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From The costs and effects of workplace accidents  Twenty case studies from Ireland.  A report for the Health and Safety Authority by: Mr. Victor Hrymak & Dr Jose Damian Pérezgonzález, School of Food Science and Environmental Health Dublin Institute of Technology March 2007 Research Team: Dr Carl Sullivan Ms Elaine Seymour & Ms Rosemary Ryan McDermott

Case Study 15
Donal Macken is a caretaker in his fifties. Prior to that, he was an electrician for twenty three years with the same company. During that timehe would use a company van for transport. One day twelve years ago, he drove a van that had a faulty ventilation system.  This allowed exhaust fumes into the van and as a result, both he and his co-worker suffered from carbon monoxide poisoning. He was off work for six weeks. To this day he still suffers from bad headaches, almost on a daily basis. He tells his story;

That day in 1995 was like any other and I arrived a t the depot in my car at my usual time.

The routine was the same, I would get my worksheet to show which jobs needed doing. I was a maintenance electrician and the company would get reports of places where electrical problems were reported. It was my job to go to these places and sort them out.

The company gave me the use of a van to get to these jobs and I was the driver. I would always have another electrician in the van and Aidan was with me that day. We were both in the front. These vans only have front seats and are converted to take shelving and storage areas for our tools and supplies in the back. So after we loaded the van with what we needed for the day, we drove to our first job. The job happened to be in the centre of town and it took us about twenty minutes to get there.

The van that we used that day was not our normal one. That one was being serviced and we were driving a replacement van. This replacement van was fairly new, about four years old and appeared ok to us.

So we drove into town as normal. I would have the windows up and the blower fan on to circulate air in the van. It was a warm day, but I still had the windows up. I always did this because I don’t like fumes from traffic getting into the cabin.

When I was in the van I started getting a headache which quickly got progressively worse and worse. By the time we arrived I had a blinding headache which was very painful and I was feeling sick. I didn’t vomit but I was feeling very nauseated. These symptoms came on very quickly and I thought I was coming down with the flu. We had arrived at the job but I was feeling too bad to do anything.

Aidan wasn’t feeling the best either, so he decided to go straight home from town. I was feeling worse again, so I also decided to call it a day and also go home. I thought I only had the flu, so I climbed back into the van and began to drive back to the depot.

I vaguely remember the drive back. I can recall snippets of the journey but large parts of that drive are just blank. I cannot for the life of me remember whole sections of that journey back in the van. I don’t know the roads I took and I don’t know what I did on the roads on the way back. It was as if sections of my memory were erased for good.

When I arrived back at the depot I was still feeling bad. The blinding headache was still with me and it was so bad at some stages that I couldn’t see properly. I was still feeling sick and nauseated.

Even so I got into my own car and drove the couple of miles back home. Again I don’t remember large parts of that journey but I remember pulling into my drive, parking and going into the house.

My wife remembers my arrival differently. She heard the car coming and went to the window to see who it was. She saw me pull into the drive and instead of park on the hard standing, I just swerved and lurched the car onto to the front lawn. I then got out and staggered to the front door talking absolute gibberish. I was acting as if I was completely drunk. As I don’t drink, my wife knew there was something wrong. She rang her brother, who happened to work for the same company and he came round later to see what was wrong. By this stage I was in the kitchen and again I was talking absolute nonsense. To me, what I was saying to my wife was normal and completely understandable. To my wife I was incoherent, babbling and talking utter gibberish.

I remember holding onto the kitchen table as I began to hallucinate. I gripped the table as I saw the floor underneath me completely disappear to reveal an endless black void. I thought I was going to fall into this blackness, which was why I was holding the table so tightly. Later on that day when my brother in law arrived, I was still in a bad way. By that time my wife had decided it was time to take me to the GP. She drove me down to the GP’s surgery. I wasn’t hallucinating as much by that time but I still had blinding headaches and nausea.

At the surgery the GP listened to my wife and myself and heard enough to ring the poisons unit at Beaumont Hospital in Dublin. It was Beaumont who made the diagnosis.

They said it was likely I was suffering from carbon monoxide poisoning. The GP sent me for blood tests at the local hospital. The blood tests were done that evening and I went to bed that night with painkillers, still suffering from very painful headaches and feeling nauseated. The bad headaches and sickness kept on going for the next three weeks. After those three weeks the nausea went but the headaches stayed with me. They weren’t as blindingly painful but still bad. These headaches are with me to this day. If I get a day a week without a headache, it’s like being on holiday. Most days and for most of the day and night, I have a headache.

On the day of the incident Aidan had also reported sick. He rang my house and had talked to my wife. He was also sent for blood tests, but he wouldn’t go. He is afraid of needles and he wanted to wait for the results of my blood test. At this stage the van had been recovered by the company and sent for an examination. The investigating engineers eventually confirmed that exhaust fumes were being pumped into the cabin by the blower fans.

I finally went back to work after six weeks. I was still doing some very strange things during those weeks off. One episode sticks in my mind. In the middle of the night I had just decided it was high time to decorate the living room ceiling. So I was found by my wife and kids getting all the materials and equipment ready to paint the ceiling. I couldn’t understand why they were at me to stop. As I said, I thought I was talking and making absolute sense. It seemed the most natural thing in the world to paint the ceiling at three o’clock in the morning.

………….My sleep was now very disturbed and I was not getting any rest. I was now very irritable. … then, my GP and wife persuaded me to go to a psychiatrist. I was reluctant to go at first but eventually I went. In the end I saw him for over two years. He diagnosed me with depression and put me on anti depressant medication. He said part of the reason for my illness was constantly thinking the incident over and over and over. Especially the part where I couldn’t recall the car journey home.

………I began having nightmares …. Those dreams were very, very, very, vivid. After one particularly bad nightmare I couldn’t sleep for two days. That dream was a horrible experience as it was so real. I thought I was actually awake and experiencing the dream for real. It involved me driving and causing a horrific car crash, too horrific to describe here.

After that particular nightmare I was referred to another psychiatrist. After a few visits to him, he suggested that I should consider another career, one that didn’t involve driving.

The second psychiatrist finally made up my mind for me. So five years after the accident, I took the redundancy and left the company. After a short while I found a job as a caretaker. The money isn’t as good but there’s no driving involved. As I said I still get the headaches, but at least the nightmares are gone.