염소가스 노출에 의한 반응성 기도과민 증후군 3예
Three Cases of Reactive Airway Dysfunction Syndrome Induced by Accidental Exposure to Chlorine Gas
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Acute inhalational exposure to chlorine gas can cause reactive airway dysfunction syndrome (RADS) but only a few data are available on its long term sequelae. We experienced three cases of RADS induced by chlorine gas. Fifteen adults were accidentally exposed to chlorine gas at a local swimming pool because of an error in exchanging disinfectant. The exposure time was within 5 minutes. Most patients experienced throat irritation and sense of breathlessness. Three of them showed wheezing and obstructive patterns in pulmonary function tests and were diagnosed as RADS. Two of them received inpatient care for respiratory difficulty. Inhaled corticosteroid and bronchodilator were discontinued within a few months with resolution of obstructive lung impairment. At the 1-year follow-up, only one patient, demonstrated a positive response to the methacholine provocation test and needed anti-asthmatic medication for frequent nocturnal wheezing. After one year medication with inhaled corticosteroid and bronchodilator, he became free of symptoms and showed negative response to the methacholine provocation test. Another patients showed a borderline airway hyperresponsiveness (PC20=25 mg/mL) and the third patient had a negative test result without any symptoms. These two patients have not experienced any respiratory symptoms since they recovered from acute symptoms of RADS.
Abstract
Acute inhalational exposure to chlorine gas can cause reactive airway dysfunction syndrome (RADS) but only a few data are available on its long term sequelae. We experienced three cases of RADS induced by chlorine gas. Fifteen adults were accidentally exposed to chlorine gas at a local swimming pool because of an error in exchanging disinfectant. The exposure time was within 5 minutes. Most patients experienced throat irritation and sense of breathlessness. Three of them showed wheezing and obstructive patterns in pulmonary function tests and were diagnosed as RADS. Two of them received inpatient care for respiratory difficulty. Inhaled corticosteroid and bronchodilator were discontinued within a few months with resolution of obstructive lung impairment. At the 1-year follow-up, only one patient, demonstrated a positive response to the methacholine provocation test and needed anti-asthmatic medication for frequent nocturnal wheezing. After one year medication with inhaled corticosteroid and bronchodilator, he became free of symptoms and showed negative response to the methacholine provocation test. Another patients showed a borderline airway hyperresponsiveness (PC20=25 mg/mL) and the third patient had a negative test result without any symptoms. These two patients have not experienced any respiratory symptoms since they recovered from acute symptoms of RADS.
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