Acute Health Effects After Exposure to Chlorine Gas Released After a Train Derailment

Patients who become critically ill following chlorine gas exposure do not have to undergo extended hospitalization. This article presents new information about the course of hospitalizations following a fatal release of chlorine gas.

A freight train collision in South Carolina in January 2005, released between 42 and 60 tons of chlorine gas. Nine people died.

For this study, researchers examined medical records for all persons hospitalized for chlorine gas exposure within five days of the accident. Statistical analyses focus on clinical presentations and examinations, specifically blood gas analyses, radiography and pulmonary investigations.

Key Findings:

  • The overall median length of ICU admission was three days. The total number of hospital inpatient days was 346.
  • Seven people (10%) were intubated during hospitalization, spending a median of six days on the ventilator.
  • Twelve (22%) of the 55 patients who underwent arterial blood gas analysis (ABG) met the criteria for acute lung injury. Twenty-nine (53%) suffered acute respiratory distress syndrome (ARDS).

A terrorist attack involving the release of chlorine gas could result in the hospitalization of up to 100,000 people in an urban area. This study describes clinical outcomes of chlorine inhalation injury following a large-scale, accidental release of chlorine gas.