Note to reader: This fact sheet is intended to provide general awareness and education on a specific chemical agent. For information on preparedness and response e.
Chlorine Cl 2 is among the ten highest volume chemicals manufactured in the United States. It is produced commercially by electrolysis of sodium chloride brine. Chlorine is used in industry and in household cleaning products. Chlorine was also the first poison gas to be used as a weapon during World War I. Chlorine has a variety of uses.
It is used to disinfect water and is part of the sanitation process for sewage and industrial waste. During the production of paper and cloth, chlorine is used as a bleaching agent. It is also used in cleaning products, including household bleach which is chlorine dissolved in water.
Chlorine is used in the preparation of chlorides, chlorinated solvents, pesticides, polymers, synthetic rubbers, and refrigerants. Given the ubiquity and volume of chlorine in industrial and commercial locations, widespread exposures could occur from an accidental spill or release, or from a deliberate terrorist attack.
Because chlorine is a gas at room temperature, exposure occurs via inhalation. People may also be exposed to chlorine through skin or eye contact, or through ingestion of chlorine-contaminated food or water.
The health effects of chlorine are primarily due to its corrosive properties. The strong oxidizing effects of chlorine cause hydrogen to split from water in moist tissue, resulting in the release of nascent oxygen and hydrogen chloride which produce corrosive tissue damage. The oxidation of chlorine may also form hypochlorous acid, which will penetrate cells and react with cytoplasmic proteins to destroy cell structure.
The health effects resulting from most chlorine exposures begin within seconds to minutes. The severity of the signs and symptoms caused by chlorine will vary according to amount, route and duration of exposure. Inhalation: Most chlorine exposures occur via inhalation. Chlorine's odor provides adequate early warning of its presence, but also causes olfactory fatigue or adaptation, reducing awareness of one's prolonged exposure at low concentrations.
Facebook Twitter LinkedIn Syndicate. Facts about Chlorine. Minus Related Pages. What chlorine is Chlorine is an element used in industry and found in some household products. Chlorine is sometimes in the form of a poisonous gas. Chlorine gas can be pressurized and cooled to change it into a liquid so that it can be shipped and stored.
When liquid chlorine is released, it quickly turns into a gas that stays close to the ground and spreads rapidly.
Chlorine gas can be recognized by its pungent, irritating odor, which is like the odor of bleach. The strong smell may provide adequate warning to people that they are exposed.
Chlorine gas appears to be yellow-green in color. Chlorine itself is not flammable, but it can react explosively or form explosive compounds with other chemicals such as turpentine and ammonia.
Where chlorine is found and how it is used Chlorine is one of the most commonly manufactured chemicals in the United States. Its most important use is as a bleach in the manufacture of paper and cloth, but it is also used to make pesticides insect killers , rubber, and solvents.
Chlorine is used in drinking water and swimming pool water to kill harmful bacteria. It is also as used as part of the sanitation process for industrial waste and sewage. Household chlorine bleach can release chlorine gas if it is mixed with certain other cleaning agents. Chlorine was used during World War I as a choking pulmonary agent.
If chlorine gas is released into the air, people may be exposed through skin contact or eye contact. They also may be exposed by breathing air that contains chlorine. If chlorine liquid is released into water, people may be exposed by touching or drinking water that contains chlorine. If chlorine liquid comes into contact with food, people may be exposed by eating the contaminated food.
Chlorine gas is heavier than air, so it would settle in low-lying areas. 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. Gas was envisaged as an effective tool to draw soldiers out of their trenches so as to attack them with conventional weapons. It was first used on 22 April , when tons of chlorine gas drifted slowly over the French trenches, where within minutes it killed more than 1, soldiers, injuring approximately 4, more.
Its effect on morale was equally substantial, and as the war continued other toxic gases like sulfur mustard and phosgene were also used, to devastating effect. After World War I some claimed that poison gas was a humane weapon, as it did not kill in the numbers that machine guns and artillery did, and there was fierce debate.
However, poison gas, including chlorine gas, is now classified as a weapon of mass destruction and is banned by the UN Chemical Weapons Convention [ 21 ]. Am J Emerg Med. Proc Am Thorac Soc. West J Emerg Med.
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