title: Management of chlorine gas-related injuries from the Graniteville, South Carolina, train derailment.
abstract: A widely produced chemical, chlorine is used in various industries including automotive, electronics, disinfectants, metal production, and many others. Chlorine is usually produced and transported as a pressurized liquid; however, as a gas it is a significant pulmonary irritant. Thousands of people are exposed to chlorine gas every year, and while large-scale exposures are uncommon, they are not rare. Symptoms are usually related to the concentration and length of exposure, and although treatment is largely supportive, certain specific therapies have yet to be validated with randomized controlled trials. The majority of those exposed completely recover with supportive care; however, studies have shown the potential for persistent inflammation and chronic hyperreactivity. This case report describes an incident that occurred in Graniteville, South Carolina, when a train derailment exposed hundreds of people to chlorine gas. This report reviews the events of January 6, 2005, and the current treatment options for chlorine gas exposure.(Disaster Med Public Health Preparedness. 2014;0:1-6).
authors.affiliation: 1Palmetto Health Richland,Department of Emergency Medicine,and Palmetto Poison Center,University of South Carolina,South Carolina College of Pharmacy,Columbia,South Carolina.
authors.forename: Emily
authors.initials: E
authors.lastname: Mackie
authors.affiliation: 2Tulane University School of Public Health and Tropical Medicine,Department of Global Environmental Health Sciences,New Orleans,Louisiana.
authors.forename: Erik
authors.initials: E
authors.lastname: Svendsen
authors.affiliation: 3North Fulton Hospital,Department of Emergency Medicine,Roswell,Georgia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Grant
authors.affiliation: 1Palmetto Health Richland,Department of Emergency Medicine,and Palmetto Poison Center,University of South Carolina,South Carolina College of Pharmacy,Columbia,South Carolina.
authors.forename: Jill E
authors.initials: JE
authors.lastname: Michels
authors.affiliation: 1Palmetto Health Richland,Department of Emergency Medicine,and Palmetto Poison Center,University of South Carolina,South Carolina College of Pharmacy,Columbia,South Carolina.
authors.forename: William H
authors.initials: WH
authors.lastname: Richardson
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D055884:Chemical Hazard Release; D002713:Chlorine / Q000506:poisoning*; D004190:Disasters; D006801:Humans; D010102:Oxygen Inhalation Therapy; D011041:Poisoning / Q000175:diagnosis / Q000188:drug therapy; D011890:Railroads; D013022:South Carolina
chemical_list: D000318:Adrenergic beta-Agonists; D002713:Chlorine