Ally Sidloski died in May after a day of boating on a lake in Ohio.

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The parents of a 21-year-old woman are speaking out after their daughter died following carbon monoxide poisoning on a boating trip. Ally Sidloski died in May after a day of boating on a lake in Ohio. Bystanders say she took a swim during her trip and never came back up.

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The coroner ruled that Sidloski's cause of death was drowning with a contributing cause of carbon monoxide intoxication, which her parents told Today, confused them. "Ally knew how to swim. It didn't make sense," her mom Tracie Sidloski, said.

Friends who were with Ally when she died said that she was sitting in the back of the boat on the swimming deck. And, while there were seats, cushions, and cup holders back there, the boat manufacturer, Yamaha, says that spot is not technically a designated sitting area. (According to the Yamaha owner's manual, "passengers must always sit in a designated seating area," highlighting the areas deemed to be safe. The manual adds that boaters should "stay away from the swim platform area while the engines are running. Exhaust gases coming from underneath it contain carbon monoxide.")

"We can't bring our daughter back. But if we can try to save other people from having to go through this, we want to do our best to do that," Tracie said. "It is preventable."

You've probably heard about carbon monoxide poisoning in indoor areas, like garages, but it turns out that this can happen in outdoor spaces as well. In fact, the U.S. Coast Guard and Centers for Disease Control and Prevention (CDC) both warn about this risk. Here's what you need to know about carbon monoxide poisoning on boats.

What is carbon monoxide, again?

Just a quick refresher: Carbon monoxide (CO) is an odorless, colorless gas that can kill you. It's found in fumes that are produced any time you burn fuel in cars or trucks, small engines, stoves, lanterns, grills, fireplaces, gas ranges, or furnaces, the CDC says. Carbon monoxide can build up and poison people and animals who breathe it in.

Why is carbon monoxide so deadly?

The biggest problem with carbon monoxide is that it interferes with your body's ability to process oxygen, Eric Adkins, MD, an emergency medicine physician at The Ohio State University Wexner Medical Center, tells Health.

"Oxygen binds with your red blood cells—called hemoglobin—which is how those red blood cells are able to deliver oxygen to your tissues," he explains. But "carbon monoxide actually displaces your oxygen from hemoglobin because it binds tighter," Justin Johnson, MD, an emergency care physician at Mercy Medical Center in Baltimore, Md., tells Health.

That, Dr. Johnson explains, keeps your body from properly delivering oxygen to your body. "Your brain doesn't function well without the oxygen it needs. You become confused and feel ill," he says. In some cases, you can die from carbon monoxide poisoning.

OK, so how can you get carbon monoxide poisoning on a boat?

There are a few different ways this can happen, per the CDC. Larger boats can have generators that vent toward the back of the boat, causing a risk of carbon monoxide build-up that can poison people on the rear swim deck. Carbon monoxide that builds up in the air space between the stern deck (back of the boat) or near the swim deck can kill someone in seconds, the CDC says.

Carbon monoxide can also build up when boats move at slow speeds or idle in water, including in the cabin, cockpit, bridge, back of the boat, or an open area. Wind from the front of the boat can actually increase the buildup of carbon monoxide.

Back drafting can also cause carbon monoxide to build up inside the cabin, cockpit, and bridge when a boat is moving at a high bow angle or is heavily loaded.

What are the symptoms of carbon monoxide poisoning?

These are the more general symptoms of carbon monoxide poisoning, per the CDC:

  • Headache
  • Dizziness
  • Weakness
  • Nausea
  • Vomiting
  • Chest pain
  • Confusion

The US Coast Guard also notes that carbon monoxide symptoms on a boat are similar to seasickness or feeling intoxicated. "The symptoms are vague and can feel like a lot of other things," Diane Calello, MD, medical and executive director of New Jersey Poison Information and Education System and an associate professor of emergency medicine at Rutgers New Jersey Medical School, tells Health. "But it's important to keep carbon monoxide at the top of your mind when you're on a boat."

How to avoid carbon monoxide poisoning on a boat—and what to do if you develop symptoms

According to the USCG, there are a few simple ways to avoid carbon monoxide poisoning while boating. First, the agency says it's important to keep fresh air circulating around the boat at all times, and to run exhaust blowers when the generator is on.

Past that, you should be aware of (and educate other passengers) where the boat's engine and generator exhaust outlets are located, and keep everyone away from those designated areas. The agency adds that you should never sit, teak surf (hold onto the boat's swim platform while its moving) while the engine is running. You can also install and maintain carbon monoxide alarms on your boat (and be sure not to ignore them if and when they sound).

Should you develop signs of carbon monoxide on a boat, Dr. Calello recommends moving to fresh air, usually away from the back of the boat and out of any enclosures. Dr. Adkins says it's also a good idea to ask the pilot to stop the engine. Then, he says, "call somebody to help you."

Typically, if you're out on the water, that means the Coast Guard. When help arrives, they should be able to give you supplemental oxygen to help replace the carbon monoxide that's built up in your body, Dr. Adkins says. Once you get to shore, you should still take a trip to the hospital, Jamie Alan, PhD, associate professor of pharmacology and toxicology at Michigan State University, tells Health, and monitor yourself for about 24 hours following exposure.

What you don't want to do is to try to make it to shore in the boat. "That could be one of the worse things you could do," Dr. Adkins says. "It's possible you won't even make it to shore."

Overall, experts stress the importance of being aware that you can get carbon monoxide poisoning on a boat—something most people have never even heard of before. "Knowing that this can happen—and getting help when you start to show symptoms—is crucial," Dr. Adkins says.

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