Industrial Chemicals and Acute Lung injury with a Focus on Exposure Scenarios

In industrialized countries, inhalational exposure to various industrial chemicals is commonplace, with acute lung injury from industrial chemicals increasing in parallel to industrialization. Most acute toxic inhalation, both in industrial and home settings, is due directly to leaks or spills or indirectly to reaction products such as nitrogen dioxide and phosgene. Acute pulmonary parenchymal injuries range from mild pneumonitis to acute respiratory distress syndrome (ARDS). The main factors that determine the severity of injury after inhalation of irritant gases are their water solubility and exposure levels. Water soluble irritants (e.g., ammonia and sulfur dioxide) generally result in upper airway injury, whereas water-insoluble irritants such as phosgene and nitrogen dioxide may cause damage to lower airways and alveoli. Cadmium and mercury can also cause acute lung injury. This review describes the industrial chemicals primarily responsible for acute lung injuries, and their clinical manifestations and exposure scenarios.