Many impurities in the water require a large amount of chlorine to react with all the impurities present. The chlorine added must first react with all the impurities in the water before a chlorine residual is present. [safewater.org]

Figure 1 Discussion People usually present after inhalation of noxious smoke or chemicals and may present with cough, shortness of breath and wheezing 1, 2 and sometimes lower epithelial damage with inhalation pneumonitis. [ispub.com]

Disinfecting Water : Chlorine is often present in chemicals used to kill bacteria in drinking water and swimming pools. Chlorine is very effect against e coli bacteria. [ivyroses.com]

Patients were placed in control and treatment groups in a sequential odd-even fashion based on their order of presentation. Treatment of all patients included corticosteroids and nebulized short-acting beta2-agonists. [ncbi.nlm.nih.gov]

Otherwise, treatment is primarily supportive and patients should be observed closely for resolution of the primary presenting symptoms and signs. [clinicaladvisor.com]

• Falling

  Extreme cyanosis with a full pulse is greatly relieved by bleeding: breathing becomes easier, headache is relieved, and the patient falls into a refreshing sleep. [vlib.us]

  Die Gesamtzellenreaktion kann somit in jedem Falle durch The overall cell reaction can therefore by in each case wiedergegeben werden. are reproduced. [google.dj]

  Bubble chlorine through humic and fumic acids common to surface water supplies and you produce the "fishy" or "musty" odors and tastes so common in the spring and fall, when the lake "turns-over." [pure-earth.com]

  And that has the odd consequence that the demand for chlorine rises and falls in line with property booms and busts. And because the supply of sodium is inextricably tied to that of chlorine, it has an even odder consequence. [bbc.co.uk]

  Whenever they saw a soldier whom the fumes had not quite killed they snatched away his rifle and advised him to lie down "to die better". (5) Captain Hugh Pollard, The Memoirs of a VC (1932) Dusk was falling when from the German trenches in front of the [spartacus-educational.com]

• Fatigue

  Since poly neuropathy and fatigue could be caused by pesticides or other poisoning, i.e. heavy metals, we have been consulted for taking a detailed exposure history. [occup-med.biomedcentral.com]

  Most symptoms improved, including disturbances such as rigor, muscle pain or cramps, hypersomnia, increased libido, sweating, fatigue, concentration, and anxiety. [gjpsy.uni-goettingen.de]

  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 IMMEDIATE SYMPTOMS OF CHLORINE EXPOSURE 10.  Ingestion: Since chlorine [slideshare.net]

  Patients who were closer to the accident spot more frequently complained of symptoms such as shortness of breath, sore throat, eye pain, itching, dizziness, anxiety, general weakness, and fatigue. [aoemj.biomedcentral.com]

  The strong “rotten egg” odor of the gas is not a reliable warning sign for toxicity due to olfactory fatigue at high concentrations or continuous low concentrations. [clinicaladvisor.com]

• Fever

  Skin: Irritation to the eyes, nose, throat, mucous membranes Other: Headache, fever, tachycardia, abdominal pain, dizziness and confusion. Supportive Care Bronchodilators should be used for bronchospasm. [lifeinthefastlane.com]

  She denied fever, nausea, vomiting and flue like symptoms. She had past medical history of hypertension asthma, and depression. She denied leg swelling, or recent travel and contact with pets and any other exposure recently. [ispub.com]

  Neither fever symptoms nor skin rashes were observed. [aoemj.biomedcentral.com]

  […] visited the Gaubschat -factory/company in Berlin-Neukoelln, which was specialized in the production of sealed/closed box- superstructures [footnote 47] where they pretended, that they needed the vans to transport the dead victims/corpses of a spotted fever [forum.axishistory.com]

• Camping

  A derivative pesticide, Zyklon B, was used to exterminate millions in Nazi concentration camps, where many of Haber’s close relatives died. [newsweek.com]

  Germany, however, did use poison gas to murder millions in its extermination camps. [history.com]

