Chlorine

CAS RN: 7782-50-5

Health Effects

0.2.1 SUMMARY OF EXPOSURE
  • 0.2.1.1 ACUTE EXPOSURE
    • A) USES: Chlorine is a greenish-yellow, noncombustible gas at room temperature and atmospheric pressure. It is used in industrial bleaching operations, sewage treatment, swimming pool chlorination tablets, and chemical warfare. It can be generated when bleach is mixed with other cleaning products.
    • B) TOXICOLOGY: The primary effects are due to local tissue injury rather than to systemic absorption. Cellular injury is believed to result from the oxidation of functional groups in cell components, from reactions with tissue water to form hypochlorous acid and hydrochloric acid, and from the generation of free oxygen radicals. Although the idea that chlorine causes direct tissue damage by generating free oxygen radicals was once accepted, this idea is now controversial.
    • C) EPIDEMIOLOGY: Chlorine gas is one of the most common single-irritant inhalation exposures, occupationally and environmentally. In a recent study of 323 cases of inhalation exposures reported to poison control centers, the largest single exposure (21%) was caused by mixing bleach with other products.
    • D) WITH POISONING/EXPOSURE
      • 1) MILD TO MODERATE POISONING: Cough, shortness of breath, chest pain, burning sensation in the throat and substernal area, nausea or vomiting, ocular and nasal irritation, choking, muscle weakness, dizziness, abdominal discomfort, and headache.
      • 2) SEVERE POISONING: Upper airway edema, laryngospasm, severe pulmonary edema, pneumonia, persistent hypoxemia, respiratory failure, acute lung injury, and metabolic acidosis.
      • 3) PREDISPOSING FACTORS: Patients with asthma, reactive airways, or COPD may develop respiratory irritation at lower concentrations.
  • 0.2.1.2 CHRONIC EXPOSURE
    • A) Chronic exposure to chlorine gas may cause dyspnea, palpitations, chest pain, reactive upper airways dysfunction syndrome, dental enamel erosion, and an increased prevalence of viral syndromes. Chronic exposure to 15 ppm produced coughing, hemoptysis, chest pain, and sore throat. Chronic exposure to chlorine gas is one of the most frequent causes of occupational asthma.
0.2.3 VITAL SIGNS
  • 0.2.3.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Tachycardia and tachypnea are common. Severe exposure may cause cardiovascular collapse and respiratory arrest.
0.2.4 HEENT
  • 0.2.4.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Green hair, dental enamel erosion, conjunctivitis, lacrimation, and nasal and throat irritation may occur. Anosmia has been reported.
0.2.5 CARDIOVASCULAR
  • 0.2.5.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Tachycardia and initial hypertension followed by hypotension may occur. Cardiovascular collapse may ensue following severe exposure.
0.2.6 RESPIRATORY
  • 0.2.6.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) A feeling of burning and suffocation, coughing, choking, laryngeal edema, bronchospasm, and hypoxia may occur. In high concentrations, syncope and almost immediate death may occur. Acute lung injury is common after severe exposure.
      • 2) Multiple exposures produced flulike symptoms and high risk of developing reactive airway dysfunction syndrome.
      • 3) Persistent pulmonary dysfunction has been reported in some individuals following severe inhalational exposure.
0.2.7 NEUROLOGIC
  • 0.2.7.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Headache may develop. Agitation and anxiety may develop in patients with significant respiratory compromise.
0.2.8 GASTROINTESTINAL
  • 0.2.8.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Vomiting may occur following initial exposure.
0.2.11 ACID-BASE
  • 0.2.11.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Following severe exposure, metabolic acidosis secondary to hypoxemia may be noted.
0.2.14 DERMATOLOGIC
  • 0.2.14.1 ACUTE EXPOSURE
    • A) WITH POISONING/EXPOSURE
      • 1) Dermal exposure may cause erythema, pain, irritation, and cutaneous burns.
0.2.20 REPRODUCTIVE HAZARDS
  • A) Chlorine (as hypochlorite) is teratogenic in experimental animals. Evaluations of sperm morphology in murine experiments demonstrated the presence of mutations.
0.2.21 CARCINOGENICITY
  • 0.2.21.1 IARC CATEGORY
    • A) IARC Carcinogenicity Ratings for CAS7782-50-5 (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004):
      • 1) Not Listed
  • 0.2.21.2 HUMAN OVERVIEW
    • A) Lymphoma has been observed in relation to water treatment with chlorine. Associations with increased renal, bladder, and gastric cancers have also been found, but firm conclusions cannot be drawn because of mixed exposures with caustic acids.
  • 0.2.21.3 ANIMAL OVERVIEW
    • A) Chlorine gas was not carcinogenic in mice and rats exposed to varying concentrations. Chlorine administered in drinking water produced lymphomas, leukemia, or both in rats, but was not carcinogenic in a third study.
0.2.22 GENOTOXICITY
  • A) Haloacetonitriles have produced DNA strand breaks in cultured human cells. Mutations have been detected in S typhimurium, and chromosome aberrations have been detected in human lymphocytes.
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