ABSTRACT
In an urban environment, carbon monoxide is produced by incomplete combustion, particularly in motor vehicles. Air pollution caused by CO produced by motor vehicles is controlled by legislation. Legal regulations have considerably lowered emission levels authorized for new vehicles and total CO emission levels. CO levels in the environment (urban environment in general and zones close to motorways) have thus declined. CO remains a public health concern both as a pollutant and as an indicator of air quality. We recall here the more recent approaches used to assess CO-related hazards developed by the Environmental Protection Agency in the United States and pertinent conclusions backing up previously defined reference levels. We then report recent French data concerning CO emission, environmental levels and evaluation procedures for different situations of human exposure: geographical situations, mode of transportation, police force, air sentinels. The third part of this article is devoted to biological data (interaction between CO and hemo-proteins, CO neurotransmitter?) and epidemiological data (serial surveys). The discussion centers on the limitations of epidemiological data and on the difficulty in evaluating hazards solely on the basis of a carboxyhemoglobin threshold. This latter point is particularly important because carboxyhemoglobin is only one of many indicators of air quality. Finally recommendations are proposed concerning weather-related aspects, evaluation of human exposure, and ways of improving biological and epidemiological data.
