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Chemical pneumonitis

Chemical pneumonitis is inflammation of the lungs or breathing difficulty due to inhaling chemical fumes or breathing in and choking on certain chemicals.

Causes

Many household and industrial chemicals can produce both an acute and a chronic form of inflammation in the lungs.

Some of the most common dangerous, inhaled substances include:

  • Chlorine gas (which are breathed in from cleaning materials such as chlorine bleach, during industrial accidents, or near swimming pools)
  • Grain and fertilizer dust
  • Noxious fumes from pesticides
  • Smoke (from house fires and wildfires)

Chronic chemical pneumonitis can occur after only low levels of exposure to the irritant over a long time. This causes inflammation and may lead to stiffness of the lungs. As a result, the lungs start to lose their ability to get oxygen to the body. Untreated, this condition can cause respiratory failure and death.

Chronic aspiration of acid from the stomach and exposure to chemical warfare can also lead to chemical pneumonitis.

Symptoms

Acute:

  • Air hunger (feeling that you cannot get enough air)
  • Breathing that sounds wet or gurgling (abnormal lung sounds)
  • Cough
  • Difficulty breathing
  • Unusual sensation (possibly burning feeling) in the chest

Chronic:

Exams and Tests

The following tests help determine how severely the lungs are affected:

Treatment

Treatment is focused on reversing the cause of inflammation and reducing symptoms. Corticosteroids may be given to reduce inflammation, especially before long-term scarring occurs.

Antibiotics are usually not helpful or needed. Oxygen therapy may be helpful.

In cases of swallowing and stomach problems, eating small meals in the upright position can help. In severe cases, a feeding tube in the stomach is needed.

Outlook (Prognosis)

The outcome depends on the chemical, the severity of exposure, and whether the problem is acute or chronic.

Possible Complications

Respiratory failure and death can occur.

When to Contact a Medical Professional

Call your doctor if you have trouble breathing after inhaling (or possibly inhaling) any substance.

Prevention

Only use household chemicals as directed, and always in well-ventilated areas. Never mix ammonia and bleach.

Follow work rules regarding breathing masks and wear the right mask. People who work near fire should take care to limit their exposure to smoke or gases.

Be careful about giving mineral oil to anyone who might choke on it (children or the elderly).

Do not siphon gas or kerosene.

References

Blanc PD. Acute pulmonary responses to toxic exposures. In: Mason RJ, Broaddus CV, Martin TR, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 68.

Christiani DC. Physical and chemical injuries of the lungs. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 94.

Updated: 8/25/2014

Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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