  The first gas vans were supplied to the Einsatzgruppen and to the Chelmno death camps in November-December 1941. The killing in Chelmno began on December 8, 1941. [forum.axishistory.com]

  Daniel Noltkamper, MD, FACEP EMS Medical Director, Department of Emergency Medicine, Naval Hospital of Camp Lejeune Daniel Noltkamper, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians Disclosure: Nothing [emedicine.medscape.com]

• Crying

  The nose runs, the eyes cry, the mouth drools and vomits, and bowels and bladder evacuate themselves. It is not a dignified state. Since sarin has no smell or taste, the person may very well have no idea what's going on. [theatlantic.com]

  People crying. Ambulances called. Don't go to Birling Gap at the moment". [telegraph.co.uk]

• Cough

  [Medscape] High-level chlorine (20%, >30 ppm) acute exposure symptoms [Medscape]: Dyspnea: Upper airway swelling and obstruction may occur Violent cough Nausea and vomiting (with the smell of chlorine in emesis) Lightheadedness Headache Chest pain or [drmz13.wordpress.com]

  Mouth and Throat Irritant Chlorine gas exposure within the mouth and throat causes coughing and throat and mouth dryness. Breathing difficulty and chronic coughing will only result at high concentrations of chlorine gas. [sciencing.com]

  Coughing and bloody nose or sputum. 5 - 10 Moderate upper respiratory irritation 10 - 20 Intense upper respiratory irritation 30 Chest pain, vomiting dyspnoea and cough Clinical features: Respiratory: Cough, sore throat, chest tightness, rhinorrhoea, [lifeinthefastlane.com]

  Exposure to chloramine gases can cause the following symptoms: Coughing. Nausea. Shortness of breath. Watery eyes. Chest pain. Irritation to the throat, nose, and eyes. Wheezing. Pneumonia and fluid in the lungs. [doh.wa.gov]

  Conclusion Our patient initially presented with cough, progressive shortness of breath and chest pain. In view of infiltrate on chest x-ray and CT scan, she was started on antibiotics. [ispub.com]

• Dyspnea

  [Medscape] High-level chlorine (20%, >30 ppm) acute exposure symptoms [Medscape]: Dyspnea: Upper airway swelling and obstruction may occur Violent cough Nausea and vomiting (with the smell of chlorine in emesis) Lightheadedness Headache Chest pain or [drmz13.wordpress.com]

  The most common symptoms were dyspnea (82%) and chest tightness (82%). Baseline characteristics of both groups were similar. Compared to the placebo group, the NSB group had significantly higher FEV1 values at 120 and 240 min (p < .05). [ncbi.nlm.nih.gov]

  Upon exposure to chlorine gas, he experienced dyspnea and presented to the emergency department. [aoemj.biomedcentral.com]

  She had severe resting dyspnea during the second hour, diffuse crackles/rhonchi on auscultation, and a partial pressure of oxygen of 32 mm Hg breathing room air. The radiograph shows diffuse pulmonary edema without significant cardiomegaly. [emedicine.medscape.com]

  CASE REPORT A 25-year-old man came to the Hahnemann University Hospital Emergency Room with severe dyspnea. He had a history of mild childhood asthma, which had resolved at the age of 5 years. [nap.edu]

• Sneezing

  Showering with unfiltered water may also cause the following symptoms: Sneezing Tightness in chest Weak cough Mild sore throat Increased dryness in throat Irritation in nasal passages Apart from monitoring the chlorine content in pools, invest in carbon [filterwater.com]

  There will generally be sneezing, nose irritation, burning sensation, and throat irritation. There may also be skin irritation or chemical burns and eye irritation or conjunctivitis. [en.wikipedia.org]

  Initial German Experiments In the capture of Neuve Chapelle in October 1914 the German army fired shells at the French which contained a chemical irritant whose result was to induce a violent fit of sneezing. [firstworldwar.com]

  Manifestations are as follows: Eye tearing, nose and throat irritation Sneezing Excess salivation General excitement or restlessness High-level (20%, >30 ppm) acute exposure In addition to the symptoms seen with low-level exposure, high-level exposure [emedicine.medscape.com]

