Exposures

• World War I Wartime Exposure
• Thermal or Ultraviolet Breakdown Product of Chlorinated Solvents (Such as Methylene Chloride)
  • Common Exposure from Welding Metals “Degreased” with Solvents

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Physiology

Phosgene Gas Inhalation

• Phosgene Gas is Not Acutely Irritating
• Low Water Solubility: may result in longer exposure and delayed injury to bronchioles and alveoli

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Diagnosis

Bronchoscopy (see Bronchoscopy)

• May Be Necessary to Rule Out Airway Injury

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Clinical Manifestaions

General Comments

Delayed Onset of Symptoms

• Symptoms Appear 12-24 hrs After Inhalational Exposure

Pulmonary Manifestations

Bronchiolitis Obliterans (BO) (see Bronchiolitis Obliterans)

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Acute Respiratory Distress Syndrome (ARDS) (see Acute Respiratory Distress Syndrome)

• Epidemiology
• Pathology: diffuse alveolar damage

Reactive Airway Dysfunction Syndrome (RADS) (see Reactive Airway Dysfunction Syndrome)

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Treatment

Corticosteroids (see Corticosteroids)

• May Be Beneficial in Acute Respiratory Distress Syndrome (ARDS), But are Unproven

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References

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