lung and airway disorders
Irritant Gas Inhalation Injury
Introduction
Irritant gas inhalation injury is the result of gases that, when inhaled, dissolve in the water of the respiratory tract mucosa and cause an inflammatory response. Symptoms depend on which gas or chemical is inhaled and how deeply and for how long it was inhaled. Symptoms may include irritation of the eyes or nose, cough, blood in the sputum, and shortness of breath. Chest x-rays, computed tomography, and breathing tests are used to determine how much lung damage has occurred. Oxygen and medications to open the airways and decrease inflammation are given. Many types of gases—such as chlorine, phosgene, sulfur dioxide, hydrogen sulfide, nitrogen dioxide, and ammonia—may suddenly be released during industrial accidents and may severely irritate the lungs. Gases have also been used as Overview of Chemical-Warfare Agents . Potentially hazardous substances can be inhaled as gases, fumes, vapors, mists, aerosols, and smoke. Toxic airborne substances can injure the respiratory tract (have local effects) and can also cause body-wide (systemic) injury. Most irritant gases are soluble in water and cause the abrupt onset of irritative symptoms at the mucosal surfaces they contact. These symptoms, which include watery eyes, runny nose, and burning of the mouth and face, can serve as warning signs to move away from the exposure if possible. Gases that are less soluble in water, for example, nitrogen dioxide and phosgene, have poor warning properties. Silo filler disease (which mostly affects farmers) results from inhaling fumes that contain nitrogen dioxide given off by moist silage, such as fresh corn or grains. Fluid may develop in the lungs as late as 12 hours after exposure. The potential for exposure exists in non-work settings. A common potential household exposure involves mixing household ammonia with cleansers containing bleach, leading to the release of the irritant gas chloramine. (See also Pulmonary Chemical-Warfare Agents and 