December 7th, 2014
Chicago Tribune
A recent article published in the
Chicago Tribune described an incident in which the entire Rosemont Hyatt
Regency Hotel in Chicago was evacuated due to the intentional release of
chlorine gas. The evacuation of the hotel resulted in the hospitalization of 19
people. Fortunately, there were no deaths associated with this incident
probably due to the lower doses of the toxic gas involved. Immediate symptoms
due to chlorine inhalation can range from a burning sensation in the nose,
coughing, chest tightness and shortness of breath. Upon inhalation of higher
doses of chlorine gas, the long term
consequences of lung injury can lead to lung edema, respiratory distress and
even death. A recent study published in the ‘American Journal of Physiol Lung
Cell Mol Physiol’ demonstrated that chlorine
inhalation caused sloughing of bronchial epithelium one day after chlorine exposure, which can cause pneumonitis and
bronchial hyper-reactivity (1). Surprisingly,
health screenings for individuals located within one mile of a 54 metric ton
release of liquid chlorine following a 16 tanker
car train derailment on 6 January, 2005 in Graniteville, South Carolina, USA
demonstrated that even 8-10 months after the event, patients still had abnormal
lung function and some even developed new pulmonary symptoms (2).
However,
there are no immediate counter-measures available to date to mitigate chlorine
toxicity. Current treatment regimes consist of providing supportive medical care in a
hospital setting. For effective treatment, first
responders and hospitals need compounds that are easily administered for the
purpose of halting the cascade of events that lead to future respiratory
complications. Recent work being conducted at the University of Alabama at
Birmingham in the labs of Drs. Sadis Matalon and Rakesh Patel have shown that
the administration of aerosolized heparin can reduce lung injury, and an
intramuscular injection of nitrite can reduce mortality after chlorine exposure
(3,4). The research was supported by the Counter Act Network, and
therefore many will potentially benefit from the work being done at UAB and
other institutions under the Counter Act umbrella.
Author: Dr. Saurabh Aggarwal MD.,
Ph.D. Instructor, Department of Anesthesiology, UAB, Birmingham, Al
3. Honavar, J., Doran, S., Oh, J. Y.,Steele, C., Matalon, S., and Patel, R. P. (2014) Am J Physiol Lung Cell Mol Physiol 307, L888-894
4. Zarogiannis, S. G., Wagener, B. M.,Basappa, S., Doran, S., Rodriguez, C. A., Jurkuvenaite, A., Pittet, J. F., andMatalon, S. (2014) Am J Physiol Lung CellMol Physiol 307, L347-354
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