All Wales Therapeutics and Toxicology Centre, University Hospital Llandough, Cardiff, Wales CF64 2XX, United Kingdom.
Toxicol Lett. 2018 Sep 1;293:249-252. doi: 10.1016/j.toxlet.2018.01.014. Epub 2018 Jan 20.
Halogen pulmonary irritants (HPIs) are volatile liquids that directly damage the respiratory mucosa. Chlorine is readily available in large volumes as an industrial chemical and has a significant potential for accidental or deliberate release. We conducted a systematic review to determine the clinical features; treatment and long-term sequelae of civilian chlorine gas exposure.
A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Medline; Ovid and Google Scholar databases were searched from 1966 to January 2017. A database of relevant papers was compiled and descriptive statistics used to summarise the data.
Thirty-six papers describing 37 incidents involving 1566 individual acute exposers to chlorine gas were identified. The most common reported features were cough (29%), dyspnoea (22%), sore throat (16%), eye features (12%) and excessive sputum or haemoptysis (7%). Acute management included high-flow oxygen (32.8%); steroids (28.4%); bronchodilators (28.2%) and ventilation (2.3%). Nine deaths (0.6%) were reported. Follow-up data available in 60% of cases; full recovery was reported in 90% of cases where data was available.
Acute chlorine gas exposure in civilian incidents presented with acute respiratory features and irritation of the eyes and throat. The development of pulmonary oedema or ARDS was relatively rare when compared to military experience in the First World War.
卤素肺部刺激物（HPIs）是挥发性液体，可直接损害呼吸道黏膜。氯气作为一种工业化学品，大量且容易获得，具有意外或故意释放的巨大潜力。我们进行了系统评价，以确定平民氯气暴露的临床特征；治疗和长期后遗症。
采用系统评价的首选报告项目和荟萃分析（PRISMA）方法进行系统评价。从 1966 年到 2017 年 1 月，在 Medline；Ovid 和 Google Scholar 数据库中进行了搜索。编译了相关论文数据库，并使用描述性统计数据对数据进行了总结。
确定了 36 篇描述了 37 起涉及 1566 名个体急性氯气暴露事件的论文。最常见的报告特征是咳嗽（29%）、呼吸困难（22%）、喉咙痛（16%）、眼部特征（12%）和过度咳痰或咯血（7%）。急性管理包括高流量氧气（32.8%）；类固醇（28.4%）；支气管扩张剂（28.2%）和通气（2.3%）。报告了 9 例死亡（0.6%）。60%的病例有随访数据；在可获得数据的病例中，90%的病例报告完全恢复。
平民事件中的急性氯气暴露表现为急性呼吸道特征和眼睛和喉咙刺激。与第一次世界大战中的军事经验相比，肺水肿或 ARDS 的发展相对较少。
