Warehouse worker's headache arises from occupational carbon monoxide poisoning that occurs from operating a combustion engine in an enclosed space.


Typical scenario:

(1) enclosed space such as a large garage or warehouse

(2) no or poor ventilation (closed windows during the winter, etc.)

(3) operation of machinery with a combustion engine (forklift using propane gas, other)


One feature is that it occurs in an enclosed space which allows the carbon monoxide to accumulate but a large enough volume that it does not reach lethal concentrations.


Clinical findings:

(1) headache

(2) nausea

(3) lightheadedness

(4) syncope

(5) loss of consciousness


Symptoms typically reverse without sequelae on removal to fresh air and delivery of oxygen.


The diagnosis can be confirmed by documenting elevated carboxyhemoglobin levels in the worker and to measure ambient atmospheric CO levels in the warehouse under working conditions.


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