Definition

Phosgene is a chemical used in plastics and pesticides. It can also be made when chemicals with chlorine are broken down or burned. Phosgene exposure can happen when someone comes in contact with gas, liquid, or food that is contaminated with it.

Causes

People can be exposed by:

  • Breathing air that has phosgene—phosgene is a gas at 68° Fahrenheit (20° Celsius)
  • Liquid phosgene or water that has phosgene and touches the skin or eyes
  • Eating foods or drinking water has liquid phosgene

Pathway to the Lungs
Air pathway breathing

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Risk Factors

This problem is more common in people who are near sources of phosgene, such as:

  • Plastic and chemical plants
  • Paint stripping
  • Dry cleaning
  • Fires fueled by plastic
  • Use of solvents that have chlorine
  • Metal cleaning
  • Welding
  • Industrial accidents
  • Bioterrorism

Symptoms

The health problems from this will depend on how much phosgene was taken in and for how long. It also depends on the parts of the body that were harmed. Sometimes, lasting damage to tissue or death can happen.

The most common exposure is by breathing the gas. At first, it may only cause minor eye or throat problems. But problems tend to worsen and reappear over 48 hours.

Breathing problems are:

  • Coughing
  • Trouble breathing
  • Choking
  • Tightness in the chest
  • Coughing up fluid that is pink in color

Skin problems are:

  • Burning pain
  • Swelling
  • Blisters

Eye problems are watering or bleeding.

Common problems are headache, nausea, and vomiting.

Diagnosis

The doctor will ask about your symptoms and health history. You will also be asked about your exposure to any chemicals. A physical exam will be done. A skin or eye exam may also be done.

Pictures may be taken of the lungs and the structures around it. This can be done with:

Treatment

There is no cure. Avoiding sources of phosgene may improve symptoms.

The goal of treatment is to manage symptoms. Choices are:

  • Monitoring for health problems
  • Supportive care, such as oxygen or help with breathing

Prevention

To lower the risk of this problem:

  • Avoid sources of phosgene
  • Wear a mask or respirator on the job
  • Work in well-ventilated areas
RESOURCES:

Centers for Disease Control and Prevention
http://emergency.cdc.gov

Occupational Health and Safety Association
https://www.osha.gov

CANADIAN RESOURCES:

Canadian Centre for Occupational Health and Safety
http://www.ccohs.ca

Health Canada
https://www.canada.ca

REFERENCES:

Acute management overview—phosgene exposure. NIH Chemical Hazards Emergency Medical Management website. Available at: https://chemm.nlm.nih.gov/phosgene_hospital_mmg.htm. Accessed October 28, 2020.

Chen TM, Malli H, et al. Toxic inhalational exposures. J Intensive Care Med. 2013 Nov-Dec;28(6):323-333.

Facts about phosgene. Centers for Disease Control and Prevention website. Available at: http://emergency.cdc.gov/agent/phosgene/basics/facts.asp. Accessed October 28, 2020.

Toxic inhalation injury. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/toxic-inhalational-injury. Accessed October 28, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 10/28/2020