  Fragrances added to many cleaners, most notably laundry detergents and fabric softeners, may cause acute effects such as respiratory irritation, headache, sneezing, and watery eyes in sensitive individuals or allergy and asthma sufferers. [organicconsumers.org]

• Painful Cough

  cough, eye irritation, increased heartbeat, rapid breathing, and death. [globalhealingcenter.com]

  Frequent and painful coughing occurs and some frothy sputum is brought up. [vlib.us]

  […] to high-concentration chlorine products Esophageal perforation Chronic exposure Manifestations of chronic exposure include the following: Acne (chloracne) Chest pain Cough Sore throat Hemoptysis Findings on physical examination may include the following [emedicine.medscape.com]

• Hemoptysis

  In addition, they often cause cough and blood in the sputum (hemoptysis). Retching and shortness of breath also are common. [merckmanuals.com]

  Immediately following this exposure, the patient experienced a transient episode of hemoptysis followed by acute shortness of breath and wheezing. [nap.edu]

  […] exposure): Corneal burns and ulcerations may occur from splash exposure to high-concentration chlorine products Esophageal perforation Chronic exposure Manifestations of chronic exposure include the following: Acne (chloracne) Chest pain Cough Sore throat Hemoptysis [emedicine.medscape.com]

• Vomiting

  [Medscape] High-level chlorine (20%, >30 ppm) acute exposure symptoms [Medscape]: Dyspnea: Upper airway swelling and obstruction may occur Violent cough Nausea and vomiting (with the smell of chlorine in emesis) Lightheadedness Headache Chest pain or [drmz13.wordpress.com]

  Headache, vomiting and fainting occur after a long exposure at high concentrations. Skin Irritant Skin exposed to chlorine gas can become frostbitten. The gas fuses into the skin cells and under the epidermal layer. [sciencing.com]

  Vomiting blood HEART AND BLOOD VESSELS Collapse Low blood pressure that develops rapidly SKIN Burns Holes (necrosis) in the skin or tissues underneath Irritation Seek medical help right away. [medlineplus.gov]

  […] in the affected individual Otherwise, following an ingestion of the substance, immediately give milk or water to drink In case of symptoms that indicate difficulty in swallowing including vomiting or decreased alertness, do not give anything by way of [dovemed.com]

  Don’t try to induce vomiting unless instructed by poison control or a medical professional. If you get chlorine on your skin, immediately wash it with soap and water. [healthline.com]

• Nausea

  [Medscape] High-level chlorine (20%, >30 ppm) acute exposure symptoms [Medscape]: Dyspnea: Upper airway swelling and obstruction may occur Violent cough Nausea and vomiting (with the smell of chlorine in emesis) Lightheadedness Headache Chest pain or [drmz13.wordpress.com]

  Nausea. Shortness of breath. Watery eyes. Chest pain. Irritation to the throat, nose, and eyes. Wheezing. Pneumonia and fluid in the lungs. [doh.wa.gov]

  Their most frequent chief complaints was headache (22.7%), followed by eye irritation (18.2%), nausea (11.3%), and sore throat (10.8%). [aoemj.biomedcentral.com]

  Drinking levels over 4 ppm can cause throat and stomach irritation, nausea and vomiting. By testing lung function and examining your skin and teeth, your doctor can evaluate the health effects of chlorine exposure. [dhs.wisconsin.gov]

  […] difficulty Water filling the lungs Pain or burning in the nose, lips or tongue Low blood pressure Changes in pH balance in the blood When a person swallowing chlorine or a product or liquid containing chlorine, they may experience the following symptoms: Nausea [symptomfind.com]

• Choking

  'I want him [Assad] to see the faces of the children who woke up choking in the middle of the night.' [aljazeera.com]

  Chlorine is a poisonous, greenish-yellow gas described as having a choking odor. It is a very corrosive, hazardous chemical. [dhs.wisconsin.gov]

