Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of MD School of Medicine, Baltimore, MD, USA.
Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Clin Toxicol (Phila). 2024 Sep;62(9):589-595. doi: 10.1080/15563650.2024.2390139. Epub 2024 Sep 12.
Chlorine and chloramine gas inhalation can occur when household cleaners are mixed. The increased emphasis on disinfecting practices during the COVID-19 pandemic may have contributed to an increase in chlorine and chloramine gas exposures in the United States, which has not been studied.
In a retrospective review, reported data on chlorine and chloramine gas exposures in the National Poison Data System were collected from January 1, 2015, to December 31, 2022. Data included demographics and exposure details, including location, dose, formulation, co-exposures, treatments, and outcomes. Demographic analyses and descriptive statistics were conducted.
During the study period, 85,104 total exposures to chlorine and chloramine gas were reported, consisting of 79,281 isolated exposures and 5,823 co-exposures. Total exposures increased by 61% from 8,385 in 2015 to 13,503 in 2022, with the largest increase of 38.3% occurring from 2019 to 2020. Total exposures remained increased through 2022 with no return to pre-pandemic levels. Most exposures occurred in "own residence" ( = 72,213, 84.9%), with a larger proportion of exposures occurring at home peri-pandemic versus pre-pandemic (88.4% versus 81.7%). One percent ( = 1,030) of exposures were admitted to a non-critical care unit, 0.73% ( = 619) were admitted to a critical care unit, and 0.03% ( = 26) resulted in death.
The onset of the COVID-19 pandemic and increased emphasis on cleaning practices were likely contributing factors to the marked increase in exposures in 2020, which persisted through 2022. Cleaning practices that developed during the beginning of the pandemic likely persisted despite returning to more normal daily routines, which may explain the ongoing increase in reported exposures. Most reported exposures were unintentional, mild in symptomatology, and required the use of non-invasive therapies, if any.
Future efforts should focus on public education on the safe use of cleaning products to prevent exposure to toxic chlorine and chloramine gases.
当家用清洁剂混合使用时，可能会吸入氯气和氯胺气体。在 COVID-19 大流行期间，人们更加重视消毒措施，这可能导致美国氯气和氯胺气体暴露的增加，但目前尚未对此进行研究。
在回顾性研究中，从 2015 年 1 月 1 日至 2022 年 12 月 31 日，从国家毒物数据系统中收集了氯气和氯胺气体暴露的报告数据。数据包括人口统计学和暴露细节，包括地点、剂量、配方、共同暴露、治疗和结果。进行了人口统计学分析和描述性统计。
在研究期间，共报告了 85104 例氯气和氯胺气体暴露，其中 79281 例为单独暴露，5823 例为共同暴露。总暴露量增加了 61%，从 2015 年的 8385 例增加到 2022 年的 13503 例，最大增幅为 2019 年至 2020 年的 38.3%。总暴露量一直保持增加，没有恢复到大流行前的水平。大多数暴露发生在“自有住所”（ = 72213，84.9%），大流行期间家庭周边发生的暴露比例高于大流行前（88.4%比 81.7%）。1%（ = 1030）的暴露者被收治于非重症监护病房，0.73%（ = 619）的暴露者被收治于重症监护病房，0.03%（ = 26）的暴露者死亡。
COVID-19 大流行的开始和对清洁措施的重视可能是导致 2020 年暴露显著增加的因素，这种情况一直持续到 2022 年。大流行初期发展起来的清洁措施可能在日常生活恢复正常后仍在继续，这可能解释了报告暴露的持续增加。大多数报告的暴露是无意的，症状轻微，需要使用非侵入性治疗方法，如果有治疗的话。
未来的工作应侧重于对清洁产品安全使用的公众教育，以防止接触有毒的氯气和氯胺气体。
