{"id":3707,"date":"2020-02-01T14:47:40","date_gmt":"2020-02-01T19:47:40","guid":{"rendered":"http:\/\/wordpress.world.dan.org\/?post_type=dan_alert_diver&p=3707"},"modified":"2023-08-25T14:26:20","modified_gmt":"2023-08-25T18:26:20","slug":"carbon-monoxide-safety","status":"publish","type":"dan_alert_diver","link":"https:\/\/world.dan.org\/fr\/alert-diver\/article\/carbon-monoxide-safety\/","title":{"rendered":"S\u00e9curit\u00e9 en mati\u00e8re de monoxyde de carbone"},"content":{"rendered":"

Alors que les articles des num\u00e9ros pr\u00e9c\u00e9dents de Alert Diver<\/em> have addressed sources of carbon monoxide (CO) (Spring 2017) and prevention of breathing gas contamination (Spring 2014), perhaps less apparent to divers are the reasons why we have limits and the effects of exceeding those limits. This article will address the effects of CO poisoning and how the limits are derived. Discussions about the effects of gas need to consider the compressed gas, depth, gas uptake and dive profiles as well as the diver\u2019s fitness level and general health.<\/p>\n\n\n\n

Numbers are not absolute, need context to understand which are important and why, and might not apply equally to all divers. The effect of CO uptake at depth is not linear, nor do we know all the factors that may affect it, but we do know some things. Depth has a direct impact on partial pressure. Dalton\u2019s law tells us that the partial pressure of all the constituents of the breathing gas in our cylinders will increase as we dive deeper, which means that the actual number of molecules per breath increases. It is a linear effect measured against absolute pressure in the same way as Boyle\u2019s law addresses volume. A level of 10 parts per million (ppm) in a tank at the surface, for example, will translate to the same effect that 60 ppm has at 165 feet of seawater (fsw) or 6 atmospheres absolute (ATA) (10 ppm x 6 ATA = 60 ppm), which is referred to as the surface equivalent value (SEV).1<\/sup><\/p>\n\n\n

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\"\"<\/figure>\n<\/div>\n\n\n

La production de nitrox par s\u00e9paration des gaz (\u00e0 l'aide d'une membrane perm\u00e9able) ou par g\u00e9n\u00e9ration de gaz (\u00e0 l'aide de l'absorption modul\u00e9e en pression, ou PSA) augmente encore le nombre de mol\u00e9cules de CO dans le gaz. La production de nitrox \u00e0 40 % \u00e0 l'aide de l'une ou l'autre de ces techniques, par exemple, augmentera la concentration de CO d'un facteur allant jusqu'\u00e0 trois (ce qui signifie qu'il faut trois volumes d'air pour produire un volume de nitrox \u00e0 40 %).2<\/sup> Une mesure de 10 ppm dans l'air peut donc donner jusqu'\u00e0 30 ppm dans la bouteille. Si l'on consid\u00e8re la VES \u00e0 une profondeur de plong\u00e9e maximale de 80 fsw (3,4 ATA), la VES serait de 30 fois 3,4, soit 102 ppm.3<\/sup> Les choses se compliquent car la pression partielle de l'oxyg\u00e8ne augmente \u00e9galement, quel que soit le gaz respiratoire utilis\u00e9. Plus nous plongeons en profondeur, plus le nombre de mol\u00e9cules d'oxyg\u00e8ne augmente. \u00c0 165 pieds de profondeur, chaque respiration contient six fois plus de mol\u00e9cules d'oxyg\u00e8ne qu'\u00e0 la surface en respirant le m\u00eame m\u00e9lange gazeux.<\/p>\n\n\n\n

Le danger du CO dans les gaz respiratoires r\u00e9side dans l'affinit\u00e9 de cette toxine pour l'h\u00e9moglobine, qui est le principal transporteur de l'oxyg\u00e8ne dans le sang. Le CO se lie au moins 200 fois plus facilement \u00e0 l'h\u00e9moglobine et en transforme une partie en carboxyh\u00e9moglobine (COHb). Il en r\u00e9sulte une diminution de la quantit\u00e9 d'h\u00e9moglobine disponible pour transporter l'oxyg\u00e8ne vers les tissus. Avec l'augmentation de la COHb, les tissus sont rapidement priv\u00e9s d'oxyg\u00e8ne. Plus le nombre de mol\u00e9cules de CO est \u00e9lev\u00e9, plus le pourcentage d'h\u00e9moglobine transform\u00e9e en COHb (%COHb) est \u00e9lev\u00e9 et plus les dommages sont importants : Nous suffoquons lorsque les niveaux d'oxyg\u00e8ne dans nos tissus sont trop bas.<\/p>\n\n\n\n

