Clinical Presentations and Outcomes of Industrial Chlorine Gas Exposure Incidence in Oman

Abstract

Objective: The main objective was to study different clinical presentations and outcomes of patients after acute industrial chlorine gas exposure in Oman with evaluation of overall incident management to help develop a chemical exposure incident protocol. Methods: This was a retrospective observational study of 15 patients exposed to chlorine gas after an accidental chlorine gas leak in a metal melting factory in Oman. Results: Six (40%) patients were admitted and nine (60%) patients were discharged from the emergency department (ED) after initial management. The important post-chlorine gas exposure clinical symptoms were eye irritation (66.6%), cough (73.3%), shortness of breath (40.0%), chest discomfort (66.6%), rhinorrhea (66.6%), dizziness (40.0%), vomiting (46.6%), sore throat (13.3%), and stridor (53.3%). Important signs included tachycardia (40.0%), tachypnea (40.0%), wheeze (20.0%), and use of accessory muscles for breathing (20.0%). Signs and symptoms of eye irritation, rhinorrhea, tachycardia, tachypnea, wheeze, and use of accessory muscles for breathing have shown significant correlation with outcome (admission) having P value of <.05. Conclusion: In the presented acute chlorine gas exposure incidence, 15 exposed persons were brought to the ED, out of which six were admitted and nine were discharged after symptomatic treatment. Signs and symptoms of eye irritation, rhinorrhea, tachycardia, tachypnea, wheeze, and use of accessory muscles of breathing show significant relation with the outcome of admission.

Chlorine exposure accidents characteristics and recent progress in treatment

“…In this study, the treatment methods obtained in 163 literatures were classified and summarized (Table 3). Dexamethasone was the mainstay of glucocorticoid treatment, and methylprednisolone were used in severe cases [29,30,35,36,37,40,43,44,46,67,78,84,88,90,95,97]. The main treatment options for atomization inhalation are: alternate aerosol inhalation of 2-5% sodium bicarbonate solution with dexamethasone, gentamicin, aminophylline, α-chymotrypsin, distilled water [102,122,134,145] 0.25-0.5% isoproterenol or 0.2% salbutamol or dexamethasone aerosol, each inhalation for half a minute to a few minutes [82,83,85,86,88] .…”

Chlorine gas: molecular mechanisms of toxicity, clinical manifestations, diagnostic biomarkers and modern treatment strategy

“…In severe cases of poisoning, tachycardia, a decrease in the contractile function of the myocardium is usually noted [22,23]. In some cases, chlorine poisoning may develop asthmatic status or ARDS with severe asphyxia [30][31][32].…”

“…Важливими ознаками також були тахікардія (40,0%), тахіпное (40,0%), хрипи (20,0%) і використання допоміжних м'язів для дихання (20,0%). Ознаки та симптоми подразнення очей, ринореї, тахікардії, тахіпное, хрипів та використання допоміжних м'язів для дихання продемонстрували значну кореляцію з результатом (госпіталізація) із значенням (р<0,05) [32].…”

“…Tachycardia (40.0 %), tachypnea (40.0 %), wheezing (20.0 %), and use of accessory muscles for breathing (20.0 %) were also important signs. Signs and symptoms of eye irritation, rhinorrhea, tachycardia, tachypnea, wheezing, and use of accessory muscles for breathing showed a significant correlation with the outcome (hospitalization) with a value of (p < 0.05) [32]. [29].…”