Collected Info on Chloramine

Small molecular weight chemicals may cause contact urticaria. Chemicals,
acting as haptens, for example ethylene oxide,
isocyanates, chloramine-T, epoxy resins and nickel sulphate have caused
IgE-mediated allergies. This can be confirmed by
using skin prick testing. 


Mrvos R, Dean BS, Krenzelok EP Home exposures to chlorine/chloramine gas: review of 216 cases. South Med J 1993 Jun;86(6):654-7 Chlorine and chloramine gas are frequently produced in the home when cleaning products are mixed. These gases are strong irritants with the potential for tissue damage. Numerous literature citations report industrial exposures to chlorine/amine gas, but there are few reports regarding home exposures. The purpose of this study was to determine symptoms, treatment, and outcome in individuals exposed to these gases in the home. All exposures to chlorine/amine gas produced as a result of mixing cleaning products in the home and reported to a Regional Poison Information Center (RPIC) over a 12-month period were reviewed. All calls were documented and follow-up was done at appropriate intervals. All patients with respiratory embarrassment either at the initial contact or on follow-up were referred to a medical facility. Of the 216 patients (ages 12 to 81 years), 200 had resolution of symptoms within 6 hours, whereas only 16 had symptoms for more than 6 hours after exposure; 145 patients were treated at home and 71 received further medical care. Ten symptoms were identified, with the majority of patients experiencing more than one. Emergency room treatment included oxygen (62 patients), bronchodilators (9 patients), and steroid therapy (3 patients). Of the 70 patients who had chest x-ray films, only one had a positive finding; 41 had arterial blood gas measurements done, and all were within normal limits. Only one patient in the study group required admission for continued respiratory distress, but he had a preexisting chronic respiratory problem as well as an upper respiratory tract infection at the time of exposure. Although the gas produced by mixing cleaning products in the home can cause severe respiratory irritation, most of the patients exposed to chlorine and chloramine gas can safely be treated at home with comfort measures. Appropriate follow-up must be done to determine resolution of symptoms. (3)

Oxidants are generated by various chemical processes (e.g. certain drugs, metals), enzymatic reactions, or they can directly be inhaled (e.g. smoking, ozone, hyperoxia) (for review see (6, 8)). Myeloperoxidase, present in polymorphonuclear cells (PMN) and released during respiratory burst, converts H2O2 into HOCl, another highly toxic oxidant which can further react to form more long-lived chloramines (9). (9: Weiss SJ, Lambert MB, Test ST Long-lived oxidants generated by human neutrophils: characterization and bioactivity. Science 1983; 222: 625-628.) -

The capacity of ambroxol to scavenge HOCl and OH can explain the above mentioned inhibitory effect of this drug on chloramine-T- and cigarette smoke-induced decrease of serum elastase inhibitory capacity (127,128). Both these factors inactivate alpha-1-antitrypsin via generation of HOCl and OH. (127 Rozniecki J, Nowak D Effect of ambroxol on the chloramine-T-induced decrease of serum elastase inhibitory capacity in vitro. Lung & Respiration 1987; 4: 14-15. 128 Rozniecki J, Nowak D Protective effect of ambroxol on serum elastase inhibitory capacity against chloramine-T and cigarette smoke extract. Bull Europ Physiopath Resp 1987; 12: 366s) -