Medical Management Guidelines for Calcium Hypochlorite
(CaCl
2O
2)|Sodium Hypochlorite(NaOCl)
CAS# Calcium Hypochlorite 7778-54-3, Sodium Hypochlorite 7681-52-9
UN# Calcium Hypochlorite 1748, Sodium Hypochlorite 1791
PDF Versionpdf icon[194 KB]
Synonyms of calcium hypochlorite include Losantin, hypochlorous acid, calcium salt, BK powder, Hy-Chlor, chlorinated lime, lime chloride, chloride of lime, calcium oxychloride, HTH, mildew remover X-14, perchloron, and pittchlor.
Synonyms of sodium hypochlorite include Clorox, bleach, liquid bleach, sodium oxychloride, Javex, antiformin, showchlon, chlorox, B-K, Carrel-dakin solution, Chloros, Dakin's solution, hychlorite, Javelle water, Mera Industries 2MOm³B, Milton, modified dakin's solution, Piochlor, and 13% active chlorine.
- Persons contaminated with calcium hypochlorite dust, or whose clothing or skin is soaked with industrial-strength hypochlorite solutions may be corrosive to rescuers and may release harmful vapor. Individuals exposed only to gases released by hypochlorite pose little risk of secondary contamination to others.
- Calcium hypochlorite is generally available as a white powder, pellets, or flat plates; sodium hypochlorite is usually a greenish yellow, aqueous solution. Although not flammable, they may react explosively. Calcium hypochlorite decomposes in water to release chlorine and oxygen; sodium hypochlorite solutions can react with acids or ammonia to release chlorine or chloramine. Odor may not provide an adequate warning of hazardous concentrations.
- Both hypochlorites are toxic by the oral and dermal routes
and can react to release chlorine or chloramine which can be inhaled. The toxic effects of sodium and calcium hypochlorite are primarily due to the corrosive properties of the hypochlorite moiety. Systemic toxicity is rare, but metabolic acidosis may occur after ingestion.
General Information
Description
Calcium hypochlorite is generally available as a white powder, pellets, or flat plates. It decomposes readily in water or when heated, releasing oxygen and chlorine. It has a strong chlorine odor, but odor may not provide an adequate warning of hazardous concentrations. Calcium hypochlorite is not flammable, but it acts as an oxidizer with combustible material and may react explosively with ammonia, amines, or organic sulfides. Calcium hypochlorite should be stored in a dry, well ventilated area at a temperature below 120ºF (50ºC) separated from acids, ammonia, amines, and other chlorinating or oxidizing agents.
Sodium hypochlorite is generally sold in aqueous solutions containing 5 to 15% sodium hypochlorite, with 0.25 to 0.35% free alkali (usually NaOH) and 0.5 to 1.5% NaCl. Solutions of up to 40% sodium hypochlorite are available, but solid sodium hypochlorite is not commercially used. Sodium hypochlorite solutions are a clear, greenish yellow liquid with an odor of chlorine. Odor may not provide an adequate warning of hazardous concentrations. Sodium hypochlorite solutions can liberate dangerous amounts of chlorine or chloramine if mixed with acids or ammonia. Anhydrous sodium hypochlorite is very explosive. Hypochlorite solutions should be stored at a temperature not exceeding 20ºC away from acids in well-fitted air-tight bottles away from sunlight.
Routes of Exposure
Inhalation
Hypochlorite solutions can liberate toxic gases such as chlorine. Chlorine's odor or irritant properties generally provide adequate warning of hazardous concentrations. However, prolonged, low-level exposures, such as those that occur in the workplace, can lead to olfactory fatigue and tolerance of chlorine's irritant effects. Chlorine is heavier than air and may cause asphyxiation in poorly ventilated, enclosed, or low-lying areas.
Children exposed to the same levels of gases as adults may receive a larger dose because they have greater lung surface area:body weight ratios and higher minute volumes:weight ratios. Children may be more vulnerable to corrosive agents than adults because of the smaller diameter of their airways. In addition, they may be exposed to higher levels than adults in the same location because of their short stature and the higher levels of chlorine found nearer to the ground.
Skin/Eye Contact
Direct contact with hypochlorite solutions, powder, or concentrated vapor causes severe chemical burns, leading to cell death and ulceration.
Because of their relatively larger surface area:weight ratio, children are more vulnerable to toxicants affecting the skin.
