Agency for Toxic Substances and Disease Registry. ToxFAQs for Chlorine. Division of Toxicology, U. Department of Health and Human Services. Medical Management Guidelines for Chlorine. Centers for Disease Control and Prevention. In: Sifton DW Ed. This fact sheet is based on the most current information. It may be updated as new information becomes available. Navigation menu. What is chlorine?
How is chlorine used? How can people be exposed to chlorine? What happens to chlorine in the body? What are the immediate health effects of chlorine exposure? Following chlorine exposure, the most common symptoms are: Airway irritation Wheezing Difficulty breathing Sore throat Cough Chest tightness Eye irritation Skin irritation The severity of health effects depend upon the route of exposure, the dose and the duration of exposure to chlorine.
What can you do if you think you may have been exposed to a release of chlorine? If you have been exposed to a release of chlorine, take the following steps: Quickly move away from the area where you think you were exposed. If the release was indoors, go outdoors.
If you are near a release of chlorine, emergency coordinators may tell you to either evacuate the area or to "shelter in place. While indoors, shut and lock all doors and windows, turn off air conditioners, fans and heaters, and close fireplace dampers. Quickly remove any clothing that may have chlorine on it. If possible, clothing that is normally removed over the head like t-shirts and sweaters should be cut off the body to prevent additional contact with the agent.
Department of Health and Human Services. Medical Management Guidelines for Chlorine. Centers for Disease Control and Prevention. In: Sifton DW Ed. This fact sheet is based on the most current information. It may be updated as new information becomes available.
Navigation menu. What is chlorine? Chlorine has a pungent, irritating odor similar to bleach that is detectable at low concentrations. The density of chlorine gas is approximately 2. Chlorine is not flammable, but may react explosively or form explosive compounds with many common substances including acetylene, ether, turpentine, ammonia, natural gas, hydrogen, and finely divided metals. Chlorine is slightly water soluble, and reacts with moisture to form hypochlorous acid HClO and hydrochloric acid HCl.
Chlorine is commonly pressurized and cooled for storage and shipment as an amber-colored liquid. How is chlorine used? How can people be exposed to chlorine? What are the immediate health effects of chlorine exposure? How is chlorine poisoning treated? Will laboratory tests assist in making treatment decisions if someone has been exposed to chlorine? How can I get more information about chlorine?
Call the following numbers, or visit the websites listed among the "Sources". August 5, At very high levels, alveolar damage occurs rapidly. Pulmonary oedema is the most significant life-threatening effect. The level of harm is influenced by victim factors age, current lung health, presence of bronchospasm response, exertional state and metabolic rate, history of smoking and environmental factors intensity and duration of exposure, quality of ventilation in the space in which exposure occurs.
Greater exposure is associated with greater potential harm [ 11 ]. This depends on the level of exposure. During or immediately after exposure to dangerous concentrations of chlorine, the following signs and symptoms are typical:.
These symptoms are not specific for chlorine; many are also features of exposure to other chemical agents such as phosgene and tear gas, and to some neurological agents. For those exposed, the most obvious clues to chlorine as the causative agent are the characteristic smell of chlorine and the sight of the yellow-green, dense gas at ground level.
The presence and speed of development of pulmonary oedema depend on exposure intensity. Patients present with worsening respiratory distress. If pulmonary oedema is to develop, it usually does so within hours, although after very high exposure it can develop in minutes with extremely poor prognosis.
Oedema fluid, usually frothy, is secreted from the bronchi, and may leak from the mouth and the nostrils. At very high levels of exposure, death occurs in minutes to hours from respiratory failure, hypoxaemia, hypovolaemia, acute respiratory obstruction, alveolar destruction or a combination of these. Acute pulmonary hypertension, pulmonary vascular congestion, and burns of the upper and proximal lower airways contribute. Hypoxia and hypotension indicate a poor prognosis, as does development of pulmonary oedema within four hours of exposure.
Chronic exposure to relatively low levels of chlorine gas tends to cause chronic low-level symptoms - particularly:. Repeated exposure to chlorine in the pool has been postulated as the cause of an excess of asthma among swimmers [ 13 ]. In atopic adolescents, the risk factor of allergic rhinitis and asthma appears to be dose-dependently augmented by chlorinated swimming pool attendance [ 14 ]. The symptoms of chlorine gas exposure are nonspecific, although the smell and sight of the gas are diagnostic if the patient can give a history.
Other possible causes of similar symptoms include:. Riot-control agents Tear gas and CS gas produce severe tearing, along with burning sensation and pain, predominantly in the eyes, upper airways, mucous membranes, and skin. The distinctive odour of chlorine is absent. CS gas produces in addition profuse coughing, disorientation, difficulty breathing, and vomiting. However, it does not cause pulmonary oedema at the levels seen in crowd-control situations [ 15 ].
Nerve agents These cause the production of watery secretions as well as respiratory distress. Other characteristic effects, such as muscle twitching and miosis, help distinguish them from chlorine. Vesicants These blistering agents, such as mustard gas, usually produce a delayed respiratory toxicity of the central airways. Vesicant inhalation severe enough to cause dyspnoea typically causes signs of airway necrosis, often with pseudomembrane formation and partial or complete upper airway obstruction.
Pulmonary damage usually manifests as haemorrhage rather than oedema. Investigations are of limited value in the immediate care of exposed patients, although some have predictive value in determining severity of outcome.
CXR Radiological changes may lag behind clinical changes by days, so the chest radiograph may be of limited value, particularly if normal. Hyperinflation suggests toxic injury of the smaller airways with alveolar air trapping.
Perihilar infiltrates suggest pulmonary oedema secondary to alveolar-capillary membrane damage. Atelectasis is common. Arterial blood gases Both central and peripheral pulmonary damage may produce hypoxia. Normal arterial blood gas values at hours are predictive of non-lethal outcome. High PaCO 2 suggests bronchospasm. Pulmonary function tests Peak expiratory flow rate may decrease soon after a massive exposure and helps to assess both degree of airway damage and effect of bronchodilator therapy.
In the field, rapid triage of patients may be necessary. It is done according to clinical condition and available treatment:. The casualty should be physically removed from the hazardous environment or, if this is not possible, given respiratory protection. Removal from the source of the poisoning includes removal of contaminated clothing and contact lenses. Decontamination of liquid agent on clothing or skin is essential.
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