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Chemical pneumonitis
Aspiration pneumonia - chemical
Chemical pneumonitis is inflammation of the lungs or breathing difficulty due to inhaling chemical fumes or breathing in and choking on certain chemicals.
Breathing difficulty
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
Causes
Many chemicals used in the home and workplace can cause pneumonitis.
Some common dangerous inhaled substances include:
- Chlorine gas (breathed in from cleaning materials such as chlorine bleach, during industrial accidents, or near swimming pools)
- Grain and fertilizer dust
- Noxious fumes from pesticides
- Smoke (from house fires and wildfires)
There are two types of pneumonitis:
- Acute pneumonitis occurs suddenly after breathing in the substance.
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Long-term (chronic) pneumonitis occurs after exposure to low levels of the substance over a long time. This causes inflammation and may lead to stiffness of the lungs. As a result, the lungs start to lose their ability to get oxygen to the body. Untreated, this condition can cause
respiratory
failure and death.
Respiratory
The words "respiratory" and "respiration" refer to the lungs and breathing.
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Chronic aspiration of acid from the stomach and exposure to chemical warfare can also lead to chemical pneumonitis.
Symptoms
Acute symptoms may include:
- Air hunger (feeling that you cannot get enough air)
- Breathing that sounds wet or gurgling (abnormal lung sounds)
- Cough
- Difficulty breathing
- Unusual sensation (possibly burning feeling) in the chest
Chronic symptoms may include:
- Cough (may or may not occur)
- Progressive disability (related to shortness of breath)
-
Rapid breathing
(tachypnea)
Rapid breathing
Hyperventilation is rapid and deep breathing. It is also called overbreathing, and it may leave you feeling breathless.
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Shortness of breath
with only mild exercise
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
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Exams and Tests
The following tests help determine how severely the lungs are affected:
-
Blood gases
(measurement of how much oxygen and carbon dioxide are in your blood)
Blood gases
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Lung function studies
(tests to measure breathing and how well the lungs are functioning)
Lung function studies
Pulmonary function tests are a group of tests that measure breathing and how well the lungs are functioning.
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X-ray of the chest
X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
ImageRead Article Now Book Mark Article - Swallowing studies to check if stomach acid is the cause of pneumonitis
Treatment
Treatment is focused on reversing the cause of inflammation and reducing symptoms. Corticosteroids may be given to reduce inflammation, often before long-term scarring occurs.
Antibiotics are usually not helpful or needed, unless there is a secondary infection. Oxygen therapy may be helpful.
In cases of swallowing and stomach problems, eating small meals in the upright position can help. In severe cases, a feeding tube in the stomach is needed.
Outlook (Prognosis)
The outcome depends on the chemical, the severity of exposure, and whether the problem is acute or chronic.
Possible Complications
Respiratory failure and death can occur.
When to Contact a Medical Professional
Call your health care provider if you have trouble breathing after inhaling (or possibly inhaling) any substance.
Prevention
Only use household chemicals as directed, and always in well-ventilated areas. Never mix ammonia and bleach.
Follow workplace rules for breathing masks and wear the right mask. People who work near fire should take care to limit their exposure to smoke or gases.
Be careful about giving mineral oil to anyone who might choke on it (children or the older people).
Sit up while eating and don't lie down right after eating if you have swallowing problems.
DO NOT siphon gas, kerosene, or other toxic liquid chemicals.
References
Blanc PD. Acute responses to toxic exposures. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 75.
Christiani DC. Physical and chemical injuries of the lungs. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 94.
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Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
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Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
-
Lungs - illustration
The major features of the lungs include the bronchi, the bronchioles and the alveoli. The alveoli are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
Lungs
illustration
-
Respiratory system - illustration
Air is breathed in through the nasal passageways, travels through the trachea and bronchi to the lungs.
Respiratory system
illustration
Review Date: 8/21/2016
Reviewed By: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
