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Acute health effects of accidental chlorine gas exposure.

Kim JA, Yoon SY, Cho SY, Yu JH, Kim HS, Lim GI, Kim JS - Ann Occup Environ Med (2014)

Bottom Line: We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%.All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, Gumi, Gyeongbuk, South Korea ; Environmental Health Center, Soonchunhyang University Gumi Hospital, Gumi, Gyeongbuk, South Korea.

ABSTRACT

Objectives: This study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.

Methods: We analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment.

Results: Immediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%).

Conclusions: The 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.

No MeSH data available.


Related in: MedlinePlus

Bronchoscopic findings of case 1 showed no abnormality except mild hyperemic bronchus.
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Figure 1: Bronchoscopic findings of case 1 showed no abnormality except mild hyperemic bronchus.

Mentions: Treatment and clinical outcome: The hospital treatment included empirical broad-spectrum antibiotics and administration of a bronchodilator. On the 2nd day of hospitalization, coughing, sputum, and shortness of breath reduced, and vital symptoms became stable. The methacholine challenge test performed on the 6th day of hospitalization showed a negative result. The patient was discharged on the 6th day upon the improvement of symptoms. On March 18, the patient was re-admitted to the department of pulmonology because of continuing cough and dyspnea. The pulmonary function test performed at March 18 revealed FVC, FEV1, and FEV1/FVC values of 77%, 96%, and 97%, respectively. The patient was hospitalized for one month. During the hospitalization, chest computerized tomography (CT) scan and bronchoscopy were performed, they did not reveal any abnormalities (Figures 1 and 2). From March 19 through April 15, the peak expiratory flow rate was measured 14 times. The minimum value was 240 ml and the maximum value was 430 ml, diurnal variability in peak expiratory flow rate was 56.7%. After discharge, treatment included inhaled corticosteroid and administration of bronchodilator for six months and the respiratory symptoms including cough, dyspnea virtually vanished.


Acute health effects of accidental chlorine gas exposure.

Kim JA, Yoon SY, Cho SY, Yu JH, Kim HS, Lim GI, Kim JS - Ann Occup Environ Med (2014)

Bronchoscopic findings of case 1 showed no abnormality except mild hyperemic bronchus.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4387786&req=5

Figure 1: Bronchoscopic findings of case 1 showed no abnormality except mild hyperemic bronchus.
Mentions: Treatment and clinical outcome: The hospital treatment included empirical broad-spectrum antibiotics and administration of a bronchodilator. On the 2nd day of hospitalization, coughing, sputum, and shortness of breath reduced, and vital symptoms became stable. The methacholine challenge test performed on the 6th day of hospitalization showed a negative result. The patient was discharged on the 6th day upon the improvement of symptoms. On March 18, the patient was re-admitted to the department of pulmonology because of continuing cough and dyspnea. The pulmonary function test performed at March 18 revealed FVC, FEV1, and FEV1/FVC values of 77%, 96%, and 97%, respectively. The patient was hospitalized for one month. During the hospitalization, chest computerized tomography (CT) scan and bronchoscopy were performed, they did not reveal any abnormalities (Figures 1 and 2). From March 19 through April 15, the peak expiratory flow rate was measured 14 times. The minimum value was 240 ml and the maximum value was 430 ml, diurnal variability in peak expiratory flow rate was 56.7%. After discharge, treatment included inhaled corticosteroid and administration of bronchodilator for six months and the respiratory symptoms including cough, dyspnea virtually vanished.

Bottom Line: We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%.All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, Gumi, Gyeongbuk, South Korea ; Environmental Health Center, Soonchunhyang University Gumi Hospital, Gumi, Gyeongbuk, South Korea.

ABSTRACT

Objectives: This study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients.

Methods: We analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment.

Results: Immediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%).

Conclusions: The 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation.

No MeSH data available.


Related in: MedlinePlus