The Pulmonary Sequelae Associated with Accidental Inhalation of Chlorine Gas

Schwartz, David; Smith, Deborah Deutsch; Lakshminarayan, S.

doi:10.1378/chest.97.4.820

Cited by 77 publications

(48 citation statements)

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“…Several studies suggest possible long-term airway hyperresponsiveness, obstructive ventilatory impairment, reactive airway dysfunction syndrome, or reduction in residual volume after acute exposure (14)(15)(16)(17). Schwartz and colleagues (18) reported initial airway obstruction for 20 construction workers acutely exposed to chlorine gas. At 12 years' follow-up, 67% showed a significant reduction in residual volume (18).…”

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Lung Function before and after a Large Chlorine Gas Release in Graniteville, South Carolina

et al. 2016

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Rationale: On January 6, 2005 a train derailment led to an estimated 54,915-kg release of chlorine at a local textile mill in Graniteville, South Carolina.Objectives: We used the employee health spirometry records of the textile to identify enduring effects of chlorine gas exposure resulting from the incident on the lung function of workers employed at the textile mill.Methods: Spirometry records from 1,807 mill workers (7,332 observations) were used from 4 years before and 18 months after the disaster. Longitudinal analysis using marginal regression models produced annual population mean estimates for FEV 1 , FVC, and FEV 1 /FVC ratio. Covariate adjustment was made for sex, age, smoking, height, season tested, technician, obesity, season 3 year interactions, and smoker 3 year interactions. The increased prevalence of mill workers having accelerated FEV 1 decline was also evaluated after the chlorine spill. Measurements and Main Results:In the year of the accident, we observed a significant reduction in mean FEV 1 (-4.2% predicted; P = 0.019) when compared with the year before the incident. In the second year, partial recovery in the mean FVC % predicted level was seen, but the cohort's average FEV 1 /FVC ratio continued to decrease over time. Severe annual FEV 1 decline was most prevalent in the year of the accident, and independent of mill worker smoking status. Conclusions:The Graniteville mill worker cohort revealed significant reductions in lung function immediately after the chlorine incident. Improvement was seen in the second year; but the proportion of mill workers experiencing accelerated FEV 1 annual decline significantly increased in the 18 months after the chlorine incident.

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confidence: 99%

“…Schwartz and colleagues (18) reported initial airway obstruction for 20 construction workers acutely exposed to chlorine gas. At 12 years' follow-up, 67% showed a significant reduction in residual volume (18). Nevertheless, otherwise healthy individuals are expected to recover, with few experiencing long-term respiratory complications (17,(19)(20)(21)(22).…”

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Lung Function before and after a Large Chlorine Gas Release in Graniteville, South Carolina

et al. 2016

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“…Several case reports of irritant induced asthma or RADS caused by chlorine (8,(22)(23)(24)(25) or hydrogen chloride (10,26,27) have been published. Chlorine has also been known to cause bronchiolitis obliterans (25,28).…”

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confidence: 99%

Prolonged respiratory symptoms caused by thermal degradation products of freons

Piirilä

Espo²,

Pfäffli³

et al. 2003

Scand J Work Environ Health

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“…Of these persons, 49 (52 %) reported a continued need for medications for unspecified chlorine-related health effects [36]. Additionally, there are several case reports that describe patients with one-time exposures to chlorine gas who developed reactive airway dysfunction syndrome that persisted for years after exposure [18,[37][38][39][40][41]. All patients reported were current smokers, former smokers, had a history of atopy, or had a history of childhood asthma.…”

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confidence: 99%