Acute respiratory symptoms and evacuation-related behavior after exposure to chlorine gas leakage

Abstract

BackgroundA study was performed on the accidental chlorine gas leakage that occurred in a factory of printed circuit boards manufactured without chlorine. Health examination was performed for all 52 workers suspected of exposure to chlorine gas, and their evacuation-related behaviors were observed in addition to analyzing the factors that affected the duration of their acute respiratory symptoms.MethodsBehavioral characteristics during the incidence of the accidental chlorine gas leakage, the estimated time of exposure, and the duration of subjective acute respiratory symptoms were investigated. In addition, clinical examination, chest radiography, and dental erosion test were performed. As variables that affected the duration of respiratory symptoms, dose group, body weight, age, sex, smoking, work period, and wearing a protective gear were included and analyzed by using the Cox proportional hazard model.ResultsOf 47 workers exposed to chlorine gas, 36 (77 %) developed more than one subjective symptom. The duration of the subjective symptoms according to exposure level significantly differed, with a median of 1 day (range, 0–5 days) in the low-exposure group and 2 days (range, 0–25 days) in the high-exposure group. Among the variables that affected the duration of the acute respiratory symptoms, which were analyzed by using the Cox proportional hazard model, only exposure level was significant (hazard ratio 2.087, 95 % CI = 1.119, 3.890). Regarding the evacuation-related behaviors, 22 workers (47 %) voluntarily evacuated to a safety zone immediately after recognizing the accidental exposure, but 25 workers (43 %) delayed evacuation until the start of mandatory evacuation (min 5, max 25 min).ConclusionsThe duration of the subjective acute respiratory symptoms significantly differed between the low- and high-exposure groups. Among the 27 workers in the high-exposure group, 17 misjudged the toxicity after being aware of the gas leakage, which is a relatively high number.

Acute chlorine poisoning caused by an accident at a swimming pool

“…This accident resulted in 9 deaths and 72 hospitalizations with wheezing as the most common and persistent physical finding. Moreover, 31, 13, 15, 14, and 1% of the patients presented cardiac, ocular, otorhinolaryngologic, gastrointestinal, and dermatologic complaints, respectively (Han et al, 2016;Van Sickle et al, 2009). In our report, the most common symptom was cough.…”

“…In this present study there have been many case reports on the acute health effects of chlorine exposure (Agabiti et al, 2001;Han et al, 2016;Kim et al, 2014;Parimon et al, 2004;Vajner and Lung, 2013;Van Sickle et al, 2009); however, follow-up studies on the long-term effects of accidental chemical release on affected populations are needed (Bonetto et al, 2006;Clark et al, 2015;Hoyle and Svendsen, 2016). Although most individuals exposed to chlorine were able to recover within months and experience little or no residual dysfunction, several follow-up studies have suggested that chlorine exposure could cause permanent lung function loss or persistent, nonspecific bronchial hyperresponsiveness.…”

Acute Atrial Fibrilation After Inhalation of Chlorine Gas

“…Eighteen of the 27 patients with high exposure had palpitation complaints but there was no EKG documentation [12] . Cardiac dysrhythmia after inhalation of chlorine gas has been reported in the literature in the form of sinus tachycardia, extrasystoles and ST depression [13,14] .…”

Estimates of the Lung Cancer Cases Attributable to Radon in Municipalities of Two Apulia Provinces (Italy) and Assessment of Main Exposure Determinants

“…Therefore, studies in never-smokers are very important. However, studies including both smokers and never-smokers are also necessary to evaluate the interactions between radon and smoking for smoking-related lung cancer [ 28 ].…”