  Phosgene as a weapon was more potent than chlorine in that while the latter was potentially deadly it caused the victim to violently cough and choke. [firstworldwar.com]

  At room temperature, it is a greenish-yellow gas with a choking smell, which is denser than air. [newsweek.com]

  […] that long-term exposure to chlorinated pools can cause symptoms of asthma in swimmers. [ 2 ] This can affect athletes who were previously healthy, especially adolescents. [ 3 ] Chlorine is even toxic enough to be a chemical weapon and categorized as a “choking [globalhealingcenter.com]

• Diarrhea

  14,000 pregnant women, they found that in homes where aerosols and air fresheners were used frequently, mothers suffered from 25% more headaches and 19% more depression, and infants under six months had 30% more ear infections and 22% higher incidence of diarrhea [organicconsumers.org]

• Chest Pain

  [Medscape] High-level chlorine (20%, >30 ppm) acute exposure symptoms [Medscape]: Dyspnea: Upper airway swelling and obstruction may occur Violent cough Nausea and vomiting (with the smell of chlorine in emesis) Lightheadedness Headache Chest pain or [drmz13.wordpress.com]

  Chest pain. Irritation to the throat, nose, and eyes. Wheezing. Pneumonia and fluid in the lungs. [doh.wa.gov]

  Conclusion Our patient initially presented with cough, progressive shortness of breath and chest pain. In view of infiltrate on chest x-ray and CT scan, she was started on antibiotics. [ispub.com]

  Immediately or shortly after exposure to 30 ppm or more of chlorine gas, a person may have: Chest pain Vomiting Coughing Difficulty breathing Excess fluid in their lungs Exposure to 430 ppm in air for 30 minutes will cause death. [dhs.wisconsin.gov]

  pains, cough, eye irritation, increased heartbeat, rapid breathing, and death. [globalhealingcenter.com]

• Cyanosis

  Of interest is the treatment of cyanosis by bleeding. [vlib.us]

  Early cyanosis carries a near-hopeless prognosis. Gastroenterological : nausea and vomiting, oesophageal perforation at high levels. Neurological : headache, disorientation. [patient.info]

  […] high-concentration chlorine products Esophageal perforation Chronic exposure Manifestations of chronic exposure include the following: Acne (chloracne) Chest pain Cough Sore throat Hemoptysis Findings on physical examination may include the following: Tachypnea Cyanosis [emedicine.medscape.com]

  […] developed classic early signs and symptoms of acute exposure. 3 Two children, after brief exposure to fumes from solid chlorine products used in residential pools in Nebraska in 1986, developed lethargy, productive cough, severe hypoxaemia, tachypnoea, cyanosis [oem.bmj.com]

• Blepharospasm

  Dose ppm Signs and symptoms 0.02 - 0.2 Odour threshold 1 - 3 Mild irritation to eyes, nose and throat 3 - 6 Itching, stinging, and boring of the eyes, lacrimation, blepharospasm, burning in the nose and throat. [lifeinthefastlane.com]

  Eye irritation - red eyes, tearing, blepharospasm. ENT irritation: chronic sore throat, rhinorrhoea, hypersalivation, stridor. [patient.info]

  […] during exertion) Tachycardia Wheezing Intercostal retractions Decreased breath sounds Rales (pulmonary edema) Nasal flaring Aphonia, stridor, or laryngeal edema Ulceration or hemorrhage of the respiratory tract Rhinorrhea Lacrimation, salivation, and blepharospasm [emedicine.medscape.com]

• Eye Pain

  9 12.3 13 10.0 22 10.8 0.608 Dental pain 24 32.9 35 26.9 59 29.1 0.370 Eye Eye pain 31 42.5 31 23.8 62 30.5 0.006 Eye redness 8 11.0 12 9.2 20 9.9 0.692 Blurred vision 9 12.3 11 8.5 20 9.9 0.375 Skin Itching 13 17.8 9 6.9 22 10.8 0.017 Nerve Headache [aoemj.biomedcentral.com]

