Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident

Abstract

Objective-Acute exposure to chlorine causes lung damage, and recovery may proceed slowly for several weeks. The short term respiratory eVects of acute chlorine inhalation during a swimming pool accident were examined. Methods-A total of 282 subjects (134 children, aged <14 years) inhaled hydrogen chloride and sodium hypochlorite during an accident caused by a malfunction of the water chlorinating system in a community pool in Rome in 1998. Most people received bronchodilators and cortisone at the emergency room; five children were admitted to hospital. A total of 260 subjects (92.2%) were interviewed about duration of exposure (<3, 3-5, >5 minutes), intensity of exposure (not at all or a little, a moderate amount, a lot), and respiratory symptoms. Lung function was measured in 184 people (82 children) after 15-30 days. The eVects of exposure to chlorine were analysed through multiple linear regression, separately in adults and in children. Results-Acute respiratory symptoms occurred among 66.7% of adults and 71.6% of children. The incidences were highest among those who had chronic respiratory disease and had a longer duration of exposure. In about 30% of the subjects, respiratory symptoms persisted for 15-30 days after the accident. Lung function levels were lower in those who reported a high intensity of exposure than in those who reported low exposure, both in children and in adults (mean (95% confidence interval (95% CI)) diVerences in forced expiratory volume in 1 second (FEV 1, ) were −109 (−310 to 93) ml, and −275 (−510 to −40) ml, respectively). Conclusion-Persistent symptoms and lung function impairment were found up to 1 month after the incident. Although community pool accidents happen rarely, the medical community needs to be alerted to the possible clinical and physiological sequelae, especially among susceptible people. (Occup Environ Med 2001;58:399-404)

Indoor swimming pools, water chlorination and respiratory health

“…Acute exposure to high levels of chlorine gas, resulting from explosions, leaks or malfunctioning of chlorine-disinfection installations [12][13][14] is a wellknown problem. The health consequences of such incidents may be more or less serious.…”

Swimming pool, respiratory health, and childhood asthma: Should we change our beliefs?

“…20 There are studies investigating the effects of acute chlorine exposure especially on children. Agabiti et al 21 examined the short-term respiratory effects of acute chlorine inhalation as a result of a swimming pool accident in 282 cases, 134 of them children: they reported that persistent symptoms and lung function impairment were found up to 1 month after the incident. They also reported that, among the children involved, the incidence of all symptoms tended to be higher in those who had a history of chronic respiratory disease 21 .…”

Acute Atrial Fibrillation Developed by the Inhalation of Chlorine Gas

“…Because, for the AF in our case there was no predisposing factor or structural cardiac abnormality. Following exposure to chlorine gas, the cases respond differently to the administered treatment, this was explained by the differences in the duration of exposure, the presence of underlying systemic diseases and chronic repiratory diseases [12,16]. The cases are frequently discharged within 48 hours [17], however there might be persistent or delayedonset symptoms.…”