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L'intoxication au monoxyde de carbone peut provoquer des sympt\u00f4mes en profondeur ou \u00e0 la remont\u00e9e \u00e0 la surface et peut entra\u00eener \u00e0 la fois des urgences imm\u00e9diates et des effets n\u00e9gatifs \u00e0 long terme sur la sant\u00e9.
<\/figcaption><\/figure>\n\n\n\n

D'autres processus complexes de fixation du CO se produisent, causant d'autres dommages et des d\u00e9ficits \u00e0 long terme de la respiration cellulaire et de la production d'\u00e9nergie. Le diagnostic d'une intoxication au CO prend en compte les sympt\u00f4mes associ\u00e9s, l'exposition r\u00e9cente au CO et les niveaux de COHb. Il existe un facteur att\u00e9nuant : Une pression partielle accrue d'oxyg\u00e8ne se dissout dans notre sang (plasma) et, malgr\u00e9 le pourcentage \u00e9lev\u00e9 de COHb et la charge r\u00e9duite d'oxyg\u00e8ne transport\u00e9e par l'h\u00e9moglobine restante, cet oxyg\u00e8ne dissous peut continuer \u00e0 alimenter nos tissus.<\/p>\n\n\n\n

Au fur et \u00e0 mesure de l'ascension, la pression partielle de l'oxyg\u00e8ne, et donc l'oxyg\u00e8ne dissous, diminue. La quantit\u00e9 de COHb, cependant, ne diminue pas \u00e0 la m\u00eame vitesse parce qu'il s'agit d'une liaison chimique et non d'un gaz dissous. Il faut g\u00e9n\u00e9ralement quatre \u00e0 six heures pour r\u00e9duire de moiti\u00e9 le taux de COHb. Les plongeurs qui respirent des quantit\u00e9s excessives de CO peuvent \u00eatre asymptomatiques en profondeur, mais d\u00e9velopper rapidement des sympt\u00f4mes lorsqu'ils remontent.<\/p>\n\n\n

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\"\"<\/figure>\n<\/div>\n\n\n

There is some debate and uncertainty over the relevance of the numbers. We would ideally be able to predict these effects so we can determine a safe level of CO in our cylinders. Time, the amount of CO, the diver\u2019s breathing rate and general health condition are all part of the equation. While we do not have any significant research data on these effects in divers underwater, we do have the results of many occupational health and safety studies. Workers exposed to elevated levels of CO \u2014 which is possible in factories with power plants, furnaces, engine exhausts, certain chemicals and even in submarines \u2014 need to be able to safely complete their working day.<\/p>\n\n\n\n

Le tableau 1 pr\u00e9sente certaines des donn\u00e9es publi\u00e9es et des niveaux de s\u00e9curit\u00e9 trouv\u00e9s dans un large \u00e9ventail d'\u00e9tudes, de documents r\u00e9glementaires et de normes sur le lieu de travail.4<\/sup> Les diff\u00e9rences dans les montants r\u00e9els varient selon les sources, mais les effets sont similaires.5<\/sup><\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Ces valeurs de COHb sont bas\u00e9es sur des expositions d'une heure avec un volume respiratoire minute (VMR) de 20 litres par minute (L\/min). Lorsque les dur\u00e9es d'exposition s'allongent et d\u00e9passent huit heures, les valeurs de COHb finissent par atteindre un plateau. Plus le VMR est \u00e9lev\u00e9, plus le %COHb est \u00e9lev\u00e9 pour des concentrations de CO et un temps donn\u00e9s. Les valeurs du RMV mesur\u00e9es chez les plongeurs peuvent aller de 6 L\/min \u00e0 bien plus de 35 L\/min.<\/p>\n\n\n\n

Le tableau 2 montre l'effet de la profondeur sur la toxicit\u00e9 potentielle du CO. Une fois encore, les valeurs de COHb sont bas\u00e9es sur des expositions d'une heure avec un VMR de 20 L\/min.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

Bien que les deux tableaux contiennent de nombreux chiffres, l'effet dramatique de la profondeur sur la COHb et l'impact n\u00e9gatif rapide sur la sant\u00e9 sont clairs.<\/p>\n\n\n\n

