Abstract
On 9/30/77 a chlorine gas leak at a water treatment facility in Philadelphia forced the evacuation of a housing project. In the next 12 hours, 56 children were brought to the emergency room and evaluated by physical exam (PE), chest x-ray (CXR), and pulmonary function tests (PFT). 29/56 were well and had normal PE. All 29 remained well on followup at 24 hrs. and again at 3 mos. A positive past respiratory history (PPRH) was present in only 5.
27/56 were symptomatic and had one or more abnormal findings on initial evaluation, (25 PE, 2 CXR, 10 PFT). Arterial blood gas (ABG) studies showed hypoxia in 7/26 patients (pO2 55-89 torr) Therapy consisted of IPPB and physical therapy and postural drain age; 10/27 required bronchodilators for severe or persistant pronchospasm which occurred in 8/10 with a PPRH but in only 4/17 without a PPRH. Abnormal PFT were found in 7/10 with a PPRH but in only 3/17 without a PPRH. On followup, 10 were symptomatic at 1 week, 6(5 with PPRH) were symptomatic at 3 months.
In summary, acute exposure to chlorine gas may cause respiratory symptoms and transient abnormality of PFT and ABG, especially in children with asthma. PE and PFT were useful in identifying those patients requiring hospitalization. A PPRH identified the majority of those who developed persistant respiratory difficulty.
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Palmer, J., Schidlow, D., Foley, C. et al. 1219 RESPIRATORY EVALUATION OF CHILDREN IN A CHLORINE GAS DISASTER: IDENTIFICATION OF RISK FACTORS. Pediatr Res 12 (Suppl 4), 567 (1978). https://doi.org/10.1203/00006450-197804001-01225
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DOI: https://doi.org/10.1203/00006450-197804001-01225
