HOME EXPOSURES TO CHLORINE CHLORAMINE GAS - REVIEW OF 216 CASES

Chlorine and chloramine gas are frequently produced in the home when c leaning products are mixed. These gases are strong irritants with the potential for tissue damage. Numerous literature citations report indu strial exposures to chlorine/amine gas, but there are few reports rega rding home exposures. The purpose of this study was to determine sympt oms, treatment, and outcome in individuals exposed to these gases in t he home. All exposures to chlorine/amine gas produced as a result of m ixing cleaning products in the home and reported to a Regional Poison Information Center (RPIC) over a 12-month period were reviewed. All ca lls were documented and follow-up was done at appropriate intervals. A ll patients with respiratory embarrassment either at the initial conta ct or on follow-up were referred to a medical facility. Of the 216 pat ients (ages 12 to 81 years), 200 had resolution of symptoms within 6 h ours, whereas only 16 had symptoms for more than 6 hours after exposur e; 145 patients were treated at home and 71 received further medical c are. Ten symptoms were identified, with the majority of patients exper iencing more than one. Emergency room treatment included oxygen (62 pa tients), bronchodilators (9 patients), and steroid therapy (3 patients ). Of the 70 patients who had chest x-ray films, only one had a positi ve finding; 41 had arterial blood gas measurements done, and all were within normal limits. Only one patient in the study group required adm ission for continued respiratory distress, but he had a preexisting ch ronic respiratory problem as well as an upper respiratory tract infect ion at the time of exposure. Although the gas produced by mixing clean ing products in the home can cause severe respiratory irritation, most of the patients exposed to chlorine and chloramine gas can safely be treated at home with comfort measures. Appropriate follow-up must be d one to determine resolution of symptoms.