A STUDY OF THE RESIDUAL EFFECTS OF PHOSGENE POISONING IN HUMAN SUBJECTS. II. AFTER CHRONIC EXPOSURE

Abstract

Five workers who had repeated exposures to small amts. of phosgene during the course of l1/2-31/2 yrs. were studied with particular emphasis on pulmonary function and cardio-vascular and psychiatric status. The methods employed were the same as in the study of the patients who had experienced a single heavy exposure to phosgene. The measurable disturbances of the lung were more striking after chronic exposure than after recovery from a serious acute exposure. Two patients exhibited well marked physical and roentgenographic evidence of emphysema of the lungs, which was confirmed by an increased proportion of residual air, a definite impairment of intrapulmonary mixing of gases, prolonged pulmonary emptying of N, a limited voluntary breathing capacity, and a discrepancy between the tension of O2 in alveolar air and arterial blood. Anoxemia was not present in these patients. "j!Jie other patients who presented no clinical evidence of disease of the lungs exhibited disturbances in pulmonary function equally as severe as those found in the 2 patients with clinical signs of emphysema. The 5th patient exhibited only a reduction in voluntary breathing capacity. The pattern of breathing in 3 of 4 patients with well developed disturbances in pulmonary function was similar to that observed after acute exposure to phosgene. The patients appeared stable and not unduly disturbed about their symptoms and psychologic factors appeared to be of little consequence in their symptoms. This is in contrast to the patients studied after acute exposure to phosgene.