What Is Chlorine Poisoning?

Chlorine poisoning is a systemic disease mainly caused by acute respiratory damage caused by inhalation of a large amount of chlorine gas in the short term during work. Chlorine gas is a yellow-green irritant gas, and its specific gravity is 2.5 times that of air, which causes severe damage to the respiratory tract and is highly irritating to the eye mucosa and skin. It is widely used in the chemical and plastic industries. It is used as a bleaching agent in the paper and textile industries. Liquid chlorine is widely used in daily disinfection and cleaning agents.

Basic Information

English name

chlorine poisoning luqi zhongdu

Visiting department

Emergency Department

Common causes

Exposure to chlorine in industry, inhaling a large amount of chlorine in a short time

Common symptoms

Cough, headache, fatigue and nausea, loss of appetite, abdominal pain, bloating, etc. Can cough a lot of white or pink foamy sputum, difficulty breathing, tightness in the chest, etc.

Causes of Chlorine Poisoning

The opportunity for industrial exposure to chlorine is that it can be exposed to chlorine during the manufacture or use of chlorine if the equipment pipeline is not tightly sealed or during maintenance. When liquid chlorine is poured, transported, and stored, if the cylinder is not properly sealed or faulty, a large amount of chlorine gas can also escape. It is mainly found in electrolytic salt solution, manufacturing various chlorine-containing compounds, papermaking, printing and dyeing, and tap water disinfection. Chlorine has two kinds of effects on the human body: acute poisoning and chronic damage. Acute poisoning can be clinically divided into stimulus, mild, moderate and severe poisoning.

Clinical manifestations of chlorine poisoning

Chlorine stimulus response

Transient eye and upper respiratory tract irritation occur. The lungs have no positive signs or occasional dry rales, which usually resolve within 24 hours.

2. Mild poisoning

Mainly manifested as bronchitis or peribronchitis, cough, a small amount of sputum, chest tightness and so on. There are scattered dry wheezing or wheezing sounds in both lungs, with a small amount of wet wheezing. X-rays of the lungs show increased lung texture, thickening, and blurred edges. Generally, the lung field below is more obvious. After rest and treatment, symptoms can disappear within 1-2 days.

3. Moderate poisoning

Mainly manifested as bronchial pneumonia, interstitial pulmonary edema or limited alveolar pulmonary edema. Eye and upper respiratory tract irritation symptoms worsened, chest tightness, dyspnea, paroxysmal cough, sputum, and sometimes coughing pink foamy sputum or blood in sputum, accompanied by headache, fatigue and nausea, loss of appetite, abdominal pain, abdominal distension and other stomach Gut reaction. Mild cyanosis, dry or wet snoring in both lungs, or diffuse wheezing in both lungs. The above symptoms gradually subsided after rest and treatment for 2 to 10 days.

4. Severe poisoning

In clinical manifestations or chest X-ray findings, one of the following conditions is severe poisoning.

(1) Clinical manifestations: Pulmonary edema occurs when inhaled high concentration of chlorine for several minutes to several hours. A large amount of white or pink foamy sputum can be coughed, dyspnea, tightness in the chest, obvious cyanosis, and diffuse wet snoring in both lungs; severe suffocation caused by throat, bronchospasm or edema; shock and moderate and deep coma; sudden death due to reflex respiratory depression or cardiac arrest; serious complications such as pneumothorax and mediastinal emphysema.

(2) The chest X-ray manifestations were mainly extensive, diffuse pneumonia or alveolar pulmonary edema. There are large flaky uniform density-increasing shadows, or flaky shadows with different sizes and densities, and fuzzy edges, which are widely distributed in the two lung fields, and a small number are butterfly wings. After severe chlorine poisoning, bronchial asthma or asthmatic bronchitis can occur. The latter is caused by organic scars formed by the corrosion of hydrochloric acid, which is difficult to recover and can develop into emphysema.

