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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.

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Lungs
Respiratory system

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Causes

Many chemicals used in the home and workplace can cause pneumonitis.

Some common dangerous inhaled substances include:

There are two types of pneumonitis:

Chronic aspiration of acid from the stomach and exposure to chemical warfare can also lead to chemical pneumonitis.

Symptoms

Acute symptoms may include:

Chronic symptoms may include:

Exams and Tests

The following tests help determine how severely the lungs are affected:

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, although this does not always completely prevent aspiration into the lungs.

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

Contact 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 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.

Related Information

Breathing difficulty
Acute
Chronic
Swelling
Blue discoloration of the skin
Respiratory

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. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 88.

Gibbs AR, Attanoos RL. Environmental- and toxin-induced lung diseases. In: Zander DS, Farver CF, eds. Pulmonary Pathology. 2nd ed. Philadelphia, PA: Elsevier; 2018:chap 18.

Tarlo SM. Occupational lung disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 87.

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Review Date: 8/3/2020  

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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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