Chemical Pneumonia

Chemical Pneumonia Overview

Chemical pneumonia is an unusual type of lung irritation. Pneumonia usually is caused by a bacteria or virus. In chemical pneumonia, inflammation of lung tissue is from poisons or toxins. Only a small percentage of pneumonias are caused by chemicals.

  • Many substances can cause chemical pneumonia, including liquids, gases, and small particles, such as dust or fumes, also called particulate matter. Some chemicals only harm the lungs; however, some toxic materials affect other organs in addition to the lungs and can result in serious organ damage or death.
  • Chemical pneumonia can be caused by aspiration. Aspiration means that you breathe oral secretions or stomach contents into your lungs. The inflammation comes from the toxic effects of stomach acid and enzymes on lung tissue. Bacteria from the stomach or mouth can also cause a bacterial pneumonia.
  • Chemical pneumonia is only one type of lung inflammation. You can read about viral pneumonia and bacterial pneumonia in their own sections.

Symptoms of Chemical Pneumonia

Signs and symptoms of chemical pneumonia vary greatly, and many factors can determine its seriousness. For instance, someone exposed to chlorine in a large outdoor pool may have only a cough and burning eyes. Someone else exposed to high levels of chlorine in a small room may die of respiratory failure.

  • Factors that determine the severity of symptoms include the following:
    • Type and strength of chemical
    • Exposure environment -- Indoors, outdoors, hot, cold
    • Length of exposure -- Seconds, minutes, hours
    • Form of chemical -- Gas, vapor, particulate, liquid
    • Protective measures used
    • Prior medical condition
    • Your age
  • Chemical pneumonia may have the following signs and symptoms:
    • Symptoms
    • Signs a doctor might observe
      • Rapid or shallow breaths
      • Rapid pulse
      • Oral, nasal, or skin burns
      • Pale skin and lips
      • Sweating
      • Altered thinking and reasoning skills
      • Unconsciousness
      • Swelling of eyes or tongue
      • Hoarse or muffled voice
      • Chemical odors on other areas of the body
      • Frothy spit from a cough
      • Fever

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When to Seek Medical Care

Should any symptoms of chemical pneumonia occur, call your doctor or the local poison control center. Any person with serious signs or symptoms should be transported immediately by ambulance to the nearest hospital's emergency department.

Chemical identification is helpful both for the poison control center and the doctor. This should not take precedence over medical care, however, especially for those with severe signs or symptoms.

Immediate evaluation in a hospital's emergency department is necessary for treating the following conditions:

  • Unconsciousness
  • Cyanosis -- A blue discoloration of the mouth or skin
  • Difficulty breathing
  • Sudden change of voice
  • Mouth or throat swelling
  • Chest pain
  • Shortness of breath
  • Cough productive of frothy or bloody spit
  • Altered thinking and reasoning skills
  • Exposure to potentially deadly chemical
  • Vomiting and aspiration

The poison control center may suggest other conditions particular to the chemical that would need emergency care.

Exams and Tests for Chemical Pneumonia

Diagnosis and treatment for chemical pneumonia will vary depending on signs and symptoms. Frequently, the symptoms will be mild, the chemical will be well known, and the medical evaluation brief and focused.

  • Sometimes serious signs and symptoms will need life-saving procedures, such as artificial ventilation, advanced cardiac life support, or complex medical therapy. In most cases, the doctor will consult local poison control experts for advice.
  • The doctor must first make sure that hospital staff are not at risk for exposure themselves.
  • The next priority is to identify the chemical and consider the effects this chemical has on the lungs and the rest of the body.
  • A thorough history will be obtained to include the length of exposure, area of exposure, form and concentration of the chemical, other medical problems, and symptoms. In addition to close inspection of the vital signs (heart rate, blood pressure, respiratory rate, temperature, and how much oxygen you have in your blood), the doctor will evaluate, at a minimum, the eyes, nose, throat, skin, heart, lungs, and abdomen.

Once these steps have been taken, further evaluation may vary depending on the status of the person injured, the type of chemical exposure, and other factors.

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Treatment for Chemical Pneumonia

Self-Care at Home

Your decision to seek medical care depends on the severity of symptoms and other factors of exposure. If you accidentally inhale a chemical, you probably want some medical advice. You can call your local poison control center for help. If your symptoms are serious, you will want immediate treatment at a hospital.

Home care may be the most important aspect of medical management.

  • Quickly get away from the offending chemical or area of exposure. If possible, avoid exposing others to the same chemical. Once you're away from the area, consider further decontamination, such as removing your clothes and showering.
  • Alert the appropriate authorities to avoid further problems.
  • Identify and contain the chemical.
  • Medical evaluation may involve local police, fire department, emergency medical services (EMS), and hazardous materials personnel.

Medical Treatment for Chemical Pneumonia

Evaluation and treatment vary. Almost everyone will have measurements of blood pressure, oxygen level, heart rate, and respiratory rate.

In many people with chemical pneumonia, treatment is mostly observation. Sometimes symptoms develop over time and the amount of damage done won't be totally known for several hours.

Many treatments are possible, including the following:

  • IV fluids
  • Oxygen by mask or tube
  • Breathing treatment with medicine to open breathing tubes
  • Steroid medications by IV or mouth
  • Nonsteroidal anti-inflammatory drugs by mouth
  • Pain medications by IV or mouth
  • Artificial ventilation (help breathing)
  • Preventive antibiotics (sometimes)

Next Steps -- Outlook

Prognosis depends on the chemical exposure and person's medical condition. For example, an elderly person with lung disease exposed to moderate amounts of vaporized ammonium chloride might suffer serious problems as compared to a young athlete with no lung problems. In general, the more severe the symptoms, the more likely you will suffer short- and long-term complications.

  • Short-term complications include other organ injury in addition to possible death.
  • Long-term complications include lung scarring and recurrent pneumonia.
WebMD Medical Reference Reviewed by Nayana Ambardekar, MD on April 14, 2018

Sources

SOURCE:

Chemical Pneumonia from eMedicineHealth

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