Ingestion
Ingestion of hypochlorite solutions causes vomiting and corrosive injury to the gastrointestinal tract. Household bleaches (3 to 6% sodium hypochlorite) usually cause esophageal irritation, but rarely cause strictures or serious injury such as perforation. Commercial bleaches may contain higher concentrations of sodium hypochlorite and are more likely to cause serious injury. Metabolic acidosis is rare, but has been reported following the ingestion of household bleach. Pulmonary complications resulting from aspiration may also be seen after ingestion.
Sources/Uses
Sodium and calcium hypochlorite are manufactured by the chlorination of sodium hydroxide or lime. Sodium and calcium hypochlorite are used primarily as oxidizing and bleaching agents or disinfectants. They are components of commercial bleaches, cleaning solutions, and disinfectants for drinking water and waste water purification systems and swimming pools (Teitelbaum 2001).
Standards and Guidelines
AIHA WEEL:
STEL (15-min) = 2 mg/m³
Physical Properties - Calcium Hypochlorite
Description: White powder, pellets or flat plates
Warning properties: Chlorine odor; inadequate warning of hazardous concentrations
Molecular weight: 142.98 daltons
Boiling point (760 mm Hg): Decomposes at 100ºC (HSDB 2001)
Freezing point: Not applicable
Specific gravity: 2.35 (water
= 1)
Water solubility: 21.4% at 76ºF
(25ºC)
Flammability: not flammable
Physical Properties - Sodium Hypochlorite
Description: Clear greenish yellow liquid
Warning properties: Chlorine odor; inadequate warning of hazardous concentrations
Molecular weight: 74.44 daltons
Boiling point (760 mm Hg): Decomposes above 40ºC (HSDB 2001)
Freezing point: 6ºC (21ºF)
Specific gravity: 1.21 (14% NAOCl solution) (water=1)
Water solubility: 29.3 g/100 g
at 32ºF (0ºC)
Flammability: not flammable
Incompatibilities
Calcium or sodium hypochlorite react explosively or form explosive compounds with many common substances such as ammonia, amines, charcoal, or organic sulfides
Health Effects
- Hypochlorite powder, solutions, and vapor are irritating and corrosive to the eyes, skin, and respiratory tract. Ingestion and skin contact produces injury to any exposed tissues. Exposure to gases released from hypochlorite may cause burning of the eyes, nose, and throat; cough as well as constriction and edema of the airway and lungs can occur.
- Hypochlorite produces tissue injury by liquefaction necrosis. Systemic toxicity is rare, but metabolic acidosis may occur after ingestion.
Acute Exposure
The toxic effects of sodium and calcium hypochlorite are primarily due to the corrosive properties of the hypochlorite moiety. Hypochlorite causes tissue damage by liquefaction necrosis. Fats and proteins are saponified, resulting in deep tissue destruction. Further injury is caused by thrombosis of blood vessels. Injury increases with hypochlorite concentration and pH. Symptoms may be apparent immediately or delayed for a few hours. Calcium hypochlorite decomposes in water releasing chlorine gas. Sodium hypochlorite solutions liberate the toxic gases chlorine or chloramine if mixed with acid or ammonia (this can occur when bleach is mixed with another cleaning product). Thus, exposure to hypochlorite may involve exposure to these gases.
Children do not always respond to chemicals in the same way that adults do. Different protocols for managing their care may be needed.
Gastrointestinal
Pharyngeal pain is the most common symptom after ingestion of hypochlorite, but in some cases (particularly in children), significant esophagogastric injury may not have oral involvement. Additional symptoms include dysphagia, stridor, drooling, odynophagia, and vomiting. Pain in the chest or abdomen generally indicates more severe tissue damage. Respiratory distress and shock may be present if severe tissue damage has already occurred. In children, refusal to take food or drink liquid may represent odynophagia.
Ingestion of hypochlorite solutions or
powder can also cause severe corrosive injury to the mouth, throat, esophagus, and stomach, with bleeding, perforation, scarring, or stricture formation as potential sequelae.
Dermal
Hypochlorite irritates the skin and can cause burning pain, inflammation, and blisters. Damage may be more severe than is apparent on initial observation and can continue to develop over time.
Because of their relatively larger surface area:body weight ratio, children are more vulnerable to toxins affecting the skin.
