Acute health effects of accidental chlorine gas exposure

Abstract

ObjectivesThis study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.MethodsWe analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment.ResultsImmediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%).ConclusionsThe 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.

Deliberate exposure of humans to chlorine-the aftermath of Ebola in West Africa

“…Most accounts of chlorine exposure in humans have been accidental usually following transportation, explosion, inaccurate chlorine mixing, or mechanical malfunction releasing large amounts of chlorine vapour which is inhaled [11–14]. …”

“…Chlorine is a noxious substance especially in its gaseous form [11]. The symptoms of acute chlorine poisoning are well documented but mainly from accidental exposure reports [12–14], which require immediate medical attention. The main symptoms are tightness of the chest [15], respiratory distress, visual disturbance, loss of visual acuity [13].…”

Acute Atrial Fibrilation After Inhalation of Chlorine Gas

“…The toxicity of chlorine gas is related to its adverse effects of free oxygen radicals released by this acid on coagulation [5,6] . Eye and throat irritation, rhonchus, cough, chest tightness, shortness of breath, hypoxemia, wheezing, and abnormal chest radiographs can be seen after inhalation of chlorine gas [7] .…”

The influence of chlorine in indoor swimming pools on the composition of breathing phase of professional swimmers

“…This prolonged exposition lead to secondary acute airway obstruction and sometimes pulmonary edema, which may convert into chronic process. The cause of chronic symptoms may be chlorine induced pulmonary inflammation and remodeling [18] sometimes called as chlorine-induced reactive airways dysfunction syndrome (RADS) [19]. Persistent chlorine induced airway irritation may be responsible for development of asthma like symptoms, but with more persistent consequences [18,20].…”

“…Secondly, we are aware that our sample size was rather small however it has to be underlined that most of the studies performed on patients highly exposed into chlorine gas were performed on small patients groups and usually after acute exposition [19], even if the observed consequences were long lasting [52]. Small study population which should be considered as study limitation ad the end turned out not to limit our findings as we have found that respiratory system response to low dose chlorine exposure was clinically significant and whereas our method proved to be clinically sensitive in detecting this response, we cannot consider small study population as a real study limitation.…”