Chlorine Toxicity Clinical Presentation

Updated: Apr 11, 2022
  • Author: Gerald F O'Malley, DO; Chief Editor: Zygmunt F Dembek, PhD, MS, MPH, LHD  more...
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Symptoms may vary depending on the degree of exposure. Exposure possibilities include acute low levels, acute high levels, and chronic low levels.

Acute exposure (low levels)

Most poisonings fall into this category and are caused by household exposure to low-concentration cleaning products. Manifestations are as follows:

  • Eye tearing, nose and throat irritation
  • Sneezing
  • Excess salivation
  • General excitement or restlessness

Acute exposure (high levels)

In addition to the symptoms seen with low-level exposure, high-level exposure may result in the following:

  • Dyspnea: Upper airway swelling and obstruction may occur
  • Violent cough
  • Nausea and vomiting (with the smell of chlorine in emesis)
  • Lightheadedness
  • Headache
  • Chest pain or retrosternal burning
  • Muscle weakness
  • Abdominal discomfort
  • Dermatitis (with liquid exposure): Corneal burns and ulcerations may occur from splash exposure to high-concentration chlorine products

Chronic exposure

Manifestations of chronic exposure include the following:

  • Acne (chloracne)
  • Chest pain
  • Cough
  • Sore throat
  • Hemoptysis

Physical Examination

Findings on physical examination may include the following:

  • Tachypnea
  • Cyanosis (most prevalent during exertion)
  • Tachycardia
  • Wheezing
  • Intercostal retractions
  • Decreased breath sounds
  • Rales (pulmonary edema)
  • Nasal flaring
  • Aphonia, stridor, or laryngeal edema
  • Ulceration or hemorrhage of the respiratory tract
  • Rhinorrhea
  • Lacrimation, salivation, and blepharospasm
  • Chloracne or tooth enamel corrosion (with chronic exposure)
  • Redness, erythema, and chemical burns to the skin from dose-dependent exposure to liquid

Superheated chlorine gas from an industrial fire or chemical warehouse explosion may carry the danger of direct thermal injury to the mucous membranes of the eyes, mouth, and respiratory tract in addition to the chemical effects.