• Fear

  Fears from the coastguard that people could be trapped on the beach saw the RNLI launch all-weather lifeboats from Eastbourne and Newhaven to the Birling Gap area. Mist could be seen in the area Credit: Reuters [telegraph.co.uk]

  This is a fleeting, but not uncommon snapshot of the destructive role chlorine attacks have played - and the fear the chemical has sown - in the country's civil war, which enters its seventh year this week. [aljazeera.com]

  “Ultimately, the administration’s statements today could lead America’s true allies and partners in the fight against Isis to fear the worst: a Faustian bargain with Assad and Putin sealed with an empty promise of counter-terrorism cooperation,” McCain [theguardian.com]

  Steve Harrison, President Environmental Systems Distributing Sunday, 20 February, 2000 The Electronic Telegraph London, England An independent study into the use of chlorine-treated drinking water has been ordered by the Government because of fears that [pure-earth.com]

  It was designed not just to kill the enemy but also to inflict fear in the enemy. You remember every second you were exposed to the gas. You don't know where to go. You see your clothes bleach before your very eyes. [scientificamerican.com]

• Delusion

  He displayed no evidence of hallucinations or delusions, he still complained of disturbances of concentration. [gjpsy.uni-goettingen.de]

• Confusion

  In the future they plan to use physically different containers or tubs so the bleach and acid baths are not confused again. Normally, the acid bath is used in an orange bucket and the bleach bath in the white square tub. [ehs.berkeley.edu]

  Skin: Irritation to the eyes, nose, throat, mucous membranes Other: Headache, fever, tachycardia, abdominal pain, dizziness and confusion. Supportive Care Bronchodilators should be used for bronchospasm. [lifeinthefastlane.com]

  Confused by Donald Trump’s policy on Syria ? That just means you’ve been listening to what his administration has been saying in the last few days. [theguardian.com]

  However the results of their experiment caused as much surprise to the German high command as confusion among their opponents. German infantry did advance into the gap, but nervously and with hesitance. [firstworldwar.com]

  But people can and do confuse bleach (sodium hypochlorite) with hydrochloric acid, and mixing them will generate chlorine gas and other nasty gasses. [finishing.com]

• Seizure

  Repeated ethanol withdrawal delays development of focal seizures in hippocampal kindling. Alcohol Clin Exp Res 1999 (in press) Bleich S, Degner D, Sprung R, Riegel A, Poser W, Rüther E. Chronic manganism: fourteen years of follow up. [gjpsy.uni-goettingen.de]

He was admitted to Hahnemann University Hospital for management of an acute exacerbation of his illness and a diagnostic workup. Physical examination revealed an afebrile, cushingoid patient in moderate respiratory distress. [nap.edu]

Laboratory examinations including blood, sputum cultures were sterile and all immunological workup were negative and work up for infective and connective tissue disorder did not reveal any abnormality .Chest x-ray revealed bilateral consolidation and [ispub.com]

See Workup for more detail. [emedicine.medscape.com]

Patients were placed in control and treatment groups in a sequential odd-even fashion based on their order of presentation. Treatment of all patients included corticosteroids and nebulized short-acting beta2-agonists. [ncbi.nlm.nih.gov]

Treatment: Both hydroxocobalamine or a combination of nitrite/sodium thiosulfate are approved for treatment of cyanide poisoning in the United States. [clinicaladvisor.com]

Chlorination may also be done as the final step in the treatment process, which is when it is usually done in most treatment plants. [safewater.org]

In addition, nearly 125 water treatment plants have switched from chlorine gas to liquid bleach or ultraviolet treatments, according to a 2008 Center for American Progress report. [foreffectivegov.org]

Early hypoxaemia has a poor prognosis. [patient.info]

The prognosis of Chlorine Poisoning is dependent on the amount of substance consumed, time between consumption and treatment, severity of the symptoms, as well as general health status of the patient If the individual can recover from the symptoms with [dovemed.com]

Chapter X describes the effects of chlorine gas poisoning, the patient's symptoms, prognosis and the treatment advocated in 1916. Of interest is the treatment of cyanosis by bleeding. [vlib.us]