Ocular
Contact with low concentrations of household bleach causes mild and transitory irritation if the eyes are rinsed, but effects are more severe and recovery is delayed if the eyes are not rinsed. Exposure to solid hypochlorite or concentrated solutions can produce severe eye injuries with necrosis and chemosis of the cornea, clouding of the cornea, iritis, cataract formation, or severe retinitis.
Respiratory
Ingestion of hypochlorite solutions may lead to pulmonary complications when the liquid is aspirated. Inhalation of gases released from hypochlorite solutions may cause eye and nasal irritation, sore throat, and coughing at low concentrations. Inhalation of higher concentrations can lead to respiratory distress with airway constriction and accumulation of fluid in the lungs (pulmonary edema). Patients may exhibit immediate onset of rapid breathing, cyanosis, wheezing, rales, or hemoptysis. Pulmonary injury may occur after a latent period of 5 minutes to 15 hours and can lead to reactive airways dysfunction syndrome (RADS), a chemical irritant-induced type of asthma.
Children may be more vulnerable to corrosive agents than adults because of the smaller diameter of their airways. Children may also be more vulnerable to gas exposure because of increased minute ventilation per kg and failure to evacuate an area promptly when exposed.
Metabolic
Metabolic acidosis has been reported
in some cases after ingestion of household bleach.
Potential Sequelae
Exposure to toxic gases generated from
hypochlorite solutions can lead to reactive airways dysfunction
syndrome (RADS), a chemical irritant-induced type of asthma. Chronic complications following ingestion of hypochlorite include esophageal obstruction, pyloric stenosis, squamous cell carcinoma of the esophagus, and vocal cord paralysis with consequent airway obstruction.
Chronic Exposure
Chronic dermal exposure to hypochlorite can cause dermal irritation.
Carcinogenicity
The International Agency for Research on Cancer has determined that hypochlorite salts are not classifiable as to their carcinogenicity to humans.
Reproductive and Developmental Effects
No information was located regarding reproductive or developmental effects of calcium or sodium hypochlorite in experimental animals or humans. Calcium and sodium hypochlorite are not included in Reproductive and Developmental Toxicants, a 1991 report published by the U.S. General Accounting Office (GAO) that lists 30 chemicals of concern because of widely acknowledged reproductive and developmental consequences.
Prehospital Management
- Rescue personnel are at low risk of secondary contamination from victims who have been exposed only to gases released from hypochlorite solutions. However, clothing or skin soaked with industrial-strength bleach or similar solutions may be corrosive to rescuers and may release harmful gases.
- Ingestion of hypochlorite solutions may cause pain in the mouth or throat, dysphagia, stridor, drooling, odynophagia, and vomiting. Hypochlorite irritates the skin and can cause burning pain, inflammation, and blisters. Acute exposure to gases released from hypochlorite solutions can cause coughing, eye and nose irritation, lacrimation, and a burning sensation in the chest. Airway constriction and noncardiogenic pulmonary edema may also occur.
- There is no specific antidote for hypochlorite poisoning. Treatment is supportive.
Hot Zone
Rescuers should be trained and appropriately attired before entering the Hot Zone. If the proper equipment is not available, or if rescuers have not been trained in its use, assistance should be obtained from a local or regional HAZMAT team or other properly equipped response organization.
Rescuer Protection
Hypochlorite is irritating to the skin
and eyes and in some cases may release toxic gases.
Respiratory Protection: Positive-pressure, self-contained breathing apparatus (SCBA) is recommended in response to situations that involve exposure to potentially unsafe levels of chlorine gas.
Skin Protection: Chemical-protective clothing should be worn due to the risk of skin irritation and burns from direct contact with solid hypochlorite or concentrated solutions.
ABC Reminders
Quickly establish a patent airway, ensure adequate respiration and pulse. If trauma is suspected, maintain cervical immobilization manually and apply a cervical collar and a backboard when feasible.
Victim Removal
If victims can walk, lead them out of the Hot Zone to the Decontamination Zone. Victims who are unable to walk may be removed on backboards or gurneys; if these are not available, carefully carry or drag victims to safety.
Consider appropriate management in victims with chemically-induced acute disorders, especially children who may suffer separation anxiety if separated from a parent or other adult.
Decontamination Zone
Victims exposed only to chlorine gas released by hypochlorite who have no skin or eye irritation do not need decontamination. They may be transferred immediately to the Support Zone. All others require decontamination as described below.
