{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:25:44Z","timestamp":1792736744886,"version":"4.5.0"},"reference-count":79,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[1993,5,1]],"date-time":"1993-05-01T00:00:00Z","timestamp":736214400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxicol Ind Health"],"published-print":{"date-parts":[[1993,5]]},"abstract":"<jats:p>We conducted a review of the literature detailing the respiratory effects of chlorine, an extremely important but toxic halogen. Historically, the heaviest mass inhalational exposures to chlorine resulted from World War I gassing. Currently potential human exposure to chlorine inhalation occurs in a variety of settings in the workplace, as a result of inadvertent environmental releases, and even in the home due to household cleaning mishaps. Chlorine species are highly reactive; tissue injury results from exposure to chlorine, hydrochloric acid, hypochlorous acid, or chloramines. Acute, high level exposure to chlorine gas in occupational or environmental settings results in a variety of dose-related lung effects ranging from respiratory mucus membrane irritation to pulmonary edema. Pulmonary function testing can reveal either obstructive or restrictive deficits immediately following exposure, with resolution over time in the majority of cases. However, some of those exposed may demonstrate long-term persistent obstructive or restrictive pulmonary deficits or increased nonspecific airway reactivity after high level exposure to chlorine gas. Symptoms and signs following inhalation of mixtures of chlorine-containing cleaners in the home are similar to those after occupational exposures and environmental releases. Although generally less severe, these events may be extremely common. Controlled human exposure data suggest that some subjects may be more responsive to the effects of chlorine gas; epidemiologic data also indicate that certain subpopulations (e.g., smokers) may be at greater risk of adverse outcome after chlorine inhalation. Although these findings are intriguing, additional study is needed to belter delineate the risk factors that predispose toward the development of long-term pulmonary sequelae following chlorine gas exposure.<\/jats:p>","DOI":"10.1177\/074823379300900304","type":"journal-article","created":{"date-parts":[[2013,9,9]],"date-time":"2013-09-09T18:36:19Z","timestamp":1378751779000},"page":"439-455","source":"Crossref","is-referenced-by-count":130,"title":["Chlorine Gas Exposure and the Lung: A Review"],"prefix":"10.1177","volume":"9","author":[{"given":"Rupali","family":"Das","sequence":"first","affiliation":[{"name":"Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Blanc","sequence":"additional","affiliation":[{"name":"Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1993,5,1]]},"reference":[{"key":"bibr1-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/56.4.430"},{"key":"bibr2-074823379300900304","unstructured":"American Conference Of Government Industrial Hygienists. (1991). Documentation of the threshold limit values and biological exposure indices. 6th ed. Cincinnatti: ACGIH. pp. 252\u2013255."},{"key":"bibr3-074823379300900304","volume-title":"Sensory response of human subjects to chlorine in air","author":"Anglen D.M.","year":"1981"},{"key":"bibr4-074823379300900304","first-page":"361","volume":"48","author":"Arloing F.","year":"1940","journal-title":"Presse Med"},{"key":"bibr5-074823379300900304","first-page":"47","volume":"14","author":"Barbour H.G.","year":"1919","journal-title":"J. Pharmacol. Exp. Ther"},{"key":"bibr6-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1080\/00039896.1977.10667258"},{"key":"bibr7-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1016\/0041-008X(79)90279-5"},{"key":"bibr8-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1016\/0041-008X(79)90280-1"},{"key":"bibr9-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1016\/0041-008X(80)90388-9"},{"key":"bibr10-074823379300900304","first-page":"231","volume":"26","author":"Beach F.X.M.","year":"1969","journal-title":"Brit. J. Ind. Med"},{"key":"bibr11-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1919.00090290099009"},{"key":"bibr12-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.2848.165"},{"key":"bibr13-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470050064024"},{"key":"bibr14-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.94.3.476"},{"key":"bibr15-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.2850.247-a"},{"key":"bibr16-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.88.3.376"},{"key":"bibr17-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1016\/0041-008X(84)90295-3"},{"key":"bibr18-074823379300900304","first-page":"333","volume":"143","author":"Charan