Emergency management of chlorine gas exposure – a systematic review

References

• Squadrito GL, Postlethwait EM, Matalon S. Elucidating mechanisms of chlorine toxicity: reaction kinetics, thermodynamics, and physiological implications. Am J Physiol Lung Cell Mol Physiol. 2010;299:L289–L300.
   PubMed Web of Science ®Google Scholar
• Honavar J, Doran S, Oh J-Y, et al. Nitrite therapy improves survival postexposure to chlorine gas. AJP Lung Cell Mol Physiol. 2014;307:L888–L894.
   Google Scholar
• Kim J-A, Yoon S-Y, Cho S-Y, et al. Acute health effects of accidental chlorine gas exposure. Ann Occup Environ Med. 2014;26:29.
   PubMedGoogle Scholar
• D'Alessandro A, Kuschner W, Wong H, et al. Exaggerated responses to chlorine inhalation among persons with nonspecific airway hyperreactivity. Chest 1996;109:331–337.
   PubMed Web of Science ®Google Scholar
• White CW, Martin JG. Chlorine gas inhalation: human clinical evidence of toxicity and experience in animal models. Proc Am Thorac Soc. 2010;7:257–263.
   PubMedGoogle Scholar
• Winder C. The toxicology of chlorine. Environ Res. 2001;85:105–114.
   PubMed Web of Science ®Google Scholar
• Carpenter A, Cox AT, Marion D, et al. A case of a chlorine inhalation injury in an Ebola treatment unit. J R Army Med Corps. 2016;162:229–231.
   PubMed Web of Science ®Google Scholar
• Shin H-J, Chang J-S, Ahn S, et al. Acute respiratory distress syndrome and chemical burns after exposure to chlorine-containing bleach: a case report. J Thorac Dis. 2017;9:E17–E20.
   PubMed Web of Science ®Google Scholar
• Leustik M, Doran S, Bracher A, et al. Mitigation of chlorine-induced lung injury by low-molecular-weight antioxidants. Am J Physiol Lung Cell Mol Physiol. 2008;295:L733–L743.
   PubMed Web of Science ®Google Scholar
• Evans RB. Chlorine: state of the art. Lung 2005;183:151–167.
   PubMed Web of Science ®Google Scholar
• Thomas HL, Murray V. Review of acute chemical incidents involving exposure to chlorine associated with swimming pools in England and Wales, June-October 2007. J Public Health Oxf Engl. 2008;30:391–397.
   PubMed Web of Science ®Google Scholar
• Annual report. Available from: http://www.eurochlor.org/download-centre/the-chlorine-industry-review.aspx
   Google Scholar
• Issue Brief on Chlorine Rail Transportation Safety. Available from: https://www.americanchemistry.com/Policy/Rail-Transportation/Rail-Issues-Survey-Final-Report.pdf
   Google Scholar
• Wenck MA, Van Sickle D, Drociuk D, et al. Rapid assessment of exposure to chlorine released from a train derailment and resulting health impact. Public Health Rep. 2007;122:784–792. Wash DC 1974.
   PubMed Web of Science ®Google Scholar
• Mackie E, Svendsen E, Grant S, et al. Management of chlorine gas-related injuries from the Graniteville, South Carolina, train derailment. Disaster Med Public Health Prep. 2014;8:411–416.
   PubMed Web of Science ®Google Scholar
• https://www.facs.org/∼/media/files/quality%20programs/trauma/disaster/wmd_dhs_planning.ashx
   Google Scholar
• Jones R, Wills B, Kang C. Chlorine gas: an evolving hazardous material threat and unconventional weapon. West J Emerg Med. 2010;11:151–156.
   PubMedGoogle Scholar
• Zarogiannis SG, Jurkuvenaite A, Fernandez S, et al. Ascorbate and deferoxamine administration after chlorine exposure decrease mortality and lung injury in mice. Am J Respir Cell Mol Biol. 2011;45:386–392.
   PubMed Web of Science ®Google Scholar
• Anderson PD. Emergency management of chemical weapons injuries. J Pharm Pract. 2012;25:61–68.
   PubMedGoogle Scholar
• Howard C, Ducre B, Burda AM, et al. Management of chlorine gas exposure. J Emerg Nurs. 2007;33:402–404.
   PubMed Web of Science ®Google Scholar
• Vajner JE, Lung D. Case files of the University of California San Francisco Medical Toxicology Fellowship: acute chlorine gas inhalation and the utility of nebulized sodium bicarbonate. J Med Toxicol. 2013;9:259–265.
   PubMedGoogle Scholar
• Aslan S, Kandiş H, Akgun M, et al. The effect of nebulized NaHCO3 treatment on “RADS” due to chlorine gas inhalation. Inhal Toxicol. 2006;18:895–900.
   PubMed Web of Science ®Google Scholar
• Reddy SC, Tajunisah I. Chemical injuries of eye- a review of 75 cases. Int J Ophthalmol 2007;7:327–330.
