ACUTE OCCUPATIONAL INTOXICATIONS BY CHLORINE AND AMMONIA: CLINICAL PICTURE, DIAGNOSTICS AND TREATMENT. CURRENT CONCEPTIONS

Abstract

Current issues of industrial accidents resulting in chlorine and ammonia emissions have been considered in the article. In general, chlorine damage pathogenesis is related to the effect of acids generated in the process of its interaction with water, the effect of active oxygen forms, resulting in respiratory tract damage, surfactant damage and oxidative stress. Ammonia intoxication consequences are mainly caused by the local effect of ammonium hydroxide generated during interaction between ammonia and water on the airways’ and ocular mucosa. High ammonia concentrations result in NMDA receptor activation and ATP amount depletion. Pulmonary toxicant damage treatment covers reduction of the airways’ and ocular mucosa irritation phenomena, use of β-adrenergic receptor agonists; oxygen, corticosteroid and symptomatic medication by indications. Stage-by-stage treatment of the damage has been discussed.