Chlorine poisoning caused by improper mixing of household disinfectants during the COVID-19 pandemic: Case series

Abstract

BACKGROUND Misuse of disinfectants during the coronavirus disease 2019 pandemic has led to several poisoning incidents. However, there are few clinical case reports on poisoning caused by improper mixing of household disinfectants. AIM To summarize the clinical characteristics and treatment effects of chlorine poisoning caused by improper mixing of hypochlorite bleach with acidic cleaning agents. METHODS We retrospectively analyzed baseline and clinical data, clinical symptoms, and treatment methods of seven patients with chlorine poisoning who were admitted to the National Army Poisoning Treatment Center. RESULTS Among the seven patients, the average poisoning time (exposure to admission) was 57 h (4-240 h). All patients were involved in cleaning bathrooms. Chest computed tomography scans revealed bilateral lung effusions or inflammatory changes in five patients. The partial pressure of oxygen decreased in six patients, and respiratory failure occurred in one. Five patients had different degrees of increase in white blood cell count. Humidified oxygen therapy, non-invasive mechanical ventilation, anti-inflammatory corticosteroids, antioxidants, and antibiotics were administered for treatment. The average length of hospital stay was 7 d (4-9 d). All seven patients recovered and were discharged. CONCLUSION Improper mixing of household disinfectants may cause damage to the respiratory system due to chlorine poisoning. Corticosteroids may improve lung exudation in severe cases, and symptomatic supportive treatment should be performed early.

Improving Health Literacy of Domestic Household Disinfection Use: Readability of Consumer-Facing Information on Domestic Household Disinfectant Products on Sale in the UK—An Infodemiology Study

“…The results showed that the majority of survey respondents reported at least one adverse event associated with the use of disinfectants, ranging from skin irritation to poisoning, and significant differences in awareness and performance mean scores among various educational levels (p < 0.001) as well as the level of performance between males and females (p < 0.001) [4]. Additionally, studies from Italy and China showed toxicological events due to the mishandling of disinfectants [5,6]. These reports collectively suggest that there was some degree of a lack of understanding in the general public as to how household disinfectants work.…”