Chlorine poisoning test

Molybdenum target X-ray examination, chest radiography, pleural effusion examination, blood routine, urine routine, white blood cell count (WBC) examination. X-ray manifestations: Chest radiographs may be normal when the disease is mild, and may also be manifested as changes in pulmonary interstitial and / or changes in lung parenchyma.

Chlorine poisoning diagnosis

1. Most patients have a history of chlorine exposure, and most of the affected persons are collective multiple people.

2. According to clinical manifestations, there are symptoms such as tears, conjunctival irritation, dry cough, sore throat, chest pain, dyspnea, etc. The diagnosis is not difficult.

Differential diagnosis of chlorine poisoning

It should be distinguished from acute laryngitis, bronchitis, and bronchopneumonia caused by other causes.

Chlorine poisoning treatment

Basic treatment

(1) General treatment Immediately evacuate the patient to fresh air. If the eyes or skin are contaminated, immediately rinse thoroughly with water or normal saline and give 0.5% cortisone eye drops and antibiotic eye drops; for skin acid burns Wet compress with 2% ~ 3% sodium bicarbonate solution. Patients exposed to a certain amount of chlorine gas should stay in the hospital for observation. The monitoring content includes changes in breathing, pulse and blood pressure, and strive for early blood gas analysis and dynamic chest X-ray film observation.

(2) Correct hypoxia Give oxygen inhalation and keep the airway open.

(3) Prevention and treatment of pulmonary edema Nebulizing inhalation neutralizer, such as local inhalation of 5% sodium bicarbonate. Reasonable application of glucocorticoids. Dexamethasone can be given intravenously or instilled depending on the condition.

2. Pulmonary Edema Treatment

(1) Oxygen Oxygen is one of the important measures to treat pulmonary edema and improve the state of hypoxia. When inhaling oxygen, pay attention to maintain the blood oxygen partial pressure at about 80mgHg, and avoid the toxicity of high concentration oxygen.

(2) Nebulization Inhalation Use gentamicin, dexamethasone, aminophylline, 5% sodium bicarbonate, add 0.9% physiological saline to 50ml, and inhale every 4 hours, 10-15 ml each time.

(3) Reduce pulmonary capillary permeability Early, adequate and short-term application of adrenal glucocorticoids is the key to the treatment of pulmonary edema. Dexamethasone or hydrocortisone can be given intravenously or intravenously, and the dose can be reduced according to the condition later. Glucocorticoids are usually used for 2 to 5 days, but severe chlorine poisoning can be applied for a period of time under close observation, depending on the condition.

(4) Antispasmodic defoaming, keeping the airway open. Aminophylline can be used. Pulmonary edema can be nebulized and inhaled when there is a large amount of foam blocking the airway (dimethyl silicone oil).

(5) Vasodilators It has been reported that the use of vasodilators to rescue toxic pulmonary edema has achieved good results. Sodium nitroprusside, analgesic, phentolamine, and anisodamine can be tried.

(6) Treatment of complications . Toxic pulmonary edema is prone to complicated with lung infections. It must be treated with antibiotics early, in sufficient quantity, and combined with antibiotics. Pulmonary edema often has acidosis. Respiratory alkalosis can occur with artificial respirators or excessive ventilation. The abnormal acid-base balance should be prevented and dealt with in a timely manner.

Chlorine poisoning prevention

Chlorine gas is an important industrial raw material. Many chemical substances contain chlorine. For example, disinfectants commonly used in drinking water disinfection, certain drugs, chemical fibers or plastics require chlorine as raw materials. Excessive chlorine inhalation can cause respiratory tract damage, and in severe cases can cause acute pulmonary edema. Improper rescue may cause suffocation and death. But the harm of chlorine gas should also be preventable.

1. Strengthen safety education, improve operating procedures, regularly check production equipment to prevent running, running, dripping, leaking, and strengthen ventilation.

2. Pay more attention to safety and personal protection during transportation.

3. Take good physical examination before employment. Those who have trachea and cardiopulmonary diseases should not engage in such operations.