sodium-hypochlorite and Asthma

The purpose of this study was a toxicological interpretation of exposure to chlorine with unusual course. Medical, clinical and court records, as well as reviews of the literature, served as the basis for this interpretation. The first case of poisoning concerns a 52-year-old man who for a short time (probably several hours), during the industrial cleaning of facilities with sodium hypochlorite, was exposed to chlorine in a presumed high concentration. The man was obese and suffered from hypertension and moderate atherosclerosis, and therefore could be more susceptible to the toxic effects of chlorine. After exposure no pulmonary edema or symptoms typical for acute respiratory distress syndrome were present. The second case concerns the chronic poisoning of a 56-year-old man who worked for eight years, 8 h a day, 5 days a week, in a room which was next to a chlorination room. In this chamber technical sodium hypochlorite was stored and dosed. In both cases, determining a cause and effect relationship between exposure to toxic and allergic agents in the form of active chlorine, and the onset of symptoms may be difficult. The findings described above in the first and second case are particularly important in cases of compensation claims and may have a completely different etiology than previously described in medical literature.

Topics: Asthma; Chlorine; Coronary Artery Disease; Disinfectants; Forensic Pathology; Forensic Toxicology; Humans; Hypertension; Lung; Male; Middle Aged; Obesity; Occupational Exposure; Pulmonary Emphysema; Sodium Hypochlorite; Time Factors

On June 27, 2011, a worker at a poultry processing plant in Arkansas began to pour sodium hypochlorite into a 55-gallon drum that contained residual acidic antimicrobial solution. When the sodium hypochlorite reacted with the solution, greenish-yellow chlorine gas was released into the small room where the drum was located and then spread into the plant, where approximately 600 workers were present. These workers promptly were evacuated. Chlorine is a respiratory irritant and can produce symptoms ranging from mild eye, nose, and throat irritation to severe inflammation of the lung, which can lead to death. Of the approximately 600 workers who were evacuated; 545 were later interviewed, 195 reported seeking medical treatment, 152 reported being hospitalized, and the plant nurse reported that five were admitted to intensive-care units. The next day, the Occupational Safety and Health Administration (OSHA) asked for technical assistance from CDC's National Institute for Occupational Safety and Health (NIOSH) to evaluate health effects of the release and make recommendations to prevent future occurrences. This report describes the results of that evaluation, including findings from two follow-up site visits conducted approximately 4 and 6 months after the release. Of the 545 workers who participated in the evaluation, three developed reactive airways dysfunction syndrome (RADS), an irritant-induced form of asthma that can persist for life. The worker who inadvertently mixed the two solutions indicated that the drum was labeled in English but he could only read Spanish. This incident underscores the danger posed by chlorine gas and the importance of employers providing adequate training and communication of health and safety precautions to employees.

Topics: Adolescent; Adult; Aged; Animals; Anti-Infective Agents; Arkansas; Asthma; Chlorine; Communication Barriers; Eye Diseases; Female; Humans; Hydrogen-Ion Concentration; Language; Male; Middle Aged; National Institute for Occupational Safety and Health, U.S.; Occupational Exposure; Poultry; Respiratory Tract Diseases; Sodium Hypochlorite; United States; Young Adult

Topics: Allergens; Asthma; Disinfectants; Household Work; Humans; Single-Blind Method; Sodium Hypochlorite; Spirometry

Chlorine bleach or sodium hypochlorite can inactivate common indoor allergens. In this cross-sectional study we evaluated to what extent regular house cleaning with bleach can influence the risks of respiratory and allergic diseases in children. We studied a group of 234 schoolchildren aged 10-13 yr among whom 78 children were living in a house cleaned with bleach at least once per week. Children examination included a questionnaire, an exercise-induced bronchoconstriction test and the measurement of exhaled nitric oxide (NO) and of serum total and aeroallergen-specific immunoglobulin (Ig)E, Clara cell protein (CC16) and surfactant-associated protein D (SP-D). Children living in a house regularly cleaned with bleach were less likely to have asthma (OR, 0.10; CI, 0.02-0.51), eczema (OR, 0.22; CI, 0.06-0.79) and of being sensitized to indoor aeroallergens (OR, 0.53; CI, 0.27-1.02), especially house dust mite (OR, 0.43; CI, 0.19-0.99). These protective effects were independent of gender, ethnicity, previous respiratory infections, total serum IgE level and of family history of allergic diseases. They were however abolished by parental smoking, which also interacted with the use of bleach to increase the risk of recurrent bronchitis (OR, 2.03; CI, 1.12-3.66). House cleaning with bleach had effect neither on the sensitization to pollen allergens, nor on the levels of exhaled NO and of serum CC16 and SP-D. House cleaning with chlorine bleach appears to protect children from the risks of asthma and of sensitization to indoor allergens while increasing the risk of recurrent bronchitis through apparently an interaction with parental smoking. As chlorine bleach is one of the most effective cleaning agent to be found, these observations argue against the idea conveyed by the hygiene hypothesis that cleanliness per se increases the risk of asthma and allergy.

Topics: Adolescent; Asthma; Bronchitis; Child; Cross-Sectional Studies; Detergents; Female; Household Work; Humans; Hypersensitivity; Male; Respiratory System; Sodium Hypochlorite; Tobacco Smoke Pollution

Chlorine gas inhalation can lead to temporary mucous membrane irritation, pulmonary edema, and transient bronchospasm. Existence of respiratory sequelae is debated. We report a case of asthma, persisting 2 years after the inhalation of a mixture of sodium hypochlorite and hydrochloric acid. Bronchial histologic findings and transmission electron microscopy examinations showed uncommon abnormalities supporting irritation for cause of this nonimmunologic asthma.

Topics: Accidents, Home; Adult; Asthma; Bronchi; Bronchial Hyperreactivity; Chlorine; Female; Humans; Hydrochloric Acid; Sodium Hypochlorite; Time Factors