9.1.1 Ingestion 9.1.2 Inhalation 9.1.3 Skin exposure 9.1.4 Eye contact 9.1.5 Parenteral exposure 9.1.6 Other 9.2 Chronic poisoning 9.2.1 Ingestion 9.2.2 Inhalation 9.2.3 Skin exposure 9.2.4 Eye contact 9.2.5 Parenteral exposure 9.2.6 Other 9.3 Course, prognosis [inchem.org]

Prognosis A majority of the patients with mild to moderate irritant exposure have a self-limited course with full recovery seen within 48 to 72 hours. [clinicaladvisor.com]

Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. [books.google.com]

However, blood and sputum cultures along with broncho-scopic examination did not reveal infective etiology and she did not improve, open lung biopsy was performed. [ispub.com]

See Etiology. Chlorine gas has also been used repeatedly as a chemical weapon. [3] The respiratory and mucous membrane irritant effects of chlorine have been well known for many years. [emedicine.medscape.com]

Smoking or pre-existing lung conditions like asthma appear to increase the risk of long term complications. [1] Epidemiology [ edit ] In 2014, the American Association of Poison Control Centers reported that about 6000 exposures to chlorine gas in the [en.wikipedia.org]

Adult Blood Lead Epidemiology & Surveillance (Ables). https://wwwcdcgov/niosh/topics/ables/. Accessed 29 June 2016. National-Toxicology-Program. [occup-med.biomedcentral.com]

American Journal of Epidemiology, 123(4), 641-647. In September 1982, two Charlottesville, Virginia, residents were found by their dentists to have general erosion of dental enamel consistent with exposure to acid. [coachsci.sdsu.edu]

Epidemiology Due to lack of consistent diagnostic methods, the incidence of inhalation injury from all chemical irritants is not readily available. [clinicaladvisor.com]

These concerns about cancer risks associated with chemical contamination from chlorination by-products have resulted in numerous epidemiological studies. [pure-earth.com]

Fein A, Leff A, Hopewell PC: Pathophysiology and management of the complications resulting from fire and the inhaled products of combustion. Crit Care Med 8:94–98, 1980 PubMed CrossRef Google Scholar 50. [link.springer.com]

Pathophysiology Inhalation of toxic gases leads to injury through a variety of mechanisms. [clinicaladvisor.com]

Pathophysiology [ 10 ] Chlorine gas is classed as a pulmonary agent or choking agent (others include phosgene, diphosgene and chloropicrin). [patient.info]

[6] The Organization for the Prohibition of Chemical Weapons (OPCW) has confirmed that since 2013, chlorine gas has been the agent used in numberous chemical attacks in Syria affecting thousands of civilians and resulting in hundreds of deaths. [3] Pathophysiology [emedicine.medscape.com]

However, the health effects of chlorine inhalation after swimming pool accidents have been documented in only few studies, and have concentrated on pathophysiology, clinical presentation, and types of treatment. 3 4 Early physiological and clinical pulmonary [oem.bmj.com]

Prevention Tips There are several ways you can help prevent chlorine poisoning, including: Read labels carefully when using household cleaning products and follow the instructions accordingly. [symptomfind.com]

How can incidents like this be prevented? Clearly label all chemical containers with the chemical's name and hazards. Use physically different containers for bleach and acid baths. Emphasize the hazard of accidentally mixing acid and bleach. [ehs.berkeley.edu]

[…] id=198&tid=36 Centers for Disease Control and Prevention. 2003. Public Health Emergency Preparedness and Response Sheets. U.S. Department of Health and Human Services. [health.ny.gov]

Ventilate the area to prevent the gas from accumulating, especially in confined spaces. Large spills or leaks: stop or reduce leak if safe to do so. Ventilate the area to prevent the gas from accumulating, especially in confined spaces. [ccohs.ca]

To prevent poisoning it is important to use and store products exactly as their labels say. Keep dangerous products where children can't get to them. Treatment for poisoning depends on the type of poison. [icdlist.com]