title: A fatal case following exposure to zinc chloride and hexachloroethane from a smoke bomb in a fire simulation at a school.
abstract: BACKGROUND
  The common mixture for smoke bombs contains zinc oxide and a chlorine donor, which allows for the formation of fine particles of zinc chloride. We report a fatal case of exposure to a smoke bomb used for a fire training exercise at a school.
  
  
  METHODS
  A 21-year-old student inhaled zinc oxide/hexachloroethane from a smoke bomb during a fire simulation at a school. Fever and tachypnea began six hours after exposure. Radiological evaluation showed a mixed interstitial-alveolar bilateral infiltrates. Despite supportive care, the patient died of multi-organ failure nine days after inhalation.
  
  
  CONCLUSIONS
  ZnCl inhalation is characterized by a lag period between exposure and evidence of respiratory toxicity, ranging from ten to 32 days, depending on the inhaled dose of ZnCl. Subjects inhaling even a small amount of aerosols from a smoke bomb should be carefully managed in a hospital setting where their respiratory function can be closely monitored.
  
  
  CONCLUSIONS
  This case highlights the risk of serious injury and even death from smoke bombs containing zinc chloride aerosol in schools and suggests that these smoke bombs should not be used for fire simulation or activities where human exposure is suspected, particularly in schools.
authors.affiliation: University of Granada Medical School, Legal Medicine and Toxicology, Granada, Spain. fgil@ugr.es
authors.forename: Fernando
authors.initials: F
authors.lastname: Gil
authors.forename: Antonio
authors.initials: A
authors.lastname: Pla
authors.forename: Antonio F
authors.initials: AF
authors.lastname: Hernández
authors.forename: Juan M
authors.initials: JM
authors.lastname: Mercado
authors.forename: Fernando
authors.initials: F
authors.lastname: Méndez
mesh_terms: D000328:Adult; D000336:Aerosols; D002712:Chlorides / Q000506:poisoning*; D004980:Ethane / Q000031:analogs & derivatives* / Q000506:poisoning; D017809:Fatal Outcome; D005334:Fever / Q000209:etiology; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000506:poisoning*; D009102:Multiple Organ Failure / Q000139:chemically induced; D012120:Respiration Disorders / Q000139:chemically induced; D012129:Respiratory Function Tests; D012574:Schools; D015208:Smoke Inhalation Injury / Q000209:etiology*; D017967:Zinc Compounds / Q000506:poisoning*
chemical_list: D000336:Aerosols; D002712:Chlorides; D006843:Hydrocarbons, Chlorinated; D017967:Zinc Compounds; C016837:zinc chloride; C010182:hexachloroethane; D004980:Ethane