Nous devons pr\u00eater une attention particuli\u00e8re aux endroits o\u00f9 le %COHb pourrait d\u00e9passer 30. Le plongeur peut perdre conscience \u00e0 ce niveau, ce qui peut entra\u00eener une noyade. La plupart des limites accept\u00e9es ou exig\u00e9es pour les gaz respiratoires en ce qui concerne le CO dans votre bouteille charg\u00e9e sont de 5 ppm ou 10 ppm.7,8<\/sup> Les deux niveaux sont sans danger pour une plong\u00e9e d'environ 60 minutes \u00e0 l'air aux profondeurs indiqu\u00e9es dans le tableau 2. Consid\u00e9rons de l'air avec une concentration de CO de 10 ppm dans 40 % de nitrox. La VES qui en r\u00e9sulte, jusqu'\u00e0 102 ppm \u00e0 80 fsw (3,43 ATA), se situe dans la zone dangereuse, avec une teneur en COHb d'environ 14 % (interpol\u00e9e \u00e0 partir des valeurs du tableau 2).<\/p>\n\n\n\n

Les plongeurs ayant des probl\u00e8mes de sant\u00e9 existants, y compris une fonction respiratoire alt\u00e9r\u00e9e, peuvent courir un risque plus \u00e9lev\u00e9. Par exemple, un fumeur qui fume un paquet par jour peut vivre avec un taux de COHb basal de 3 \u00e0 6 %.9<\/sup> La respiration d'un m\u00e9lange nitrox contamin\u00e9 au CO peut amener le taux de COHb dans la zone dangereuse.<\/p>\n\n\n\n

\"\"
A diver\u2019s overall health as well as exposure to CO outside of diving, such as with smoking, can change their risk level for CO toxicity.  
<\/figcaption><\/figure>\n\n\n\n

Une norme r\u00e9aliste, s\u00fbre, r\u00e9alisable et pratique pour la plupart des plongeurs est de 5 ppm. De nombreux analyseurs de CO portables et bon march\u00e9 mesurent de z\u00e9ro \u00e0 25 ppm, avec une r\u00e9solution de 1 ppm, ce qui les rend aptes \u00e0 d\u00e9tecter des niveaux s\u00fbrs de CO dans l'environnement de plong\u00e9e.<\/p>\n\n\n

\n
\"\"
There are many factors that affect a diver\u2019s carbon monoxide uptake at depth, and each diver is different. <\/figcaption><\/figure>\n<\/div>\n\n\n

Why 5 ppm when 10 ppm might also be safe? A maximum background level as high as 5 ppm is realistically possible. To achieve 10 ppm means there is likely a CO source nearby. While this level is perhaps safe, the compressor filling station needs to investigate the likely cause and assess the risk of drawing in CO of more than 10 ppm. Most operators do the required quarterly, biannual or annual air quality tests, depending on their legal requirements, but that doesn\u2019t provide you much assurance about the level in your cylinder on the day you dive.<\/p>\n\n\n\n

This article is not a thorough scientific analysis of the effects of elevated CO on divers, and DAN is not the appropriate organization to state limits. We also have not discussed what happens in technical diving, where the gas volume at depth contains a greater amount of CO. As the world\u2019s leading dive safety organization, however, we advise that a maximum CO level of 5 ppm is relatively safe. While 10 ppm may be safe for diving, the value could feasibly change between filling sessions to levels that rapidly approach being dangerous. It makes little difference whether you are diving on nitrox or air.10<\/sup> Pour garantir la s\u00e9curit\u00e9 contre les effets du CO, le chiffre id\u00e9al et celui auquel il faut s'attendre est z\u00e9ro.<\/p>\n\n\n\n