   Google Scholar
• Mangat HS, Stewart TL, Dibden L, et al. Complications of chlorine inhalation in a pediatric chemical burn patient: a case report. J Burn Care. 2012;33:e216–e221.
   Google Scholar
• Van Sickle D, Wenck MA, Belflower A, et al. Acute health effects after exposure to chlorine gas released after a train derailment. Am J Emerg Med. 2009;27:1–7.
   PubMed Web of Science ®Google Scholar
• Ngo A, Ponampalam R, Leong M, et al. Chlorine and its impact on an emergency department. Prehosp Disaster Med. 2007;22:136–139.
   PubMedGoogle Scholar
• Cevik Y, Onay M, Akmaz I, et al. Mass casualties from acute inhalation of chlorine gas. South Med J. 2009;102:1209–1213.
   PubMed Web of Science ®Google Scholar
• Bellenger SR, Frizzi JD. Sevoflurane as a therapy for acute chlorine gas exposure in an austere healthcare environment: a case report. Aana J. 2014;82:223–226.
   PubMedGoogle Scholar
• Sever M, Mordeniz C, Sever F, et al. Accidental chlorine gas intoxication: evaluation of 39 patients. J Clin Med Res. 2009;1:274–279.
   PubMedGoogle Scholar
• Ho M-P, Yang C-C, Cheung W-K, et al. Chlorine gas exposure manifesting acuyte lung injury. J Intern Med Taiwan. 2010;21:210–215.
   Google Scholar
• Akdur O, Durukan P, Ikizceli I, et al. A rare complication of chlorine gas inhalation: pneumomediastinum. Emerg Med. 2006;23:e59.
   Google Scholar
• Li B, Jia L, Shao D, et al. Pneumomediastinum from acute inhalation of chlorine gas in 2 young patients. Am J Emerg Med. 2011;29:357.e1–354.
   Web of Science ®Google Scholar
• Warren B, Royall N, Smith H, et al. Novel treatment of acute respiratory distress syndrome after chlorine gas inhalation injury. Am Surg 2016;82:219–220.
   Web of Science ®Google Scholar
• Matos AM, de Oliveira RR, Lippi MM, et al. Use of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report. Rev Bras Ter Intensiva. 2017;29:105–110.
   PubMedGoogle Scholar
• Chen J, Mo Y, Schlueter CF, et al. Inhibition of chlorine-induced pulmonary inflammation and edema by mometasone and budesonide. Toxicol Appl Pharmacol. 2013;272:408–413.
   PubMed Web of Science ®Google Scholar
• Jonasson S, Wigenstam E, Koch B, et al. Early treatment of chlorine-induced airway hyperresponsiveness and inflammation with corticosteroids. Toxicol Appl Pharmacol. 2013;271:168–174.
   PubMed Web of Science ®Google Scholar
• Wigenstam E, Koch B, Bucht A, et al. N-acetyl cysteine improves the effects of corticosteroids in a mouse model of chlorine-induced acute lung injury. Toxicology 2015;328:40–47.
   PubMed Web of Science ®Google Scholar
• Rivkin I, Galnoy-Glucksam Y, Elron-Gross I, et al. Treatment of respiratory damage in mice by aerosols of drug-encapsulating targeted lipid-based particles. J Control Release. 2017;257:163–169.
   PubMed Web of Science ®Google Scholar
• Wigenstam E, Elfsmark L, Koch B, et al. Acute respiratory changes and pulmonary inflammation involving a pathway of TGF-β1 induction in a rat model of chlorine-induced lung injury. Toxicol Appl Pharmacol. 2016;309:44–54.
   PubMed Web of Science ®Google Scholar
• Hoyle GW, Chen J, Schlueter CF, et al. Development and assessment of countermeasure formulations for treatment of lung injury induced by chlorine inhalation. Toxicol Appl Pharmacol. 2016;298:9–18.
   PubMed Web of Science ®Google Scholar
• Bracher A, Doran SF, Squadrito GL, et al. Targeted aerosolized delivery of ascorbate in the lungs of chlorine-exposed rats. J Aerosol Med Pulm Drug Deliv. 2012;25:333–341.
   PubMed Web of Science ®Google Scholar
• Fanucchi MV, Bracher A, Doran SF, et al. Post-exposure antioxidant treatment in rats decreases airway hyperplasia and hyperreactivity due to chlorine inhalation. Am J Respir Cell Mol Biol. 2012;46:599–606.
   PubMed Web of Science ®Google Scholar
• Yadav AK, Bracher A, Doran SF, et al. Mechanisms and modification of chlorine-induced lung injury in animals. Proc Am Thorac Soc. 2010;7:278–283.
   PubMedGoogle Scholar
• Samal AA, Honavar J, Brandon A, et al. Administration of nitrite after chlorine gas exposure prevents lung injury: effect of administration modality. Free Radic Biol Med. 2012;53:1431–1439.
