By Tony and special guest blogger Heather Ipema
A common telephone call to the IPC starts with a person coughing, sniffling, short of breath, and having difficulty finishing sentences. The caller wonders if it is due to poisoning from mixing bathroom cleaners.
Determined to really disinfect the entire germy bathroom, the caller has made the common mistake of mixing household bleach (5% sodium hypochlorite) with an acidic toilet bowl cleaner. They are shocked to learn that the combination of bleach and any acid results in a substance once used as a chemical warfare agent in World War I, and still considered a weapon of mass destruction today. So, what is this nasty greenish-yellow vapor emanating from their commode? It’s chlorine gas, and it’s poisonous.
Depending on the concentration in the air and duration of exposure, chlorine gas causes minor to severe eye and respiratory tract irritation as noted by red, itchy, watery eyes, runny nose, cough, chest burning and tightness, and difficulty breathing. People with asthma or other respiratory problems are more sensitive to chlorine gas toxicity. All exposed patients are advised to move to fresh air. Some patients may require referral to an emergency department if their symptoms are severe. Treatment may consist of giving the patient oxygen and medications to open and relax the airway. Nebulization treatment with sodium bicarbonate helps neutralize the acidic effect of chlorine gas.
Don’t do what one patient did when she called the IPC wanting to know what the emergency room would do for her. She figured she could create her own sodium bicarbonate nebulizer by standing in her warm shower and tossing handfuls of baking soda (sodium bicarbonate) into the air. This won’t work, so don’t try it.
Another similar problem is the combination of bleach with household ammonia or ammonium-containing detergents. This toxic twosome creates another noxious, irritating gas called chloramine. Also, believe it or not, chloramine will be generated when you pour bleach on your pet’s urine. The symptoms of chloramine are very similar to those of chlorine gas, although the treatment differs because sodium bicarbonate is not recommended.
The IPC receives approximately 400 calls each year involving household chlorine and chloramine gas exposures. That’s more than one a day! How could the IPC receive so many calls when the bleach label clearly states: “WARNING …do not use or mix with other household chemicals such as toilet bowl cleaners, rust removers, acid, or ammonia-containing products. To do so will release hazardous gasses…”? When asked, callers will often admit they got over-zealous and threw into a bucket a concoction of bleach, pine cleaner, ammonia, all-purpose cleaner, powdered cleanser, etc, etc. This does not improve cleaning effectiveness; however, it does increase the risk of harmful chemical interactions.
The key take-home lesson here is prevention. Read all cleaning product labels carefully before use and heed any warnings. If there is any doubt about the safe use of cleaning products, call the IPC for guidance.
If you have been exposed to chlorine or chloramine gas, immediately move to fresh air and call the IPC at 1-800-222-1222 for assistance.
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Once I was urinating in a toilet in my office building’s bathroom, and once it started mixing with the water asphyxiating fumes started rising up. I felt like I’d been maced. I’ve often wondered what caused this. Was it just bleach in the toilet? Seems like this would happen more often if so (it never happened again, there or anywhere else).
That sounds very scary. But you’re right usually the mix of household bleach diluted in toilet water and urine wouldn’t cause such a potent release of gases. My guess is whoever cleaned the toilet prior to your use, left a mixture of several chemicals which once mixed with urine contributed to the gas release. There’s really no way to know. But if that should ever happen again, and hopefully it doesn’t, make sure you immediately call the poison center hotline: 1-800-222-1222.
[…] involved in accidental poisoning are those that contain chlorine. Chlorine fumes are a significant respiratory irritant. Always take caution when using these chemicals: open and use them in a very well ventilated […]
Thanks for your comment Dr!
Posts like this brighten up my day. Thanks for taking the time.