Rescuer Protection
If exposure levels are determined to be safe, decontamination may be conducted by personnel wearing a lower level of protection than that worn in the Hot Zone (described above).
ABC Reminders
Quickly establish a patent airway, ensure adequate respiration and pulse. Stabilize the cervical spine with a collar and a backboard if trauma is suspected. Administer supplemental oxygen as required. Assist ventilation with a bag-valve-mask device if necessary.
Basic Decontamination
Rapid decontamination is critical. Victims who are able may assist with their own decontamination. Remove and double-bag contaminated clothing and personal belongings.
Flush exposed skin and hair with copious amounts of plain tepid water. Use caution to avoid hypothermia when decontaminating victims, particularly children or the elderly. Use blankets or warmers after decontamination as needed.
Irrigate exposed or irritated eyes with saline, Ringer's lactate, or D5W for at least 20 minutes. Eye irrigation may be carried out simultaneously with other basic care and transport. Remove contact lenses if it can be done without additional trauma to the eye. If a corrosive material is suspected or if pain or injury is evident, continue irrigation while transferring the victim to the support zone.
In cases of ingestion, do not induce emesis or offer activated charcoal.
Victims who are conscious and able to swallow should be given 4 to 8 ounces of water or milk; if the victim is symptomatic, delay decontamination until other emergency measures have been instituted. Dilutants are contraindicated in the presence of shock, upper airway obstruction, or in the presence of perforation.
Consider appropriate management of chemically contaminated children at the exposure site. Provide reassurance to the child during decontamination, especially if separation from a parent occurs.
Transfer to Support Zone
As soon as basic decontamination is complete, move the victim to the Support Zone.
Support Zone
Be certain that victims have been decontaminated properly (see Decontamination Zone above). Victims who have undergone decontamination or have been exposed only to vapor pose no serious risks of secondary contamination to rescuers. In such cases, Support Zone personnel require no specialized protective gear.
ABC Reminders
Quickly establish a patent airway, ensure adequate respiration and pulse. If trauma is suspected, maintain cervical immobilization manually and apply a cervical collar and a backboard when feasible. Administer supplemental oxygen as required and establish intravenous access if necessary. Place on a cardiac monitor, if available.
Additional Decontamination
Continue irrigating exposed skin and
eyes, as appropriate.
In cases of ingestion, do not induce
emesis or offer activated charcoal.
Victims who are conscious and able to
swallow should be given 4 to 8 ounces of water or milk; if
the victim is symptomatic, delay decontamination until other
emergency measures have been instituted. Dilutants are contraindicated
in the presence of shock, upper airway obstruction, or in
the presence of perforation.
Advanced Treatment
In cases of respiratory compromise secure
airway and respiration via endotracheal intubation. Avoid
blind nasotracheal intubation or use of an esophageal obturator:
only use direct visualization to intubate. When the patient's
condition precludes endotracheal intubation, perform cricothyrotomy
if equipped and trained to do so.
Treat patients who have bronchospasm
with an aerosolized bronchodilator such as albuterol.
Consider racemic epinephrine aerosol
for children who develop stridor. Dose 0.25-0.75 mL of 2.25%
racemic epinephrine solution in water, repeat every 20 minutes
as needed cautioning for myocardial variability.
Patients who are comatose, hypotensive,
or having seizures or who have cardiac arrhythmias should
be treated according to advanced life support (ALS) protocols.
Transport to Medical Facility
Only decontaminated patients or those
not requiring decontamination should be transported to a medical
facility. "Body bags" are not recommended.
Report to the base station and the receiving
medical facility the condition of the patient, treatment given,
and estimated time of arrival at the medical facility.
If a chemical has been ingested, prepare
the ambulance in case the victim vomits toxic material. Have
ready several towels and open plastic bags to quickly clean
up and isolate vomitus.
Multi-Casualty Triage
Consult with the base station physician
or the regional poison control center for advice regarding
triage of multiple victims.
Patients who have ingested hypochlorite,
or who show evidence of significant exposure to hypochlorite
or chlorine (e.g., severe or persistent cough, dyspnea or
chemical burns) should be transported to a medical facility
for evaluation. Patients who have minor or transient irritation
of the eyes or throat may be discharged from the scene after
their names, addresses, and telephone numbers are recorded.