\n\n\n\n

Notes<\/h3>\n\n\n\n
    \n
  1. Dans cet article, la mesure des parties par million (ppm) est relative au volume.<\/li>\n\n\n\n
  2. Nous supposons un facteur d'efficacit\u00e9 de 50 %, ce qui est typique des s\u00e9parateurs \u00e0 membrane bon march\u00e9.<\/li>\n\n\n\n
  3. Cela suppose que l'unit\u00e9 g\u00e9n\u00e9ratrice de nitrox n'utilise pas un syst\u00e8me de filtration comprenant un \u00e9l\u00e9ment pour catalyser le CO dans l'air. Les convertisseurs catalytiques sont efficaces \u00e0 99 % pour l'\u00e9limination du CO.<\/li>\n\n\n\n
  4. Sources include the U.S. National Institute for Occupational Safety and Health (NIOSH), U.S. Environmental Protection Agency (EPA), U.K. Health and Safety Executive (HSE), New Zealand\u2019s Health and Safety at Work Act (HSWA) and the World Health Organization (WHO).<\/li>\n\n\n\n
  5. Malgr\u00e9 les sources illustrant les effets potentiels d'un taux \u00e9lev\u00e9 de %COHb, une \u00e9tude r\u00e9alis\u00e9e en 2015 a fourni un \u00e9ventail encore plus large des r\u00e9sultats de l'empoisonnement au CO. Il n'y a donc pas de corr\u00e9lation d\u00e9finitive entre le %COHb dans le sang et les effets n\u00e9fastes, car ces effets varient d'une personne \u00e0 l'autre. Pour cet article et sur la base des sources r\u00e9glementaires cit\u00e9es pr\u00e9c\u00e9demment, ce tableau sert de guide jusqu'\u00e0 ce qu'il soit modifi\u00e9 par de futures \u00e9tudes.<\/li>\n\n\n\n
  6. Les valeurs de COHb sont interpol\u00e9es lin\u00e9airement entre les valeurs connues, mais la corr\u00e9lation n'est lin\u00e9aire que pour les premi\u00e8res heures d'exposition. Les temps de plong\u00e9e typiques le permettent. Les valeurs sont arrondies \u00e0 l'entier le plus proche pour les valeurs sup\u00e9rieures \u00e0 3,5 en surface.<\/li>\n\n\n\n
  7. EN 12021 (Europe), CZ275.2 (Canada), SANS 10019 (Afrique du Sud).<\/li>\n\n\n\n
  8. CGA Grade E (USA), AS\/NZ 2299.1 (Australie).<\/li>\n\n\n\n
  9. Un fumeur d'un paquet par jour peut commencer la plong\u00e9e avec une %COHb de 3 \u00e0 6 %.<\/li>\n\n\n\n
  10. While nitrox contains more oxygen, some people do not realize that producing nitrox using a membrane or molecular sieve separator does not remove the CO or the carbon dioxide. The effect is an increase in the amounts of both of these contaminants in the final gas produced \u2014 more oxygen but also more CO.<\/li>\n<\/ol>\n\n\n\n
    \n\n\n\n

    R\u00e9f\u00e9rences<\/strong><\/h3>\n\n\n\n
      \n
    • Hampson NB. Myth busting in carbon monoxide poisoning (d\u00e9mystifier l'empoisonnement au monoxyde de carbone). Am J Emerg Med 2016 ; 34(2):295-97. doi : 10.1016\/j.ajem.2015.10.051.<\/li>\n\n\n\n
    • Rose JJ, et al. Intoxication au monoxyde de carbone : pathogen\u00e8se, gestion et orientations futures de la th\u00e9rapie. Am J Respir Crit Care Med 2017 ; 195(5):596-606. doi : 10.1164\/rccm.201606-1275CI.<\/li>\n\n\n\n
    • Russel MAH. Blood carboxyhemoglobin changes during tobacco smoking. Postgrad Med J 1973 ; 49(576):684-87. doi : 10.1136\/pgmj.49.576.684.<\/li>\n\n\n\n
    • Turner JA, McNicol MW, Sillett RW. Distribution of carboxyhaemoglobin concentrations in smokers and non-smokers. Thorax 1986 ; 41(1):25-27. doi : 10.1136\/thx.41.1.25<\/li>\n<\/ul>\n\n\n\n

      \u00a9 Alert Diver<\/em> \u2014 Q1 2020<\/p>","protected":false},"excerpt":{"rendered":"

      Quel est le niveau de s\u00e9curit\u00e9 du monoxyde de carbone (CO) dans l'air que nous respirons ? D\u00e9couvrez les effets de l'empoisonnement au CO et comment les limites sont calcul\u00e9es. <\/p>","protected":false},"featured_media":13397,"template":"","dan_alert_diver_categories":[73],"dan_alert_diver_issues":[408],"class_list":["post-3707","dan_alert_diver","type-dan_alert_diver","status-publish","has-post-thumbnail","hentry","dan_alert_diver_categories-features","dan_alert_diver_issues-q1-2020"],"acf":[],"yoast_head":"\nCarbon Monoxide Safety - DAN World<\/title>\n<meta name=\"description\" content=\"What is a safe carbon monoxide (CO) level in our breathing air? Learn the effects of CO poisoning and how the limits are derived.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/world.dan.org\/fr\/alert-diver\/article\/carbon-monoxide-safety\/\" \/>\n<meta property=\"og:locale\" content=\"fr_CA\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Carbon Monoxide Safety\" \/>\n<meta property=\"og:description\" content=\"What is a safe carbon monoxide (CO) level in our breathing air? 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