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]

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]

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]

There should not be any inorganic chlorine present in the body. [heavymetalstest.com]

• Inflammation

  Oxygen and drugs to open the airways and decrease inflammation are given. [merckmanuals.com]

  Thus the biopsy revealed nonspecific inflammation and was negative for BOOP or other connective tissue diseases. [ispub.com]

  Chlorine can be absorbed through the skin, resulting in pain, inflammation, swelling, and blistering. Hydrochloric acid also causes burns to the skin, eyes, nose, throat, mouth, and lungs. [doh.wa.gov]

  Higher chlorine exposure may also lead to acute respiratory distress syndrome, an inflammation of the lungs from breathing in chemical fumes, and even death. [foreffectivegov.org]

  People develop bronchitis, or inflammation of the airways. In some, but not in all people, the bronchitis induces asthma, said Dr. [scientificamerican.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]

  About 900 ppm of chloroform can cause dizziness, fatigue, and headaches. Chronic exposure may cause damage to the liver and kidneys. [safewater.org]

• 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

  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]

  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]

  Acute Effects of Chlorine Exposure on the Respiratory Tract of Humans [CDC data] Concentration (ppm) Effects 0.2–3.5 Odor detection 1–3 Mild mucous membrane irritation tolerated up to 1 hour 5–15 Moderate irritation 30 Immediate chest pain, dyspnea, cough [drmz13.wordpress.com]

  At 30 ppm and beyond, there is immediate chest pain, shortness of breath, and cough. At approximately 40–60 ppm, a toxic pneumonitis and/or acute pulmonary edema can develop.... [en.wikipedia.org]

  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]

• Dyspnea

  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]

  [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 retrosternal [drmz13.wordpress.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]

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

  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]

  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]

  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]

• 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]

• 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]

  Cough Sore throat Hemoptysis Findings on physical examination may include the following: Tachypnea Cyanosis (most prevalent during exertion) Tachycardia Wheezing Intercostal retractions Decreased breath sounds Rales (pulmonary edema) Nasal flaring Aphonia [emedicine.medscape.com]

• Vomiting

  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]

  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]

• Nausea

  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]

  [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 retrosternal [drmz13.wordpress.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]

  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]

  […] 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]

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

  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]

  The hope was that the choking fumes would cause panic and chaos. French troops would simply run away and a gap would be left wide open for German troops, wearing gas masks, to advance and gain huge amounts of ground. [theguardian.com]

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

• Chest Pain

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

  [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 retrosternal [drmz13.wordpress.com]

  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]

• Muscle Cramp

  As early as 2 weeks after the beginning of poisoning, psychological and neurological alterations such as impairment of vision, fasciculations, hemihypesthesia, impaired concentration, severe fatigue, hypersomnia, pain and muscle cramps, sweating, and [gjpsy.uni-goettingen.de]

• 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]

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

• Eye Pain

  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]

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]

• Hypercapnia

  The associated hypercapnia may also have directly beneficial effects [ 19 ]. Suction : is helpful for profuse pulmonary secretions. Diuretics : have limited value and may predispose the patient to hypotension. [patient.info]

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 for poisoning depends on the type of poison. If you suspect someone has been poisoned, call your local poison control center at 1-800-222-1222 right away. [icdlist.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]

Initial Response and Treatment: As with all hazardous materials exposures, only highly trained HazMat teams should attempt entry into the Hot Zone. Patient treatment should never be rendered near the site of exposure. [prehospitalpush.com]

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]

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]

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]

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]

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]

CDC-NIOSH funded the ABLES (adult blood lead epidemiology & surveillance) program and conducted adult blood lead levels (BLL) surveillance [ 12 ]. In 2010, ABLES program reported 31,081 adults with BLL   100 μg/L [ 13 ]. [occup-med.biomedcentral.com]

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]

[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]

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

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]

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]

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]

Centers for Disease Control and Prevention. 2003. Public Health Emergency Preparedness and Response Sheets. U.S. Department of Health and Human Services. Public Health Service; Atlanta, GA. Chlorine. [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]

Geneva 1990 ILO, International Labour Organisation, Prevention of Major Industrial accidents, Code of Practice, Geneva 1991 IPCS, International Programme on Chemical Safety, Environmental Health Criteria 21, Chlorine and Hydrogen Chloride, WHO, Geneva [ilo.org]