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Phosgene Exposure

 

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 this gas, liquid, or food that is contaminated with it.

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.

 

Causes    TOP

People can be exposed by:

  • Breathing air that has phosgene—phosgene is a gas at 68° Farenheit (20° Celcius)
  • 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

Copyright © Nucleus Medical Media, Inc.

 

Risk Factors    TOP

You are at risk if you are near sources that make phosgene. Places with at higher risk are:

  • 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    TOP

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
  • A hard time breathing
  • Choking
  • Tightness in the chest
  • Coughing up fluid that is pink in color—a sign of pulmonary edema

Skin problems are:

  • Burning pain
  • Swelling
  • Blisters

Eye problems are watering or bleeding.

Common problems are headache, nausea, and vomiting.

 

Diagnosis    TOP

You will be asked about your symptoms and health history. The doctor will ask how you were exposed and for how long. A physical exam will be done. Tests may be done depending on your exposure. You may have a skin or eye exam.

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

 

Treatment    TOP

There is no cure. People exposed to phosgene, then taken away from the source, may start to feel better. You will need to be watched for 48 hours. Supportive care, such as oxygen or a breathing tube, may be needed until you can heal.

Call for emergency medical services and tell them about the phosgene exposure. Take these steps right away:

  • If indoors, move to fresh air.
  • If outdoors, move to higher ground because phosgene will sink to lower ground.
  • Remove phosgene-soaked clothing right away. Do not pull clothes over your head. Instead, cut the clothing off.
    • Put clothing in a plastic bag and seal it. Put the plastic bag inside bag and set it aside. Do not touch or let other people touch the bags until help gets to you. Let them know about the plastic bags so they can handle them the right way.
    • If you wear contact lenses, put them in the plastic bags with the clothes. Eyeglasses can be washed with soap and water, then worn again.
  • Wash your body with plenty of soap and water. Flush your eyes with plain water for 10 to 15 minutes for any burning, watering, or blurry vision.
  • Do not try to make yourself vomit or drink any fluids if phosgene was swallowed.

You must rest for the first 48 hours after exposure. It will lower the risk of lung problems.

 

Prevention    TOP

The best way to prevent phosgene exposure is to know about it and avoid it. If you work somewhere that is high risk, follow protective steps from your company and National Occupational Safety agency.

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. Updated September 29, 2017. Accessed July 20, 2018.

Facts about phosgene. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Updated April 12, 2013. Accessed July 20, 2018.

Toxic inhalation injury. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T906193/Toxic-inhalational-injury . Updated March 5, 2015. Accessed July 20, 2018.



Last reviewed May 2018 by James Cornell, MD
Last Updated: 7/20/18

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