Objective: To determine the number of states with laws monitoring toxic gases in ice arenas. To inform physicians who care for ice skaters of the dangers of carbon monoxide and nitrogen dioxide exposure in ice arenas.
Design: Survey, literature review.
Participants: Health Departments of the 50 states and Washington D.C.
Assessment of risk factors: At risk are users of ice arenas. Vigorous exercise (hockey or competitive figure skating) and underlying pulmonary or cardiovascular disease increase the risk toxicity. Toxic gas concentration is determined by the amount of production from internal combustion engines, effectiveness and use of the ventilation system, and the "cold air pool" over the ice.
Main outcome measures: Number of states with laws regulating toxic gases in ice arenas.
Results: Only two states (Minnesota and Rhode Island) have laws regulating toxic gases in indoor ice areas.
Conclusions: Physicians and the public are generally unaware of this problem. Toxic gas exposure in ice arenas is under recognized and underreported. The risks are not documented in journals generally seen by physicians who care for skaters. Conversion to electric ice resurfacing machines--the best solution--is not economically practical; legislation on the monitoring of toxic gas levels offers a reasonable alternative.