Lung damage from chlorine can persist in children

Ten children who were accidentally exposed to chlorine at a swimming pool experienced substantial impairment of lung function that was still apparent to some degree several months later, according to a report from Italy.

Chlorine inhalation can cause several types of lung damage, depending on the extent of exposure, ranging from irritation of the mucous membranes to accumulation of fluid in the lungs that can cause respiratory failure. However, little information is available on the underlying process that causes these symptoms, Dr. Eugenio Baraldi, of the University of Padua, Italy, and colleagues report in the American Journal of Respiratory and Critical Care Medicine.

Although most people do recover from the chlorine exposure, the possibility of long-term damage is still a concern, they add.

The researchers therefore examined the lung function and potential long-term damage soon after chlorine exposure and over the next 15 months in 10 previously healthy children.

The children were in a group of 18 participating in a swimming lesson. Because of a mistake that occurred when the pool was serviced, too much chlorine was added to the water, the water turned yellow and the children became ill. Ten children were hospitalized, and four of them were placed in the pediatric intensive care unit.

Immediately after exposure all of the patients had respiratory distress and reduced lung function of about 50 percent. One child needed mechanical ventilation. The patients also had low levels of exhaled air and high levels of biologic markers of inflammation.

Measures of lung function returned to normal within 15 days after chlorine exposure. Levels of exhaled air were normal after 2 months, but markers of lung inflammation remained high for several months.

The children took an exercise challenge test 8 months after the accident, and no exercise-induced asthma occurred. None of the children experienced a significant drop in measures of lung function, Baraldi’s team reports.

Noting the persistent inflammation indicating lung damage, they suggest that treatment with steroids and other drugs that may reduce inflammation may be useful.

SOURCE: American Journal of Respiratory and Critical Care Medicine, September 2006.

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