bay, where she and Richard grew up.

A phalanx of fire trucks, police cruisers and emergency vehicles lined the runway to welcome her home. She died a few days later.   

'It not only educated the police department but all emergency services as well as the public.'— OPP Cmdr. Jack Goodlett

The seemingly preventable tragedy raised public awareness about carbon-monoxide in a way no other previous accident had in Ontario.   

Within days of the Hawkins family deaths, carbon-monoxide detectors began selling out in several cities and towns. Collections were set up to provide detectors to low-income families.   

"It not only educated the police department but all emergency services as well as the public," said Goodlett. "Even after Laurie's tragedy and death, she's still educating people. Even in death, she educates."   

North Bay officially declared that carbon-monoxide detectors were mandatory in all homes last month. Sault Ste. Marie, Ont., made the change in the spring.   

Local MPP Ernie Hardeman felt so affected by the Hawkins case that he immediately drafted a private member's bill to make detectors mandatory across the province. Currently, detectors are only mandatory in Ontario in new homes.   

The Hawkins Gignac bill has passed second reading at Queen's Park, and Hardeman says he hopes the Liberal government will give it the stamp of approval to move quickly through the legislative process.   

 A new study by New York City's Mount Sinai School of Medicine backs up what police and firefighters already suspected — the numbers of patients who suffered severe effects from carbon monoxide significantly declined after that city brought in a law in 2004 requiring detectors in all homes and businesses.   

 "There but for the grace of God go I — it could have been my house, it could have been anyone's house," said Hardeman, a former volunteer firefighter.   

"It would have been so simple to go to town and pay $29 for a detector and plug it in the socket and you're done, and this would have been avoided."   

Unanswerable questions

Almost a year later, Laurie Hawkins' parents Donna and Ben Gignac in North Bay are still trying to make sense of it all.   

They've just sold the Hawkins home in Woodstock. The fireplace was the first thing to be ripped out when they renovated it from top to bottom.   

Cassie's 15th birthday came and went on Aug. 27. They remember gentle Jordy when they hike up at Duchesnay Falls near North Bay.   

The Gignacs have the kind of unanswerable questions that families have after a tragedy.   

Why didn't anyone raise they alarm when two days worth of Jordy's papers were piled up in front of the house? Jordy was autistic, and delivering the papers like clockwork every morning at 7 a.m. was a routine that helped him get a start on the day.   

Why didn't the members of the peewee hockey team that Richard coached notice he was a no-show with all their equipment?   

"Why didn't somebody phone the house and say 'Hey Richard, are you coming to practice? Where's the sweaters, where's the pucks?'," says Donna Gignac.   

 They also wonder about how long the family had been suffering the affects of carbon-monoxide poisoning, since Laurie sometimes complained of feeling unwell in their home.   

Above all, would Laurie have survived if someone had found her a little sooner?   

'People pay attention now'

But they also see meaning in what happened to Laurie. They believe Laurie survived a little longer to help them cope with the loss of Richard, Cassandra and Jordan.   

"I believe Laurie did that for us, I really do. We were so busy focusing on her that it's not that we weren't grieving for the other ones, but it gave us a little peace. It gave us someone to talk to, someone to touch."   

And they hope that the story of their beloved daughter will save lives. Already, a nephew who had been ignoring a beeping detector in his basement discovered that his furnace was indeed leaking carbon monoxide.   

"We'll never know the answers, will we? I don't know why He had to pick my family over someone else's," says Donna Gignac.   

"But there had to be a good reason. … People pay attention now. I really think that's one of the reasons why."

Interactive: Carbon monoxide poisoning