Severe Lung Injury after Exposure to Chloramine Gas from Household Cleaners

To the Editor: The inhalation of the noxious fumes associated with the mixing of household cleaners can lead to pulmonary irritation and pneumonitis. Household ammonia (3 to 10 percent aqueous NH 3 ) and bleach (5 percent NaOCl) are two of the most common cleaning agents. Combining them releases chloramine gas, which is a combination of monochloramines (NH 2 Cl) and dichloramines (NHCl 2 ). When inhaled, chloramines react with the moisture of the respiratory tract to release ammonia (NH 3 ), hydrochloric acid (HCl), and oxygen free radicals. Typically, exposures to low concentrations of chloramines produce only mild respiratory . . .