Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2022; 10(25): 8872-8879
Published online Sep 6, 2022. doi: 10.12998/wjcc.v10.i25.8872
Chlorine poisoning caused by improper mixing of household disinfectants during the COVID-19 pandemic: Case series
Guo-Dong Lin, Jie-Yi Wu, Xiao-Bo Peng, Xiao-Xia Lu, Zhong-Ying Liu, Zhi-Guo Pan, Ze-Wu Qiu, Jian-Guang Dong
Guo-Dong Lin, Jie-Yi Wu, Zhi-Guo Pan, Department of Critical Care Medicine, General Hospital of Southern Theater Command of PLA, Guangzhou 510010, Guangdong Province, China
Guo-Dong Lin, Xiao-Bo Peng, Xiao-Xia Lu, Zhong-Ying Liu, Ze-Wu Qiu, Jian-Guang Dong, Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China
Author contributions: Lin GD, Pan ZG, Qiu ZW, and Dong JG conceived the study, designed the trial, and obtained research funding; Peng XB, Lu XX, and Liu ZY supervised data collection and managed the data, including quality control; Qiu ZW and Dong JG provided statistical advice on study design and analyzed the data; Lin GD and Wu JY drafted the manuscript, and all authors contributed substantially to its revision; Pan ZG, Qiu ZW, and Dong JG take responsibility for the paper as a whole.
Supported by the National Natural Science Foundation of China, No. 81873116.
Institutional review board statement: The retrospective study design was approved by the Fifth Medical Center of PLA General Hospital Institutional review board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Guang Dong, PhD, Senior Department of Hematology, The Fifth Medical Center of PLA General Hospital, No. 8 East Street, Fengtai District, Beijing 100071, China. 347800520@qq.com
Received: February 18, 2022
Peer-review started: February 18, 2022
First decision: June 15, 2022
Revised: June 24, 2022
Accepted: July 20, 2022
Article in press: July 20, 2022
Published online: September 6, 2022
Processing time: 188 Days and 22.7 Hours
Abstract
BACKGROUND

Misuse of disinfectants during the coronavirus disease 2019 pandemic has led to several poisoning incidents. However, there are few clinical case reports on poisoning caused by improper mixing of household disinfectants.

AIM

To summarize the clinical characteristics and treatment effects of chlorine poisoning caused by improper mixing of hypochlorite bleach with acidic cleaning agents.

METHODS

We retrospectively analyzed baseline and clinical data, clinical symptoms, and treatment methods of seven patients with chlorine poisoning who were admitted to the National Army Poisoning Treatment Center.

RESULTS

Among the seven patients, the average poisoning time (exposure to admission) was 57 h (4-240 h). All patients were involved in cleaning bathrooms. Chest computed tomography scans revealed bilateral lung effusions or inflammatory changes in five patients. The partial pressure of oxygen decreased in six patients, and respiratory failure occurred in one. Five patients had different degrees of increase in white blood cell count. Humidified oxygen therapy, non-invasive mechanical ventilation, anti-inflammatory corticosteroids, antioxidants, and antibiotics were administered for treatment. The average length of hospital stay was 7 d (4-9 d). All seven patients recovered and were discharged.

CONCLUSION

Improper mixing of household disinfectants may cause damage to the respiratory system due to chlorine poisoning. Corticosteroids may improve lung exudation in severe cases, and symptomatic supportive treatment should be performed early.

Keywords: Hypochlorite bleach; Acidic cleaning agents; Chlorine poisoning; Toxic lung injury; Household disinfectant

Core Tip: During the coronavirus disease 2019 pandemic, disinfectants should be used carefully. Improper mixing of household disinfectants may cause damage to the respiratory system due to chlorine poisoning. Corticosteroids may improve lung exudation in severe cases, and symptomatic supportive treatment should be performed early.