N.B.","year":"1985","journal-title":"West J. Med"},{"key":"bibr19-074823379300900304","first-page":"152","volume":"4","author":"Chasis H.","year":"1947","journal-title":"Occup. Med"},{"key":"bibr20-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.72.2.247"},{"key":"bibr21-074823379300900304","first-page":"230","volume-title":"The Industrial Revolution 1750 to 1850, Vol IV: A History of Technology","author":"Clow A.","year":"1958"},{"key":"bibr22-074823379300900304","first-page":"193","volume":"24","author":"Cralley L.V.","year":"1942","journal-title":"J. Ind. Hyg. Toxicol"},{"key":"bibr23-074823379300900304","unstructured":"Davis D.S., DeWolf G.B., Ferland K.A.  (1989). \u201cAccidental releases of air toxics.\u201d Park Ridge, New Jersey: NDC. pp. 6\u20139."},{"key":"bibr24-074823379300900304","first-page":"275","volume":"159","author":"Donelly S.C.","year":"1990","journal-title":"I.J.M.S"},{"key":"bibr25-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1097\/00000433-199106000-00007"},{"key":"bibr26-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196409172711209"},{"key":"bibr27-074823379300900304","first-page":"26","volume":"24","author":"Ferris B.G.","year":"1967","journal-title":"Brit. J. Industr. Med"},{"key":"bibr28-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1177\/096032718600500205"},{"key":"bibr29-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1982.03330030055026"},{"key":"bibr30-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.285.6348.1086"},{"key":"bibr31-074823379300900304","first-page":"229","volume":"9","author":"Gilchrist H.L.","year":"1933","journal-title":"Med. Bull. Vet. Admins"},{"key":"bibr32-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/os-13.50.121"},{"key":"bibr33-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1038\/330711a0"},{"key":"bibr34-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1080\/00039896.1983.10543984"},{"key":"bibr35-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.bi.38.070169.000321"},{"key":"bibr36-074823379300900304","unstructured":"Henderson Y., Haggard H.W. (1943). \u201cNoxious gases and the principles of respiration influencing their action.\u201d 2nd ed. New York: Reinhold Publishing Corp. pp. 171\u2013173."},{"key":"bibr37-074823379300900304","first-page":"110","volume":"26","author":"Hill L.","year":"1916","journal-title":"J. Roy Army Med. Corps"},{"key":"bibr38-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/141.3.640"},{"key":"bibr39-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1972.03210100060033"},{"key":"bibr40-074823379300900304","first-page":"1190","volume":"134","author":"Jones R.N.","year":"1986","journal-title":"Am. Rev. Respir. Dis"},{"key":"bibr41-074823379300900304","first-page":"152","volume":"4","author":"Joyner R.E.","year":"1962","journal-title":"J. Occ. Med"},{"key":"bibr42-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1080\/00039896.1971.10665950"},{"key":"bibr43-074823379300900304","first-page":"50","volume":"235","author":"Kavaler A.R.","year":"1989","journal-title":"Chemical Marketing Reporter"},{"key":"bibr44-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/143.1.74"},{"key":"bibr45-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1016\/0272-0590(87)90037-6"},{"key":"bibr46-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1128\/JB.55.4.451-458.1948"},{"key":"bibr47-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1080\/00039896.1967.10664791"},{"key":"bibr48-074823379300900304","first-page":"231","volume":"7","author":"Lehman K.B.","year":"1887","journal-title":"Arch. Hyg"},{"key":"bibr49-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1926.26720480001008a"},{"key":"bibr50-074823379300900304","first-page":"968","volume":"9","author":"Meakins J.C.","year":"1919","journal-title":"Can. Med. Assoc. J"},{"key":"bibr51-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.100.3.855"},{"key":"bibr52-074823379300900304","first-page":"372","volume":"33","author":"Mrvos R.","year":"1991","journal-title":"Vet. Hum. Toxicol"},{"key":"bibr53-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.69.3.372"},{"key":"bibr54-074823379300900304","unstructured":"National Academy Of Sciences. (1976). \u201cCommittee on Medical and Biologic Effects of Environmental Pollutants. Chlorine and hydrogen chloride.