Chloropicrin Poisoning 

  • Author: Kermit D Huebner, MD, FACEP; Chief Editor: Robert G Darling, MD, FACEP   more...
 
Updated: Jan 12, 2011
 

Background

Chloropicrin is a soil fumigant used for its broad biocidal and fungicidal properties, primarily in high-value crops such as strawberries, peppers, onions, tobacco, flowers, tomatoes, and nursery crops. John Stenhouse, a Scottish chemist and inventor, synthesized chloropicrin in 1848. Because chloropicrin is toxic by all routes of entry, it has the potential for widespread destruction as a chemical warfare agent.

Properties, stability, and reactivity

Chloropicrin is a colorless–to–light green oily liquid with an intense and penetrating odor. Even though chloropicrin is not flammable, it is a significant explosion hazard if involved in a fire. Bulk containers of this liquid are shock sensitive and can detonate. Chloropicrin is an irritant to all body surfaces. This liquid decomposes in the environment. Photochemical reactions with chloropicrin produce phosgene; other decomposition products include nitrogen oxides and chlorine compounds.

Chloropicrin photodegrades, with a half-life of 20 days. It is known to undergo violent reactions with aniline, 3-bromopropyne, sodium hydroxide/alcohol solutions, sodium methoxide, and propargyl bromide. Hazardous polymerization does not occur with chloropicrin. The chemical structure of chloropicrin is portrayed in the image below.

Chemical structure of chloropicrin. Chemical structure of chloropicrin.

Detection

The odor is a distinctive warning property of this liquid compound.

Table. Symptoms According to Concentrations (Open Table in a new window)

1 ppm*Irritation with pain in the eyes
4 ppmIncapacitates exposed individuals
20 ppmCauses definite bronchial or pulmonary lesions
*Concentrations expressed in parts of material per million parts of air or water.
Next

Pathophysiology

Inhalation

Overexposure leads to irritation of the nose and throat. Chloropicrin is a lacrimator. Exposure to vapors leads to coughing, labored breathing, sore throat, dizziness, bluish skin, vomiting, and in some instances, chemical pneumonitis and pulmonary edema.

Contact with skin or eyes

Contact with chloropicrin can lead to chemical burns or dermatitis manifested by red, cracked, irritated skin. The extent of skin injury depends on the concentration and duration of exposure. Contact with the eyes can cause pain, redness, and tearing. Prolonged eye exposure to chloropicrin can cause blindness. Entrance through damaged skin causes similar symptoms as those seen in overexposure through inhalation.

Ingestion

If ingested, chloropicrin can cause burns to the mouth, throat, and esophagus. Other symptoms are similar to those of overexposure through inhalation. Ingestion of large quantities of chloropicrin liquid can be fatal.

Injection

Overexposure to chloropicrin by injection can lead to redness and irritation of surrounding tissues. Other symptoms are similar to those of overexposure through inhalation.

Chronic exposure

Dermatitis may result from repeated exposure to chloropicrin.

Previous
Next

Epidemiology

Frequency

United States

Chloropicrin is commonly used as a soil fumigant for agricultural pest control. Human exposures have occurred in the United States, usually in residential areas in close proximity to agricultural areas. The most recently reported large-scale exposure occurred in Kern County, California, in 2003. One hundred sixty-five people developed symptoms as a result of off-site drift of chloropicrin from a nearby agricultural site. Peak concentrations of chloropicrin were estimated to exceed 1 part per million. Nearly all (99%) of those exposed experienced eye pain, burning, or lacrimation. Fifty-one percent experienced respiratory symptoms including cough, dyspnea, or upper respiratory irritation. Nearly half (47%) complained of gastrointestinal complaints such as nausea, vomiting, abdominal pain or diarrhea, and 25% complained of headache.[1]

Mortality/Morbidity

Fatal chloropicrin exposures have been reported. An intentional ingestion of 100 mL of chloropicrin sodium solution resulted in death from metabolic acidosis and acute heart failure approximately 7 hours after ingestion.[2] Homicidal intoxication has also been reported, in which an 18-year-old female died approximately 4 hours after being sprayed with a liquid that was later determined to be chloropicrin. Postmortem examination demonstrated severe pulmonary edema.[3]

