Longitudinal assessment of airway caliber and responsiveness in workers exposed to chlorine

Am J Respir Crit Care Med. 1999 Oct;160(4):1232-7. doi: 10.1164/ajrccm.160.4.9811074.


This longitudinal study (1992-1994) was performed to determine the relation between accidental chlorine exposure and changes in lung function and airway responsiveness in 239 workers in a metal production plant. These workers had taken part in a cross-sectional survey in 1992. In both the initial and the follow-up surveys, history of exposure to chlorine ("puffs"), accidental chlorine inhalation reported to the first-aid unit (gassing incidents), and of chronic symptoms were documented; spirometry and methacholine challenge tests were performed. At follow-up, 211 workers (88.3%) were seen. In workers with 20 pack-years or more of cigarette smoking, the fall in FEV(1) was associated with having had a gassing incident during the follow-up period; the fall in FEV(1)/FVC (%) was predicted by the number of puffs causing mild symptoms between the two assessments. An increase in airway responsiveness (PC(20) decrease > 1.5-fold) was present in 19 workers; it was associated with accidents reported to the first-aid unit during the previous 2 yr (OR: 5.9, 95% CI: 1.1 to 32.3). These findings suggest: (1) an effect on airway function related to the estimated number of puffs with mild symptoms and gassing incidents, mostly among smokers; (2) a detectable increase in airway responsiveness associated with gassing incidents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Occupational*
  • Bronchial Hyperreactivity / chemically induced*
  • Bronchial Provocation Tests
  • Bronchoconstrictor Agents / pharmacology
  • Chlorine / adverse effects*
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Humans
  • Inhalation Exposure*
  • Longitudinal Studies
  • Male
  • Metallurgy
  • Methacholine Chloride
  • Middle Aged
  • Occupational Exposure*
  • Respiration Disorders / chemically induced*
  • Respiration Disorders / diagnosis
  • Smoking
  • Spirometry
  • Vital Capacity


  • Bronchoconstrictor Agents
  • Methacholine Chloride
  • Chlorine