[Bleaching agent poisoning with sodium chlorite. The toxicology and clinical course]

A woman gardener of 49 years of age suffered an inhalational intoxication from chlorine dioxide while bleaching dried flowers. Preparation of the bleaching solutions was associated with a sharp pungent smell, coughing, pharyngeal irritation and headache. Seven hours later increasing cough and dyspnoea led to hospitalisation. Clinical findings were tachypnoea, tachycardia, and rales of auscultation; clinical chemistry revealed marked leucocytosis. Chest X-ray did not yield any abnormal findings. Initially the vital capacity and forced expiratory volume in 1 s markedly reduced and the resistance correspondingly enhanced. Blood gas analysis showed hypoxaemia despite alveolar hyperventilation. Administration of corticosteroids resulted in significant alleviation of complaints and in improved lung function with stabilisation in a highly normal range, as confirmed by follow-up examination two years later. The chlorine dioxide intoxication had been due to pH level reduction resulting from an incorrect proportioning and handling of the individual bleaching agent components when preparing the solution.