Pulmonary injury following exposure to chlorine gas. Possible beneficial effects of steroid treatment.

Two sisters were exposed to chlorine gas in toxic quantities in the same room of their home during an industrial accident. One was hospitalized and treated with corticosteroids and oxygen therapy, while the other received evaluation in the emergency room, and brief oxygen therapy and was released without corticosteroid therapy. Pulmonary physiologic studies have been performed on both patients at intervals following the exposure. The treated patient was stable, with normal results on studies of pulmonary function at the end of two years, while the sibling not treated with corticosteroids had demonstrable abnormalities of gas exchange which persisted during 55 months of observation. This "natural experiment" gives evidence of prolonged detrimental effects of sublethal exposure to chlorine gas on human pulmonary function in some patients. The effect of the differences in treatment between the two siblings cannot be definitely assessed in this single situation.