They should be advised to seek medical care promptly if symptoms
develop or recur (see Patient Information Sheet below).
Emergency Department Management
- Hospital personnel are at low risk of secondary contamination
from victims who have been exposed only to gases released
from hypochlorite solutions. However, clothing or skin soaked
with industrial-strength bleach or similar solutions may
be corrosive to rescuers and may release harmful gases.
- Ingestion of hypochlorite solutions may cause pain in
the mouth or throat, dysphagia, stridor, drooling, odynophagia,
and vomiting. Hypochlorite irritates the skin and can cause
burning pain, inflammation, and blisters. Acute exposure
to gases released from hypochlorite solutions can cause
coughing, eye and nose irritation, lacrimation, and a burning
sensation in the chest. Airway constriction and noncardiogenic
pulmonary edema may also occur.
- There is no specific antidote for hypochlorite poisoning.
Treatment requires supportive care.
Decontamination Area
Unless previously decontaminated, all
patients suspected of contact with hypochlorite and all victims
with skin or eye irritation require decontamination as described
below. Patients exposed only to chlorine gas who have no skin
or eye irritation may be transferred immediately to the Critical
Care Area. Because hypochlorite is an irritant, don butyl
rubber gloves and apron before treating patients.
Be aware that use of protective equipment
by the provider may cause anxiety, particularly in children,
resulting in decreased compliance with further management
efforts.
Because of their relatively larger surface
area:weight ratio, children are more vulnerable to toxicants
affecting the skin. Also, emergency department personnel should
examine children's mouths because of the frequency of hand-to-mouth
activity among children.
ABC Reminders
Evaluate and support airway, breathing,
and circulation. Children may be more vulnerable to corrosive
agents than adults because of the smaller diameter of their
airways. In cases of respiratory compromise secure airway
and respiration via endotracheal intubation. If not possible,
surgically secure an airway.
Treat patients who have bronchospasm
with an aerosolized bronchodilator such as albuterol.
Consider racemic epinephrine aerosol
for children who develop stridor. Dose 0.25-0.75 mL of 2.25%
racemic epinephrine solution in water, repeat every 20 minutes
as needed cautioning for myocardial variability.
Patients who are comatose, hypotensive,
or having seizures or cardiac arrhythmias should be treated
in the conventional manner.
Metabolic acidosis can be managed with
intravenous sodium bicarbonate and buffer solutions.
Basic Decontamination
Patients who are able may assist with
their own decontamination. Remove and double bag contaminated
clothing and personal belongings.
Flush exposed skin and hair with copious
amounts of plain water. Use caution to avoid hypothermia when
decontaminating victims, particularly children or the elderly.
Use blankets or warmers after decontamination as needed.
Irrigate exposed or irritated eyes with
saline, Ringer's lactate, or D5W for at least 20
minutes. Remove contact lenses if it can be done without additional
trauma to the eye. Continue irrigation while transporting
the patient to the Critical Care Area.
In cases of ingestion, do not induce
emesis or offer activated charcoal.
Victims who are conscious and able to
swallow should be given 4 to 8 ounces of water or milk. Dilutants
are contraindicated in the presence of shock, upper airway
obstruction, or in the presence of perforation.
Critical Care Area
Be certain that appropriate decontamination
has been carried out (see Decontamination Area above).
ABC Reminders
Evaluate and support airway, breathing,
and circulation as in ABC Reminders above. Children may be
more vulnerable to corrosive agents than adults because of
the smaller diameter of their airways. Establish intravenous
access in seriously ill patients if this has not been done
previously. Continuously monitor cardiac rhythm.
Patients who are comatose, hypotensive,
or having seizures or cardiac arrhythmias should be treated
in the conventional manner.
Metabolic acidosis can be managed with
intravenous sodium bicarbonate and buffer solutions.
Inhalation Exposure
Administer supplemental oxygen by mask
to patients who have respiratory symptoms. Treat patients
who have bronchospasm with an aerosolized bronchodilator such
as albuterol.
Consider racemic epinephrine aerosol
for children who develop stridor. Dose 0.25-0.75 mL of 2.25%
racemic epinephrine solution in water, repeat every 20 minutes
as needed cautioning for myocardial variability.
Skin Exposure
If concentrated hypochlorite solutions
contact the skin, chemical burns may occur; treat as thermal
burns. Patients developing dermal hypersensitivity reactions
may require treatment with systemic or topical corticosteroids
or antihistamines.
