Medical Phosgene Problems and Their Possible Solution

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Abstract
Occupational exposure [human] to phosgene during its manufacture and use is discussed. Solvents, paint removers and noninflammable dry cleaning fluids containing chlorinated hydrocarbons may also decompose accidentally to phosgene in the presence of fire or heat. As a consequence, phosgene inhalations are not extremely rare occurrences. On inhalation in moderate dosage, phosgene, only slightly soluble in water, does not noticeably react with the aqueous mucus film of the upper respiratory tract. After moderate phosgene doses, the clinical latent period for damage may last for about 6-15 h. To delay intensive therapy until the end of the clinical latent period (i.e., until the onset of clinical symptoms of pulmonary edema) would mean losing precious time.sbd.the very period during which therapy is supposed to be most effective. The beginning pulmonary edema should be detected as early as possible, long before the onset of clinical symptoms. During the clinical latent period of phosgene intoxications, the prognosis is absolutely uncertain.sbd.it is not known whether the inhaled dose was too small to cause any illness, or whether a life-threatening pulmonary edema will develop. Devices are needed for rough estimation of phosgene exposure dose. Effective therapy and adequate medical surveillance are discussed.