Etiology of Ammonia Inhalation

  • Anhydrous Ammonia: gas at room temperature
    • Commercial Refrigerant
    • Farming: ammonia is used as a fertilizer
    • Illicit Methamphetamine Labs
  • Aqueous Ammonia: liquid at room temperature
    • Household Cleaning Solutions

Physiology of Ammonia Inhalation

  • Inhalational Exposure to Anhydrous Ammonia Gas
    • Highly soluble in water -> immediately affects upper airway and conjunctiva
    • Upper airway effects usually elicit early escape before damage occurs

Clinical Manifestations of Ammonia Inhalation

Pulmonary Manifestations

  • Upper Airway Irritation: anhydrous ammonia gas immediately affects upper airway
  • Upper Airway Obstruction-Laryngeal Edema (see Obstructive Lung Disease)
  • Acute Lung Injury-ARDS (see Acute Lung Injury-ARDS)
    • Diagnosis
      • FOB: may be necessary to rule out airway mucosal injury
      • OLB: diffuse alveolar damage
    • Clinical: delayed onset of pulmonary injury is unusual
    • Treatment
      • Steroids: may be benficial in acute lung injury, but are unproven
  • Reactive Airway Dysfunction Syndrome (see Reactive Airway Dysfunction Syndrome)
  • Bronchiolitis Obliterans (see Bronchiolitis Obliterans)
  • Bronchiectasis (see Bronchiectasis)
    • Epidemiology: case reports

Other Manifestations

  • Conjunctival Irritation: anhydrous ammonia gas immediately affects conjunctiva
  • Contact Dermatitis-Irritant Type (see Contact Dermatitis)
  • Residual Olfactory Effects: decreased olfactory acuity


  • xxx