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Chlorine (Cl 2 ). Chlorine (Cl 2 ). Widely distributed element Sodium chloride in seawater Natural deposits Most important use is bleach Chemical reagent use Commercial use. Chlorine - Overview. Noncombustible, yellow-green gas with a pungent, irritating odor and strong oxidizing effects
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Chlorine (Cl2) • Widely distributed element • Sodium chloride in seawater • Natural deposits • Most important use is bleach • Chemical reagent use • Commercial use
Chlorine - Overview • Noncombustible, yellow-green gas with a pungent, irritating odor and strong oxidizing effects • Slightly soluble in water • Combines with it to form hypochlorous acid (HClO) and hydrochloric acid (HCl) • Highly corrosive action causes injury when the gas reacts with moisture in the body
Chlorine - Overview • One of the first chemicals used as a weapon in general warfare • Available in commercial and home compounds
Chlorine - Toxicity • Major route of toxicity is inhalation • Solutions that generate chlorine can be highly corrosive to skin or GI tract • Strong oxidizing capability • Produce major tissue damage
Chlorine - Toxicity • Hypochlorous acid • Penetrates cells and react with cytoplasmic proteins • Form N-chloro derivatives that destroy cell structure • Estimated lowest lethal concentration • 30-minute exposure is 430 ppm -- 1000 ppm • Fatal within minutes
Chlorine - Toxicity • Children may be more vulnerable than adults
Protective Equipment • Variety of rubber and plastic materials resist chlorine • Wear protective clothing appropriate to the type and degree of contamination • Use air-purifying or supplied-air respiratory equipment • Chlorine-resistant plastic sheeting and disposable bags useful in preventing spread of contamination
Detection • Yellow-green color and distinctive odor • Variety of chlorine monitors and gas sensors are available commercially
Decontamination • Victims should be removed from exposure area • Remove and double-bag contaminated clothing and personal belongings
Decontamination • Eye exposure • Flush the eyes with lukewarm water for a minimum of 15 minutes • Skin exposure • Flush skin and hair with plain water for 5 minutes • Wash with soap and water for at least 15 minutes • Rinse thoroughly afterwards
Signs and Symptoms • Diagnosis is a clinical one • May be apparent immediately or delayed for a few hours • General • Dizziness • Agitation • Anxiety • Nausea • Vomiting
Signs and Symptoms • Eyes • Low concentrations • Burning discomfort • Tearing • Spasmodic blinking or involuntary closing of the eyelids • Redness • Conjunctivitis • High concentrations • Corneal burns
Signs and Symptoms • Skin • Corrosive effects irritate the skin • Causing burning pain, inflammation, sweating and blisters • Exposure to liquefied chlorine can produce frostbite injury
Signs and Symptoms • Respiratory System • Low concentrations (1 to 10 ppm): eye and nasal irritation, sore throat, a stinging chest pain and coughing • Higher concentrations (>15 ppm): rapid progression to respiratory distress with airway constriction and pulmonary edema • Injury can progress to lung collapse over several hours • Hospitalize and observe symptomatic patients
Signs and Symptoms • Cardiovascular • Tachycardia and hypertension initially, followed by hypotension • After severe exposure, cardiovascular collapse may occur from lack of oxygen • Metabolic • A major inhalation exposure can produce a form of acid-base imbalance: hyperchloremic metabolic acidosis
Treatment • Basic first aid for victim • Advanced life support (ALS) protocols • Patients who are comatose, hypotensive, having seizures or who have cardiac arrhythmias • There is no specific treatment and care is primarily supportive
Treatment • Eyes • Irrigate eyes for at least 15 minutes, until pH returns to normal • Test visual acuity, check for corneal damage, and treat appropriately • Consult an ophthalmologist immediately for corneal injuries
Treatment • Skin • Treat chemical burns as thermal burns • Frostbite injuries • Water bath at temperature of 102° to 108° F (40° to 42° C) • 20 to 30 minutes or until a flush has returned to the affected area
Treatment • Cardiopulmonary • Severe respiratory compromise • Secure the airway and maintain ventilation • Be aware of an increased risk for pneumonia • Bronchospasm: aerosolized bronchodilators • Children with stridor: aerosolized epinephrine
Treatment • Laboratory • Routine studies: CBC, glucose, and electrolytes • Monitor pulse oximetry (or ABG measurements) and obtain a chest x-ray • If hyperchloremic metabolic acidosis is present, monitor the blood pH closely and treat with bicarbonate
Long-Term Medical Sequelae • Pulmonary function usually normalizes within 7 to 14 days after acute exposure • Complete recovery generally occurs • Reactive airways dysfunction syndrome (RADS) • Flu-like symptoms and prolonged pulmonary impairment
Long-Term Medical Sequelae • Not been classified for carcinogenic effects • No information available on reproductive or developmental effects
Environmental Sequelae • Chlorine causes environmental harm at low levels • High reactivity • Chlorine is not likely to move through the ground and enter groundwater
Summary • High potential for terrorist use because it is readily and commercially available • Natural element that is extremely oxidizing and corrosive • Combines with water to form hypochlorous acid, hydrochloric acid and oxygen free radicals • All cause major tissue damage
Summary • Estimated lowest lethal concentration for a 30-minute exposure is 430 ppm • Signs and symptoms • Mild eye and nasal irritation • Pulmonary edema and cardiopulmonary collapse • Decontamination and basic first aid are critical • Care is primarily supportive, using standard ALS protocols when indicated