Phosgene is an industrial chemical used in plastics and pesticides. It can also be produced when chemicals that contain chlorine are broken down or burned. Phosgene exposure can occur when someone comes in contact with this gas, liquid, or food that is contaminated with it.
The effect of phosgene exposure will depend on how much phosgene was absorbed, what areas were affected, and how long the exposure lasted. More severe exposures may cause permanent damage to affected tissue or even death.
People can be exposed by:
You are at risk of exposure if you are near sources that generate it. Occupational or environmental situations with a risk of phosgene exposure include:
The most common exposure is by inhaling the gas. At first, phosgene gas exposure may only produce minor eye or throat irritation. However, symptoms tend to develop, worsen, and reappear over a period of 48 hours.
Respiratory symptoms may include:
Skin symptoms may include:
Eye symptoms include watering or bleeding.
General symptoms may include headache, nausea, and vomiting.
Exposure to phosgene, regardless of the time involved, requires medical attention because some serious symptoms are delayed. If left untreated, complications, including permanent tissue damage or death, can occur.
You will be asked about your symptoms and medical history. The doctor will ask how you were exposed and for how long. A physical exam will be done. Tests may be done depending on the type of exposure you had. This may include a thorough skin or eye exam.
Imaging tests can help evaluate the lungs and surrounding structures for damage. Tests may include:
There is no antidote for phosgene exposure. People exposed to phosgene, then taken away from the source, may begin to feel better. Monitoring for 48 hours for the development or recurrence of symptoms will be needed. Supportive care, such as oxygen or intubation, may be needed until affected tissue can heal.
The faster you respond to exposure, the better the outcomes. Call for emergency medical services and inform them about the phosgene exposure. Steps to take before help arrives:
Enforced rest for the first 48 hours after exposure lowers the risk of rapid progression of lung complications.
Centers for Disease Control and Prevention
Occupational Health and Safety Association
Canadian Centre for Occupational Health and Safety
Acute management overview—phosgene exposure. NIH Chemical Hazards Emergency Medical Management website. Available at: https://chemm.nlm.nih.gov/phosgene_hospital_mmg.htm. Updated January 14, 2015. Accessed June 10, 2016.
Facts about phosgene. Centers for Disease Control and Prevention website. Available at: http://emergency.cdc.gov/agent/phosgene/basics/facts.asp. Updated April 12, 2013. Accessed June 10, 2016.
Phosgene general information. UK Health Protection Agency website. www.gov.uk/ https://government/uploads/system/uploads/attachment_data/file/341399/hpa_phosgene_general_info_v1.pdf. Accessed June 10, 2016.
Toxic inhalation injury. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T906193/Toxic-inhalational-injury. Updated March 5, 2015. Accessed June 10, 2016.
Last reviewed September 2016 by James Cornell, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.