Because of their relatively larger surface
area:body weight ratio children are more vulnerable to toxicants
that affect the skin.
Eye Exposure
Irrigate exposed or irritated eyes with
saline, Ringer's lactate, or D5W for at least 20
minutes. Check the pH of the conjunctiva every 30 minutes
for 2 hours after irrigation is stopped. If the pH is not
neutral an irrigating contact lens should be used to apply
continuous irrigation for several hours until the pH of the
tissue normalizes. Test visual acuity and examine the eyes
for corneal damage and treat appropriately. Immediately consult
an ophthalmologist for patients who have corneal injuries.
Ingestion
In cases of ingestion, do not induce
emesis or offer activated charcoal.
Give 4 to 8 ounces of water or milk to
alert patients who can swallow if not done previously. Dilutants
are contraindicated in the presence of shock, upper airway
obstruction, or in the presence of perforation.
Direct visualization of the esophagus
is of primary importance for determining the extent of injury.
All patients who are suspected of having significant ingestion,
or those (such as children) for whom there is an unreliable
history, must have early endoscopy within 36 to 48 hours of
ingestion. Use of a flexible endoscope is associated with
a lower risk of perforation. The esophagus, stomach and duodenum
should be endoscopically evaluated because burns of the esophagus
do not correlate with the presence of burns in the stomach.
Contraindications for endoscopy include:
unstable patient, evidence of perforation, upper airway compromise,
or more than 48 hours after ingestion.
Gastric lavage is not generally recommended
for hypochlorite ingestion.
Antidotes and Other Treatments
There is no specific antidote for hypochlorite.
Treatment is supportive.
Laboratory Tests
The diagnosis of acute hypochlorite toxicity
is primarily clinical. However, laboratory testing is useful
for monitoring the patient and evaluating complications. Routine
laboratory studies for all exposed patients include CBC, glucose,
and electrolyte determinations. Patients who have respiratory
complaints may require pulse oximetry (or ABG measurements)
and chest radiography. Chlorine inhalation may be complicated
by hyperchloremic metabolic acidosis; in addition to electrolytes,
monitor blood pH.
Disposition and Follow-up
Consider hospitalizing patients who have
a suspected significant exposure or have eye burns or serious
skin burns. Patients with perforation should be prepared for
emergency surgery.
Delayed Effects
Patients who ingested large volumes of
hypochlorite, who have unreliable histories, or are symptomatic
complaining of pain in swallowing, persistent shortness of
breath, severe cough, or chest tightness should be admitted
to the hospital and observed until symptom-free. Injury may
progress for several hours.
Patient Release
Asymptomatic patients and those who experienced
only minor irritation of the nose, throat, eyes, or respiratory
tract may be released. In most cases, these patients will
be free of symptoms in an hour or less. They should be advised
to seek medical care promptly if symptoms develop or recur
(see the Hypochlorite--Patient Information Sheet below).
Follow-up
Obtain the name of the patient's primary
care physician so that the hospital can send a copy of the
ED visit to the patient's doctor.
Follow up is recommended for all hospitalized
patients because long-term gastrointestinal or respiratory
problems can result. Respiratory monitoring is recommended
until the patient is symptom-free. Chlorine-induced reactive
airways dysfunction syndrome (RADS) has been reported to persist
from 2 to 12 years.
Patients who have skin or corneal injury
should be re-examined within 24 hours.
Reporting
If a work-related incident has occurred,
you may be legally required to file a report; contact your
state or local health department.
Other persons may still be at risk in
the setting where this incident occurred. If the incident
occurred in the workplace, discussing it with company personnel
may prevent future incidents. If a public health risk exists,
notify your state or local health department or other responsible
public agency. When appropriate, inform patients that they
may request an evaluation of their workplace from OSHA or
NIOSH. See Appendix III for a list of agencies that may be
of assistance.
Patient Information Sheet
This handout provides information and
follow-up instructions for persons who have been exposed to
calcium or sodium hypochlorite.
Print this handout only.pdf icon[47 KB]
What is hypochlorite?
