Abstract
Exposure to chlorine gas induces various respiratory insufficiencies, including upper respiratory tract irritation and acute lung injury (ALI). Previous reports suggested a latent period between exposure to chlorine gas and the development of ALI. Here we report 2 patients with ALI after exposure to chlorine gas. Patient #1 was a 26-year-old female who inhaled chlorine gas, produced by mixing 3 different chemical cleaners. She had no symptoms on arrival. However, hypoxia and pulmonary infiltration appeared 10 hours later, and she was diagnosed with ALI. Patient #2 was a 64-year-old male who inhaled mixtures of chlorine-containing chemicals. He complained of dyspnea, and mild hypoxia was observed on arrival. His symptoms and hypoxia deteriorated 35 hours later. He developed pulmonary infiltration and was diagnosed with ALI. On the basis of the present results and previous reports and the results of previous animal experiments, we speculated that there could be a latent period as long as 10 hours, and symptoms may worsen 48 hours after exposure to chlorine gas. Thus, we recommend observation for at least 10 hours, even though some patients may not show any symptoms on initial examination. Observation for at least 48 hours is necessary in patients with respiratory symptoms.