\u201d Division of Medical Sciences, Assembly of Life Sciences, National Research Council. Washington: National Academy of Sciences, pp. 163\u2013174."},{"key":"bibr55-074823379300900304","volume-title":"\u201cNIOSH criteria for a recommended standard: Occupational exposure to chlorine.\u201d","author":"National Instutute For Occupational Safety And Health","year":"1976"},{"key":"bibr56-074823379300900304","volume-title":"\u201cNational Occupational Exposure Survey.\u201d","author":"NATIONAL INSTUTUTE FOR OCCUPATIONAL SAFETY AND HEALTH.","year":"1981"},{"key":"bibr57-074823379300900304","first-page":"256","volume-title":"Concise Encyclopedia of Chemical Technology","author":"Nelson G.D.","year":"1985"},{"key":"bibr58-074823379300900304","volume-title":"\u201cAir Contaminants-Permissible Exposure Limits.\u201d","author":"Occupational Safety And Health Administration","year":"1989"},{"key":"bibr59-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1080\/0002889708506314"},{"key":"bibr60-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1016\/0006-291X(72)90690-0"},{"key":"bibr61-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1016\/0304-4165(73)90198-0"},{"key":"bibr62-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198201000-00007"},{"key":"bibr63-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.89.1.49"},{"key":"bibr64-074823379300900304","first-page":"81","volume-title":"On health and occupation","author":"Richardson B.W.","year":"1879"},{"key":"bibr65-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1983.54.4.1120"},{"key":"bibr66-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1007\/BF00376170"},{"key":"bibr67-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1080\/00039896.1962.10663316"},{"key":"bibr68-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.4700200107"},{"key":"bibr69-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.2850.245"},{"key":"bibr70-074823379300900304","first-page":"297","volume":"2","author":"Schwartz D.A.","year":"1987","journal-title":"Occupational Medicine: State of the Art Reviews"},{"key":"bibr71-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.4.820"},{"key":"bibr72-074823379300900304","first-page":"873","volume":"122","author":"Sheppard D.","year":"1980","journal-title":"Am. Rev. Rcspir. Dis"},{"key":"bibr73-074823379300900304","unstructured":"Stokinger H.E. (1981). Patty's Industrial Hygiene and Toxicology. 3rd ed. Vol II B. New York: John Wiley & Sons. pp. 2954\u20132965."},{"key":"bibr74-074823379300900304","doi-asserted-by":"publisher","DOI":"10.1378\/chest.96.2.297"},{"key":"bibr75-074823379300900304","unstructured":"Underhill F.P. (1920). The Lethal War Gases. New Haven: Yale University Press, pp. 1\u201321, 40\u201384."},{"key":"bibr76-074823379300900304","first-page":"374","volume":"99","author":"Weill H.","year":"1969","journal-title":"Am. Rev. Resp. Dis"},{"key":"bibr77-074823379300900304","first-page":"1","volume-title":"Collected Studies on the Pathlogy of War Gas Poisoning","author":"Winternitz M.C.","year":"1920"},{"key":"bibr78-074823379300900304","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1542\/peds.79.3.427","volume":"79","author":"Wood B.R.","year":"1987","journal-title":"Pediatrics"},{"key":"bibr79-074823379300900304","volume-title":"Chlorine and hydrogen chloride","author":"World Health Organization","year":"1982"}],"container-title":["Toxicology and Industrial Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/074823379300900304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/074823379300900304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:49:22Z","timestamp":1777668562000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/074823379300900304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,5]]},"references-count":79,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1993,5]]}},"alternative-id":["10.1177\/074823379300900304"],"URL":"https:\/\/doi.org\/10.1177\/074823379300900304","relation":{},"ISSN":["0748-2337","1477-0393"],"issn-type":[{"value":"0748-2337","type":"print"},{"value":"1477-0393","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,5]]}}}