Elevations of creatine phosphokinase levels have been described in the setting of chloropicrin exposure and may represent some degree of rhabdomyolysis.[4]

Chloropicrin may cause methemoglobinemia.[5]

Previous
 
 
Contributor Information and Disclosures
Author

Kermit D Huebner, MD, FACEP  Research Director, Carl R Darnall Army Medical Center

Kermit D Huebner, MD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, Association of Military Surgeons of the US, Society for Academic Emergency Medicine, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

David N Trickey, MD  Staff Physician, Department of Emergency Medicine, Martin Army Community Hospital

David N Trickey, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Mark Keim, MD  Senior Science Advisor, Office of the Director, National Center for Environmental Health, Centers for Disease Control and Prevention

Mark Keim, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Robert G Darling, MD, FACEP  Adjunct Clinical Assistant Professor of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Associate Director, Center for Disaster and Humanitarian Assistance Medicine

Robert G Darling, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Telemedicine Association, and Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Joanne Williams, MD, to the development and writing of this article.

References
  1. O'Malley MA, Edmiston S, Richmond D, Ibarra M, Barry T, Smith M, et al. Illness associated with drift of chloropicrin soil fumigant into a residential area--Kern County, California, 2003. MMWR Morb Mortal Wkly Rep. Aug 20 2004;53(32):740-2. [Medline]. [Full Text].

  2. Honda H, Kawashima T, Kaku N, Kawasaki K. [A case of fatal chloropicrine poisoning induced by ingestion]. Chudoku Kenkyu. Oct 2002;15(4):381-4. [Medline].

  3. Gonmori K, Muto H, Yamamoto T, Takahashi K. A case of homicidal intoxication by chloropicrin. Am J Forensic Med Pathol. Jun 1987;8(2):135-8. [Medline].

  4. Prudhomme JC, Bhatia R, Nutik JM, Shusterman DJ. Chest wall pain and possible rhabdomyolysis after chloropicrin exposure. A case series. J Occup Environ Med. Jan 1999;41(1):17-22. [Medline].

  5. Material Safety Data Sheet - Lacrythor Fumigation Warning Agent. Revised October 2006. Material Safety Data Sheet. Available at http://forthor.com/labels/chloropicrin/pic_MSDS.pdf. Accessed January 1, 2008.

  6. Goldman LR, Mengle D, Epstein DM, Fredson D, Kelly K, Jackson RJ. Acute symptoms in persons residing near a field treated with the soil fumigants methyl bromide and chloropicrin. West J Med. Jul 1987;147(1):95-8. [Medline].

  7. Harber LF. The Poisonous Cloud: Chemical Warfare in the First World War. 1986:15-40.

  8. HoltraChem Manufacturing Company, LLC. Material Safety Data Sheet, Chloropicrin. July 30, 1996; revised February 28, 2000.

  9. McEvoy GK, Litvak K, Welsh, Jr. OH. AHFS 96 Drug Information. 1996;861-864, 2654-2657.

  10. Smart JK. History of chemical and biological warfare fact sheets. In: Special Study 50; US Army Chemical and Biologic Defense Command. 1996.

  11. Tintinalli JE. Emergency medicine. JAMA. Jun 19 1996;275(23):1804-5. [Medline].

  12. Wilhelm SN, Sheipier K, Lawrence H. Environmental fate of chloropicrin. In: Fumigants: Environmental Fate, Exposure, and Analysis. 1996.

Previous
Next
 
Chemical structure of chloropicrin.
Level A suit (DuPont Tychem 10,000).
Chemical Terrorism Agents and Syndromes. Signs and symptoms. Chart courtesy of North Carolina Statewide Program for Infection Control and Epidemiology (SPICE), copyright University of North Carolina at Chapel Hill, www.unc.edu/depts/spice/chemical.html.
Table. Symptoms According to Concentrations
1 ppm*Irritation with pain in the eyes
4 ppmIncapacitates exposed individuals
20 ppmCauses definite bronchial or pulmonary lesions
*Concentrations expressed in parts of material per million parts of air or water.
Previous
Next
 
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.