   PubMed Web of Science ®Google Scholar
• Yadav AK, Doran SF, Samal AA, et al. Mitigation of chlorine gas lung injury in rats by postexposure administration of sodium nitrite. AJP Lung Cell Mol Physiol. 2011;300:L362–L369.
   Google Scholar
• Honavar J, Doran S, Ricart K, et al. Nitrite therapy prevents chlorine gas toxicity in rabbits. Toxicol Lett. 2017;271:20–25.
   PubMed Web of Science ®Google Scholar
• McGovern T, Day BJ, White CW, et al. AEOL10150: a novel therapeutic for rescue treatment after toxic gas lung injury. Free Radic Biol Med. 2011;50:602–608.
   PubMed Web of Science ®Google Scholar
• McGovern TK, Powell WS, Day BJ, et al. Dimethylthiourea protects against chlorine induced changes in airway function in a murine model of irritant induced asthma. Respir Res. 2010;11:138.
   PubMed Web of Science ®Google Scholar
• Zarogiannis SG, Wagener BM, Basappa S, et al. Postexposure aerosolized heparin reduces lung injury in chlorine-exposed mice. AJP Lung Cell Mol Physiol. 2014;307:L347–L354.
   Google Scholar
• Song W, Wei S, Liu G, et al. Postexposure administration of a {beta}2-agonist decreases chlorine-induced airway hyperreactivity in mice. Am J Respir Cell Mol Biol. 2011;45:88–94.
   PubMed Web of Science ®Google Scholar
• Hoyle GW, Hoyle CI, Chen J, et al. Identification of triptolide, a natural diterpenoid compound, as an inhibitor of lung inflammation. AJP Lung Cell Mol Physiol. 2010;298:L830–L836.
   Google Scholar
• Balakrishna S, Song W, Achanta S, et al. TRPV4 inhibition counteracts edema and inflammation and improves pulmonary function and oxygen saturation in chemically induced acute lung injury. AJP Lung Cell Mol Physiol. 2014;307:L158–L172.
   Google Scholar
• Hoyle GW. Mitigation of chlorine lung injury by increasing cyclic AMP levels. Proc Am Thorac Soc. 2010;7:284–289.
   PubMedGoogle Scholar
• Chang W, Chen J, Schlueter CF, et al. Inhibition of chlorine-induced lung injury by the type 4 phosphodiesterase inhibitor rolipram. Toxicol Appl Pharmacol. 2012;263:251–258.
   PubMed Web of Science ®Google Scholar
• Bosse GM. Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation. J Toxicol Clin Toxicol. 1994;32:233–241.
   PubMed Web of Science ®Google Scholar
• Juniper EF, Svensson K, Mörk A-C, et al. Measuring health-related quality of life in adults during an acute asthma exacerbation. Chest 2004;125:93–97.
   PubMed Web of Science ®Google Scholar
• Williams R, Zou X, Hoyle GW. Tachykinin-1 receptor stimulates proinflammatory gene expression in lung epithelial cells through activation of NF-kappaB via a G(q)-dependent pathway. Am J Physiol Lung Cell Mol Physiol. 2007;292:L430–L437.
   PubMed Web of Science ®Google Scholar
• Hoyle GW, Svendsen ER. Persistent effects of chlorine inhalation on respiratory health. Ann NY Acad Sci. 2016;1378:33–40.
   PubMed Web of Science ®Google Scholar
• Weber T, Schiebenpflug C, Deusch E. Inhalational sevoflurane in severe bronchial obstruction unresponsive to multipharmacologic therapy: a case report. F1000Research. 2012;1:56.
   PubMedGoogle Scholar
• Govier P, Coulson JM. Civilian exposure to chlorine gas: a systematic review. Toxicol Lett. 2018;293:249–252.
   PubMed Web of Science ®Google Scholar
• Schott AF, Goldstein LJ, Cristofanilli M, et al. Phase Ib pilot study to evaluate reparixin in combination with weekly paclitaxel in patients with HER-2-negative metastatic breast cancer. Clin Cancer Res. 2017;23:5358–5365.
   PubMed Web of Science ®Google Scholar
• Liu Q. Triptolide and its expanding multiple pharmacological functions. Int Immunopharmacol. 2011;11:377–383.
   PubMed Web of Science ®Google Scholar
• van der Aart J, Salinas C, Dimber R, et al. Quantification of human brain PDE4 occupancy by GSK356278: a [11C](R)-rolipram PET study. J Cereb Blood Flow Metab. 2018;38:2033–2040.
   PubMed Web of Science ®Google Scholar
• Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924–926.
   PubMed Web of Science ®Google Scholar
• Woodruff TJ, Sutton P. The Navigation Guide systematic review methodology: a rigorous and transparent method for translating environmental health science into better health outcomes. Environ Health Perspect. 2014;122:1007–1014.
   PubMed Web of Science ®Google Scholar