Calcium hypochlorite is generally available
as a white powder, pellets, or flat plates, while sodium hypochlorite
is usually a greenish yellow, aqueous solution. Hypochlorite
is used widely in cleaning agents, and in bleaching, drinking-water
and swimming-pool disinfecting. Calcium hypochlorite decomposes
in water to release chlorine and sodium hypochlorite solutions
and can release chlorine gas if mixed with other cleaning
agents.
What immediate health effects can be caused by exposure to hypochlorite?
Hypochlorite powder, solutions, and vapor
are irritating and corrosive. Swallowing hypochlorite or contact
with the skin or eyes produces injury to any exposed tissues.
Exposure to gases released from hypochlorite may cause burning
of the eyes, nose, and throat; cough; and damage to the airway
and lungs. Generally, the more serious the exposure, the more
severe the symptoms.
Can hypochlorite poisoning be treated?
There is no antidote for hypochlorite,
but its effects can be treated and most exposed persons get
well. Persons who have experienced serious symptoms may need
to be hospitalized.
Are any future health effects likely to occur?
A single small exposure from which a
person recovers quickly is not likely to cause delayed or
long-term effects. After a serious exposure, symptoms may
worsen for several hours.
What tests can be done if a person has been exposed to hypochlorite?
Specific tests for the presence of hypochlorite
in blood or urine generally are not useful to the doctor.
If a severe exposure has occurred, blood and urine analyses
and other tests may show whether the lungs, heart, or brain
have been injured. Testing is not needed in every case.
Where can more information about hypochlorite be found?
More information about hypochlorite can
be obtained from your regional poison control center, your
state, county, or local health department; the Agency for
Toxic Substances and Disease Registry (ATSDR); your doctor;
or a clinic in your area that specializes in occupational
and environmental health. If the exposure happened at work,
you may wish to discuss it with your employer, the Occupational
Safety and Health Administration (OSHA), or the National Institute
for Occupational Safety and Health (NIOSH). Ask the person
who gave you this form for help in locating these telephone
numbers.
Follow-up Instructions
Keep this page and take it with you to
your next appointment. Follow only the instructions
checked below.
Print instructions only.pdf icon[47 KB]
[ ] Call your doctor or the Emergency
Department if you develop any unusual signs or symptoms within
the next 24 hours, especially:
- difficulty swallowing, or pain in the abdomen or chest
- coughing or wheezing, difficulty breathing, shortness
of breath, or chest pain
- increased ocular pain or discharge, change in vision
- increased redness or pain or a pus-like discharge in the
area of a skin burn
[ ] No follow-up appointment is necessary
unless you develop any of the symptoms listed above.
[ ] Call for an appointment with Dr.____
in the practice of ________.
When you call for your appointment, please
say that you were treated in the Emergency Department at _________
Hospital by________and were advised to be seen again in ____days.
[ ] Return to the Emergency Department/Clinic
on ____ (date) at _____ AM/PM for a follow-up examination.
[ ] Do not perform vigorous physical
activities for 1 to 2 days.
[ ] You may resume everyday activities
including driving and operating machinery.
[ ] Do not return to work for _____days.
[ ] You may return to work on a limited
basis. See instructions below.
[ ] Avoid exposure to cigarette smoke
for 72 hours; smoke may worsen the condition of your lungs.
[ ] Avoid drinking alcoholic beverages
for at least 24 hours; alcohol may worsen injury to your stomach
or have other effects.
[ ] Avoid taking the following medications:
________________
[ ] You may continue taking the following
medication(s) that your doctor(s) prescribed for you: _______________________________
[ ] Other instructions:
____________________________________
_____________________________________________________
- Provide the Emergency Department with the name and the
number of your primary care physician so that the ED can
send him or her a record of your emergency department visit.
- You or your physician can get more information on the
chemical by contacting: ____________ or _____________, or by
checking out the following Internet Web sites:
___________;__________.
Signature of patient _______________ Date ____________
Signature of physician _____________ Date ____________
Where can I get more information?
If you have questions or concerns, please contact your community or state health or environmental quality department or:
For more information, contact:
Agency for Toxic Substances and Disease Registry
Division of Toxicology and Human Health Sciences
4770 Buford Highway
Chamblee, GA 30341-3717
Phone: 1-800-CDC-INFO 888-232-6348 (TTY)
Email: Contact CDC-INFO
ATSDR can also tell you the location of occupational and environmental health clinics. These clinics specialize in recognizing, evaluating, and treating illnesses resulting from exposure to hazardous substances.