{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T09:28:36Z","timestamp":1780824516856,"version":"3.54.1"},"reference-count":19,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J R Army Med Corps"],"accepted":{"date-parts":[[2015,9,21]]},"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:p>We present a 26-year-old male British military nurse, deployed to Sierra Leone to treat patients with Ebola virus disease at the military-run Kerry Town Ebola Treatment Unit. Following exposure to chlorine gas during routine maintenance procedures, the patient had an episode of respiratory distress and briefly lost consciousness after exiting the facility. Diagnoses of reactive airways disease, secondary to the chlorine exposure and a hypocapnic syncopal episode were made. The patient was resuscitated with minimal intervention and complete recovery occurred in less than 1\u2005week. This case highlights the issues of using high-strength chlorine solution to disinfect the red zone. Although this patient had a good outcome, this was fortunate. Ensuring Ebola treatment centres are optimally designed and that appropriate management systems are formulated with extraction scenarios rehearsed are important to mitigate the chlorine-associated risk.<\/jats:p>","DOI":"10.1136\/jramc-2015-000501","type":"journal-article","created":{"date-parts":[[2016,5,26]],"date-time":"2016-05-26T08:53:19Z","timestamp":1464252799000},"page":"229-231","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["A case of a chlorine inhalation injury in an Ebola treatment unit"],"prefix":"10.1136","volume":"162","author":[{"given":"Adrian","family":"Carpenter","sequence":"first","affiliation":[{"name":"2 Field Ambulance, Garrison Petawawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A T","family":"Cox","sequence":"additional","affiliation":[{"name":"Royal Centre for Defence Medicine, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Marion","sequence":"additional","affiliation":[{"name":"Misericordia Community Hospital, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Phillips","sequence":"additional","affiliation":[{"name":"York District Hospital, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Ewington","sequence":"additional","affiliation":[{"name":"Royal Centre for Defence Medicine, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2015,10,15]]},"reference":[{"key":"2025081314592874000_162.3.229.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00705-010-0791-0"},{"key":"2025081314592874000_162.3.229.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2672.2010.04778.x"},{"key":"2025081314592874000_162.3.229.3","doi-asserted-by":"publisher","DOI":"10.1089\/fpd.2010.0782"},{"key":"2025081314592874000_162.3.229.4","doi-asserted-by":"crossref","first-page":"3601","DOI":"10.1128\/aem.56.11.3601-3604.1990","article-title":"Chemical disinfection of hepatitis A virus on environmental surfaces","volume":"56","author":"Mbithi","year":"1990","journal-title":"Appl Environ Microbiol"},{"key":"2025081314592874000_162.3.229.5","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00869-10"},{"key":"2025081314592874000_162.3.229.6","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268800058738"},{"key":"2025081314592874000_162.3.229.7","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1128\/CMR.10.4.597","article-title":"Uses of inorganic hypochlorite (bleach) in health-care facilities","volume":"10","author":"Rutala","year":"1997","journal-title":"Clin Microbiol Rev"},{"key":"2025081314592874000_162.3.229.8","unstructured":"WHO. Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus haemorrhagic fever in health-care settings, with focus on Ebola. Geneva, Switzerland: WHO, 2014."},{"key":"2025081314592874000_162.3.229.9","unstructured":"Op GRITROCK Standard Operating Procedure 81\u2014Chlorine dated 23 April 2015 (Ministry of Defence internal document)."},{"key":"2025081314592874000_162.3.229.10","doi-asserted-by":"publisher","DOI":"10.1097\/00075198-199506000-00017"},{"key":"2025081314592874000_162.3.229.11","doi-asserted-by":"publisher","DOI":"10.1513\/pats.201001-008SM"},{"key":"2025081314592874000_162.3.229.12","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.97.10010241"},{"key":"2025081314592874000_162.3.229.13","unstructured":"Ellenhorn MJ , Barceloux DG . Medical toxicology: diagnosis and treatment of human poisoning. Elsevier, 1988."},{"key":"2025081314592874000_162.3.229.14","unstructured":"World Health Organization. WHO Task Group on Environmental Health Criteria for Chlorine and Hydrogen Chloride (accessed 3 Dec 2009). Mercier M, convenor. Geneva: WHO; 1982 . http:\/\/www.inchem.org\/documents\/ehc\/ehc\/ehc21.htm#SubSection-Number:1.2.4 (accessed 10 Sep 2015)."},{"key":"2025081314592874000_162.3.229.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2007.12.006"},{"key":"2025081314592874000_162.3.229.16","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3109\/15563659409017956","article-title":"Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation","volume":"32","author":"Bosse","year":"1994","journal-title":"J Toxicol Clin Toxicol"},{"key":"2025081314592874000_162.3.229.17","unstructured":"Op GRITROCK Standard Operating Procedure 80\u2014\u2018Medical emergencies in the green zone\u2019 dated 21 April 2015 (Ministry of Defence internal document)."},{"key":"2025081314592874000_162.3.229.18","unstructured":"Op GRITROCK Standard Operating Procedure 30\u2014\u2018Collapse in the red zone\u2019 dated 12 April 2015 (Ministry of Defence internal document)."},{"key":"2025081314592874000_162.3.229.19","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1006\/enrs.2000.4110","article-title":"The toxicology of chlorine","volume":"85","author":"Winder","year":"2001","journal-title":"Environ Res"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-2015-000501","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T21:59:34Z","timestamp":1755122374000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-2015-000501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10,15]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2016,5,26]]},"published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1136\/jramc-2015-000501"],"URL":"https:\/\/doi.org\/10.1136\/jramc-2015-000501","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,10,15]]}}}